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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.
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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.
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.
The nurse is caring for a patient who had a stapedotomy yesterday. Which of the following findings is most important for the nurse to communicate to the health care provider?
- A. The patient complains of 'congestion' in the ear.
- B. The patient's oral temperature is 38°C (100.4°F).
- C. The patient reports mild dizziness when standing.
- D. The patient has slight redness at the surgical site.
Correct Answer: B
Rationale: An oral temperature of 38°C (100.4°F) after a stapedotomy may indicate a postoperative infection, which requires prompt reporting to the healthcare provider. Congestion, mild dizziness, and slight redness are less urgent, as they may be expected postoperative symptoms unless severe or persistent.
The nurse is caring for a patient with a left retinal detachment who had a pneumatic retinopexy procedure. Which of the following information should be included in the discharge teaching plan?
- A. The use of bilateral eye patches to reduce movement of the operative eye
- B. The need to wear dark or tinted glasses
- C. The procedure for sterile dressing changes
- D. The purpose of maintaining the head in a prescribed position for several weeks
Correct Answer: D
Rationale: Following pneumatic retinopexy, maintaining the head in a prescribed position is critical to keep the gas bubble in contact with the retinal tear, promoting reattachment. Bilateral eye patches are not typically used, dark glasses may be recommended for comfort but are not the focus, and sterile dressing changes are not standard for this procedure.
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.