Nokea
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.
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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.
Which of the following actions is an example of an approach magnification?
- A. Using a telescopic lens
- B. Sitting closer to a television while watching it
- C. Using a black-tipped felt marker when writing
- D. Reading books with large-type print
Correct Answer: B
Rationale: Approach magnification is a simple but sometimes overlooked technique for enhancing the patient's residual vision. The nurse can recommend that the patient sit closer to the television or hold books closer to the eyes, which the patient may be reluctant to do unless encouraged. Using a telescopic lens is an optical device. Using a black-tipped marker to write is a contrast enhancement technique. Reading large-type print books may be helpful but is not an approach magnification action unless the book was brought close to the eyes, which is not indicated in the answer choice.
The nurse is admitting a patient to the outpatient surgery unit who is scheduled for cataract extraction and implantation of an intraocular lens. Which of the following information has the most immediate implications for the patient's care?
- A. The patient has not eaten anything for 8 hours.
- B. The patient takes three antihypertensive medications.
- C. The patient gets nauseated with general anaesthesia.
- D. The patient has had blurred vision for several years.
Correct Answer: B
Rationale: Mydriatic medications used for pupil dilation are sympathetic nervous system stimulants and may increase heart rate and blood pressure. Using punctal occlusion when administering the mydriatic to minimize systemic effects and monitoring of blood pressure are indicated for this patient. Patients are expected to be NPO for 6-8 hours before the surgical procedure. Blurred vision is an expected finding with cataracts. Cataract extraction and intraocular lens implantation are done using local anaesthesia.
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 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.