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Which of the following assessment findings in a patient who was struck in the right eye with a baseball is a priority for the nurse to communicate to the health care provider in the emergency department?
- A. The patient complains of a right-sided headache.
- B. The sclerae on the right eye have broken blood vessels.
- C. The area around the right eye is bruised and tender to the touch.
- D. The patient complains of 'a curtain' blocking part of the visual field.
Correct Answer: D
Rationale: The patient's sensation that a curtain is coming across the field of vision suggests retinal detachment and the need for rapid action to prevent blindness. The other findings would be expected with the patient's history of being hit in the eye with a ball.
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Which of the following topics will the nurse include in patient teaching following outpatient cataract surgery and lens implantation?
- A. Use of oral opioids for pain control
- B. Administration of antibiotic eye drops
- C. Importance of coughing and deep-breathing exercises
- D. Need for bed rest for the first 24 hours after the surgery
Correct Answer: B
Rationale: Antibiotic and corticosteroid eye drops are commonly prescribed after cataract surgery, and the patient should be able to administer them using safe technique. Pain is not expected after cataract surgery and opioids will not be needed. Coughing and deep-breathing exercises are not needed since a general anaesthetic agent is not used. There is no bed rest restriction after cataract surgery.
To decrease the risk for future hearing loss, which of the following actions should the nurse working with college students at the on-campus health clinic implement?
- A. Arrange to include otoscopic examinations for all patients.
- B. Administer rubella immunizations to all students at the clinic.
- C. Discuss the importance of limiting exposure to very high amplified music.
- D. Teach patients to regularly irrigate the ear to decrease cerumen impaction.
Correct Answer: C
Rationale: Exposure to high amplified music is a significant risk factor for hearing loss in young adults. Otoscopic exams and cerumen irrigation do not directly prevent hearing loss, and rubella immunization is unrelated to noise-induced hearing damage.
The nurse is caring for a patient with persistent otitis media. Which of the following findings should the nurse expect to assess?
- A. Ear pain
- B. Fever
- C. Hearing loss
- D. Tinnitus
- E. Fluid drainage from the ear
Correct Answer: A,C,E
Rationale: Persistent otitis media is characterized by ear pain, hearing loss, and potential fluid drainage from the ear. Fever may occur but is less consistent, and tinnitus is not a primary symptom unless associated with complications.
A patient who had cataract extraction and intraocular lens implantation the previous day calls the eye clinic and gives the nurse all of this information. Which of the following information is the priority to communicate to the health care provider?
- A. The patient has eye pain rated at a 5 (on a 0-10 scale).
- B. The patient has questions about the ordered eye drops.
- C. The patient has poor depth perception when wearing an eye patch.
- D. The patient complains that the vision has 'not improved very much.'
Correct Answer: A
Rationale: Postoperative cataract surgery patients usually experience little or no pain, so pain at a 5 on a 10-point pain level may indicate complications such as hemorrhage, infection, or increased intraocular pressure. The other information given by the patient indicates a need for patient teaching but does not indicate that complications of the surgery may be occurring.
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.