Deck 27: Care of Patients With Disorders of the Eyes and Ears

Question 1

Before enucleation,the patient is taught that,aside from removing the eye,the surgeon will:

A)suture an artificial eye in the socket to preserve normal appearance.
B)suture an implant to eye muscles to which the prosthesis can be attached.
C)place iodoform dressing in the socket to preserve shape for the prosthesis.
D)suture the orbit closed and apply a removable eye patch to wear until a prosthesis is fitted.

Answer 1

suture an implant to eye muscles to which the prosthesis can be attached.

Question 2

A patient is suspected of having macular degeneration.During the assessment the patient is asked to focus on an image.What evidence will support the diagnosis?

A)The patient only sees disconnected pieces of the image.
B)The patient sees a dark spot in center of what is viewed.
C)The patient sees nothing in the peripheral vision.
D)The patient sees wavy lines and bright flashing lights.

Answer 2

The patient sees a dark spot in center of what is viewed.

Question 3

The patient with a corneal transplant asks how long he must wear the eye shield at night.The nurse's best response is that wearing the shield at night will be necessary for _____ month(s).

A)1
B)2
C)3
D)6

Answer 3

1

Question 4

The nurse is caring for a patient following a left corneal transplant.When positioning the patient,the nurse correctly assists the patient into which positions? (Select all that apply.)

A)Flat on back
B)On back with head on small pillow
C)Left side-lying
D)Right side-lying
E)High Fowler's

Question 5

The nurse is observing a patient applying eye ointment.Which action indicates understanding of the correct application of eye ointment?

A)The patient applies the ointment from the inner to outer canthus.
B)The patient applies the ointment in the center of the conjunctival sac.
C)The patient applies the ointment liberally from the outer to inner canthus.
D)The patient applies the ointment directly to the sclera.

Question 6

The patient with glaucoma is prescribed an Ocusert miotic.The medication should be replaced with what frequency?

A)Daily
B)Semiweekly
C)Weekly
D)Biweekly

Question 7

The nurse is preparing to discharge a patient from the ambulatory care clinic who has been treated with irrigation after having gotten a large amount of sand in his eyes following an ATV accident.The patient reports that his eyes hurt and feel irritated.What action by the nurse is most appropriate?

A)Instruct the patient that these feelings are normal after an eye irrigation.
B)Instruct the patient that the prescribed ointment will help to soothe the eye irritation.
C)Repeat the eye irrigation with a solution of 50% sterile water and normal saline.
D)Notify the physician.

Question 8

To help reduce the nausea and vomiting experienced by a patient with Ménière's disease,the nurse would caution the patient to avoid:

A)drinking coffee.
B)moving the head or eyes suddenly.
C)bending over at the waist.
D)facing backward in a moving vehicle.

Question 9

The nurse is discussing the postoperative period with a patient with a corneal transplant.Which statement concerning the improvement of vision indicates understanding?

A)"I will have my full vision restored within 48 to 72 hours."
B)"It will take about 24 hours before I see improvement in my vision."
C)"My vision will show improvement in about 2 weeks."
D)"It may take about a month before my vision shows improvement."

Question 10

The nurse explains that the classic early warning symptom of a detached retina is:

A)tearing and swelling of the eye.
B)flashing colored lights in the eye.
C)bleeding into the anterior chamber.
D)intense brow pain.

Question 11

A patient has developed keratitis.When planning care,the nurse would anticipate that the first intervention to improve the patient's comfort would be the use of:

A)eye shields.
B)artificial tears.
C)cold compresses.
D)warm compresses.

Question 12

The nurse notices that the patient must hold the newspaper at arm's length and squint to read.The most likely diagnosis will be:

A)myopia.
B)hyperopia.
C)presbyopia.
D)astigmatism.

Question 13

The nurse explains that a photorefractive keratectomy (PRK)is a very brief surgery that corrects myopia by:

A)using a laser to remove a thin layer of the cornea.
B)using a laser to reshape the cornea, then replace the outer layer.
C)making tiny cuts in the cornea to flatten it.
D)using a laser to reshape the fundus.

Question 14

The patient is scheduled to have surgery to manage glaucoma.The patient correctly explains that the procedure will:

A)increase outflow of aqueous humor.
B)reduce amount of vitreous humor.
C)widen pupils.
D)reduce pain.

Question 15

The nurse is reviewing the plan of care for a patient following a tympanoplasty.The nurse correctly notes which intervention in the immediate postoperative care?

A)Keeping the patient flat in bed for 2 to 3 hours
B)Encouraging deep breathing and coughing
C)Repositioning the patient quickly to reduce nausea and vomiting
D)Turning the head toward the operated side

Question 16

The nurse in the walk-in clinic assesses a small piece of rock embedded in the right eye of a man who was breaking up rocks with a sledge hammer.The most appropriate action by the nurse would be to:

A)flush the eye with a continuous stream of warm water.
B)instill artificial tears and cover the injured eye with a dressing.
C)irrigate the eye with cool water and apply a pressure dressing.
D)cover both eyes with a dressing and refer to the physician.

Question 17

The patient who had a corneal transplant is taught that inflammatory changes (redness,swelling,and pain)in the corneal graft are best indicators of which complication?

A)Graft rejection
B)Allergy to graft
C)Infection
D)Revascularization

Question 18

The nurse is administering dipivefrin (Propine).What assessment finding may be noted in response to this medication?

A)BP 80/50
B)Pulse 112
C)Respirations 16
D)Temperature 98.8

Question 19

The nurse is caring for a patient who has come to the ambulatory care clinic after experiencing a chemical burn to the eye.Which solution is preferred for use when irrigating the eye?

A)Normal saline
B)Tap water
C)Sterile water
D)50% solution of sterile water and normal saline

Question 20

A patient comes to the ambulatory care clinic with reports of getting hay into the eyes while farming.When providing care to the patient,which actions may be included in the plan of care? (Select all that apply.)

A)Flush the eye with warm water.
B)Gently evert the upper lid to inspect underneath.
C)Sweep the eye with a dampened cotton swab.
D)Pull the upper lid over the lower lid to sweep underneath the upper lid.
E)Ask the patient to rub the eyes with the lids closed to produce more tears.

Question 21

Matching
Place the steps of eye irrigation in appropriate sequence.

Step: 5

A)Ask patient to turn head to affected side.
B)Don gloves.
C)Direct continuous stream of fluid from inner to outer canthus.
D)Instruct patient to lie supine.
E)Hold lids apart with thumb and finger.
F)Have patient close eyes to move debris from upper eyelid to conjunctival sac.

Question 22

The nurse reviews the classic symptoms of a cataract,which are: (Select all that apply.)

A)nystagmus.
B)troubled by glare.
C)increased myopia.
D)color distortion.
E)night blindness.

Question 23

Arrange the steps of the pathophysiological process of open-angle glaucoma in the correct order.

Step: 4

A)Intraocular pressure exceeding 25 mm Hg
B)Optic nerve and retina damaged by ischemia
C)Permanent and irreversible vision impairment
D)Overproduction of aqueous humor
E)Continued high intraocular pressure restricting blood flow to optic nerve and retina

Question 24

Arrange the steps of the pathophysiological process of open-angle glaucoma in the correct order.

Step: 1

A)Intraocular pressure exceeding 25 mm Hg
B)Optic nerve and retina damaged by ischemia
C)Permanent and irreversible vision impairment
D)Overproduction of aqueous humor
E)Continued high intraocular pressure restricting blood flow to optic nerve and retina

Question 25

Arrange the steps of the pathophysiological process of open-angle glaucoma in the correct order.

Step: 3

A)Intraocular pressure exceeding 25 mm Hg
B)Optic nerve and retina damaged by ischemia
C)Permanent and irreversible vision impairment
D)Overproduction of aqueous humor
E)Continued high intraocular pressure restricting blood flow to optic nerve and retina

Question 26

Accommodation is accomplished through the interaction of the ciliary bodies and the _____.

Question 27

Matching
Place the steps of eye irrigation in appropriate sequence.

Step: 1

A)Ask patient to turn head to affected side.
B)Don gloves.
C)Direct continuous stream of fluid from inner to outer canthus.
D)Instruct patient to lie supine.
E)Hold lids apart with thumb and finger.
F)Have patient close eyes to move debris from upper eyelid to conjunctival sac.

Question 28

Matching
Place the steps of eye irrigation in appropriate sequence.

Step: 6

A)Ask patient to turn head to affected side.
B)Don gloves.
C)Direct continuous stream of fluid from inner to outer canthus.
D)Instruct patient to lie supine.
E)Hold lids apart with thumb and finger.
F)Have patient close eyes to move debris from upper eyelid to conjunctival sac.

Question 29

Arrange the steps of the pathophysiological process of open-angle glaucoma in the correct order.

Step: 5

A)Intraocular pressure exceeding 25 mm Hg
B)Optic nerve and retina damaged by ischemia
C)Permanent and irreversible vision impairment
D)Overproduction of aqueous humor
E)Continued high intraocular pressure restricting blood flow to optic nerve and retina

Question 30

Following a scleral buckling procedure,the postoperative nursing care would include: (Select all that apply.)

A)placing the patient in a supine lateral position for 24 to 48 hours.
B)placing pillows under the abdomen to increase gravity pull on gas bubbles in the eye.
C)warning the patient that vision does not return immediately.
D)instructing the patient to wear an eye shield at night and while napping.
E)instructing the patient to change the eye patch every day.

Question 31

The nurse has completed the assessment on a newly admitted patient.Which findings would be associated with the development of cataracts? (Select all that apply.)

A)Two-pack-a-day smoker for the last 10 years
B)Radiation therapy for cancer completed 1 month ago
C)Postmenopausal hormone replacement therapy
D)Asthmatic on long-term corticosteroid protocol

Question 32

Postoperative teaching for a person who has had a cataract removed from the left eye would include: (Select all that apply.)

A)sleeping on the right side.
B)taking a stool softener to avoid straining at stool.
C)bending over from the waist; not stooping.
D)providing instruction for instilling eyedrops.
E)providing instruction on signs of complications.

Question 33

Matching
Place the steps of eye irrigation in appropriate sequence.

Step: 3

A)Ask patient to turn head to affected side.
B)Don gloves.
C)Direct continuous stream of fluid from inner to outer canthus.
D)Instruct patient to lie supine.
E)Hold lids apart with thumb and finger.
F)Have patient close eyes to move debris from upper eyelid to conjunctival sac.

Question 34

Arrange the steps of the pathophysiological process of open-angle glaucoma in the correct order.

Step: 2

A)Intraocular pressure exceeding 25 mm Hg
B)Optic nerve and retina damaged by ischemia
C)Permanent and irreversible vision impairment
D)Overproduction of aqueous humor
E)Continued high intraocular pressure restricting blood flow to optic nerve and retina

Question 35

Matching
Place the steps of eye irrigation in appropriate sequence.

Step: 4

A)Ask patient to turn head to affected side.
B)Don gloves.
C)Direct continuous stream of fluid from inner to outer canthus.
D)Instruct patient to lie supine.
E)Hold lids apart with thumb and finger.
F)Have patient close eyes to move debris from upper eyelid to conjunctival sac.

Question 36

Matching
Place the steps of eye irrigation in appropriate sequence.

Step: 2

A)Ask patient to turn head to affected side.
B)Don gloves.
C)Direct continuous stream of fluid from inner to outer canthus.
D)Instruct patient to lie supine.
E)Hold lids apart with thumb and finger.
F)Have patient close eyes to move debris from upper eyelid to conjunctival sac.