Nokea
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.
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These medications are prescribed by the health care provider for a patient who has just been admitted to hospital with acute angle-closure glaucoma. Which of the following medications should the nurse give first?
- A. Morphine sulphate 4 mg intravenously
- B. Betaxolol 1 drop in each eye
- C. Acetazolamide 250 mg orally
- D. Mannitol 100 mg intravenously
Correct Answer: D
Rationale: The most immediate concern for the patient is to lower intraocular pressure, which will occur most rapidly with IV administration of a hyperosmolar diuretic such as mannitol. The other medications also are appropriate for a patient with glaucoma but would not be the first medication administered.
Which of the following topics should the nurse plan to include when teaching the patient with herpes simplex keratitis of the left eye about management of the infection?
- A. How to apply an occlusive dressing to the affected eye
- B. Need for frequent handwashing and avoiding touching the eyes
- C. Application of antibiotic drops to the left eye several times daily
- D. Use of corticosteroid ophthalmic ointment to decrease inflammation
Correct Answer: B
Rationale: The best way to avoid the spread of infection from one eye to another is to avoid rubbing or touching the eyes and to use careful handwashing when touching the eyes is unavoidable. Occlusive dressings are not used for herpes keratitis. Herpes simplex is a virus and antibiotic drops will not be prescribed. Topical corticosteroids typically are not ordered because they can contribute to a longer course of infection and more complications.
A patient has been seen at a clinic for repeated hordeolum of the eyes during the last 6 months. Which of the following actions should the nurse recommend to the patient to help prevent further infection?
- A. Apply cold compresses at the first sign of recurrence.
- B. Discard all open or used cosmetics used near the eyes.
- C. Wash the scalp and eyebrows with an anti-seborrheic shampoo.
- D. Seek evaluation for the presence of sexually transmitted infections (STIs).
Correct Answer: B
Rationale: Hordeolum (stye) is commonly caused by Staphylococcus aureus, which may be present in cosmetics that the patient is using. Warm compresses are recommended to treat hordeolum. Anti-seborrheic shampoos are recommended for seborrheic blepharitis. Patients with adult inclusion conjunctivitis, which is caused by Chlamydia trachomatis, should be referred for STD testing.
The nurse is assessing the presence or absence of contact lenses in an unconscious patient. Which of the following directions should the nurse shine a pen light?
- A. Parallel to the eye
- B. At a 90-degree angle to the eye
- C. Obliquely into the eye
- D. Toward the centre of the nasal bridge
Correct Answer: C
Rationale: The nurse must know whether the patient has contact lenses in and assesses the eye by shining a light obliquely on the eyeball to help the nurse visualize a contact lens.
The nurse is assessing a patient in the outpatient eye clinic who has myopia and presbyopia. Which of the following assessments should the nurse implement to evaluate the effectiveness of the prescribed bifocals?
- A. Strength of the eye muscles
- B. Both near and distant vision
- C. Cloudiness in the eye lenses
- D. Intraocular pressure changes
Correct Answer: B
Rationale: The lenses are prescribed to correct the patient's near and distant vision. The nurse also may assess for cloudiness of the lenses, increased intraocular pressure, and eye movement, but these data will not evaluate whether the patient's bifocals are effective.