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Which of the following actions should the nurse take when assisting a totally blind patient to walk to the bathroom?
- A. Take the patient by the arm and lead the patient slowly to the bathroom.
- B. Have the patient place a hand on the nurse's shoulder and guide the patient.
- C. Stay beside the patient and describe any obstacles on the path to the bathroom.
- D. Walk slightly ahead of the patient and allow the patient to hold the nurse's elbow.
Correct Answer: D
Rationale: When using the sighted-guide technique, the nurse walks slightly in front and to the side of the patient and has the patient hold the nurse's elbow. The other techniques are not as safe in assisting a blind patient.
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A patient with hearing loss asks the nurse about the use of a cochlear implant. Which of the following information will the nurse include when replying to the patient?
- A. Cochlear implants require training in order to receive the full benefit.
- B. Cochlear implants are not useful for patients with congenital deafness.
- C. Cochlear implants are most helpful as an early intervention for presbycusis.
- D. Cochlear implants improve hearing in patients with conductive hearing loss.
Correct Answer: A
Rationale: Extensive rehabilitation is required after cochlear implants in order for patients to receive the maximum benefit. Hearing aids, rather than cochlear implants, are used initially for presbycusis. Cochlear implants are used for sensorineural hearing loss and would not be helpful for conductive loss. They are appropriate for some patients with congenital deafness.
Which of the following actions should the nurse take when communicating with a patient who has a moderate hearing loss?
- A. Overenunciate words.
- B. Speak normally but more slowly.
- C. Increase the volume when speaking.
- D. Use more facial expressions when talking.
Correct Answer: B
Rationale: Patient understanding of the nurse's speech will be enhanced by speaking at a normal tone, but more slowly. Increasing the volume, overenunciating, and exaggerating facial expressions will not improve the patient's ability to comprehend the nurse.
The nurse is caring for a patient with age-related macular degeneration who has just had photodynamic therapy. Which of the following statements by the patient indicates that the discharge teaching has been effective?
- A. I will need to use bright lights to read for at least the next week.
- B. I will use drops to keep my pupils dilated until my appointment.
- C. I will not use facial lotions near my eyes during the recovery period.
- D. I will keep covered with long-sleeve shirts and pants for the next 5 days.
Correct Answer: D
Rationale: The photosensitizing drug used for photodynamic therapy is activated by exposure to bright light and can cause burns in areas exposed to light for 5 days after the treatment. There are no restrictions on use of facial lotions, medications to keep the pupils dilated are not appropriate, and bright lights would increase the risk for damage caused by the treatment.
Which of the following information should the nurse include when teaching a patient with keratitis caused by herpes simplex type 1?
- A. Application of corticosteroid ophthalmic ointment to the eyes
- B. Application of povidone-iodine gel around the eye
- C. Avoidance of nonsteroidal anti-inflammatory drugs (NSAIDs)
- D. Importance of taking all of the ordered oral acyclovir
Correct Answer: D
Rationale: Oral acyclovir may be ordered for herpes simplex infections. Corticosteroid ointments are usually contraindicated because they prolong the course of the infection. Although povidone-iodine gel may be applied to the skin around the eyes for herpes zoster (varicella) infections, it is not used for herpes simplex infections. NSAIDs can be used to treat the pain associated with keratitis.
The nurse is caring for a patient with an acute attack of Méni?¨re's disease. Which of the following actions carried out by a family member that is visiting the patient should the nurse intervene?
- A. Raises the side rails on the bed
- B. Turns on the patient's television
- C. Turns the patient to the right side
- D. Places an emesis basin at the bedside
Correct Answer: B
Rationale: Watching television may exacerbate the symptoms of an acute attack of Méni?¨re's disease. The other actions are appropriate.