Question 1

The camp nurse is caring for a patient who is complaining of bilateral eye pain after a campfire log exploded, sending sparks into the patient's eyes. Which of these actions will the nurse take first?

Accepted Answer

A)  Apply ice packs to the eyes. 
B)  Flush the eyes with sterile saline. 
C)  Cover the eyes with dry sterile patches and protective eye shields. 
D)  Apply antiseptic ophthalmic ointment from the first aid kit to the eyes.

Question 2

A patient with Ménière's disease is admitted with vertigo, nausea, and vomiting. Which nursing intervention will be included in the care plan?

Accepted Answer

A)  Encourage oral fluids to 3000 ml daily. 
B)  Change the patient's position every 2 hours. 
C)  Keep the head of the bed elevated 30 degrees. 
D)  Keep the patient's room darkened.

Question 3

A patient with a head injury after a motor-vehicle accident arrives in the emergency department (ED) complaining of shortness of breath and severe eye pain. Which action will the nurse take first?

Accepted Answer

A)  Check the patient's oxygen saturation. 
B)  Administer the ordered analgesic. 
C)  Elevate the head to 45 degrees. 
D)  Examine the eye for evidence of trauma.

Question 4

A 74-year-old patient has bifocals prescribed to correct myopia and presbyopia. To evaluate the effectiveness of the lenses, the nurse working in the eye clinic will check the patient for

Accepted Answer

A)  cloudiness in the eye lenses. 
B)  intraocular pressure changes. 
C)  strength of the eye muscles. 
D)  both near and distant vision.

Question 5

The nurse notes a nursing assistant (NA) accomplishing all the following actions when caring for a patient with Ménière's disease who is experiencing an acute attack. Which action by the NA indicates that the nurse should intervene immediately?

Accepted Answer

A)  The NA raises the side rails on the bed. 
B)  The NA turns on the patient's television. 
C)  The NA places an emesis basin at the bedside. 
D)  The NA turns the patient to the right side.

Question 6

Which teaching will the nurse implement for a patient who has just been diagnosed with viral conjunctivitis?

Accepted Answer

A)  Demonstrate appropriate handwashing technique. 
B)  Explain the purpose of antiviral eye drops. 
C)  Show how to perform eye irrigation safely. 
D)  Instruct about how to insert soft contact lenses.

Question 7

Timolol (Timoptic) ophthalmic drops are prescribed for a patient with open-angle glaucoma. After using the drops for several days, the patient tells the nurse that the eyedrops cause eye burning and visual blurriness for a time. The best response by the nurse to the patient's complaint is,

Accepted Answer

A)  "These are normal side effects of the drug, which should become less noticeable with time." 
B)  "If you occlude the puncta after you administer the drops, it will help relieve these side effects." 
C)  "These symptoms are caused by glaucoma and may indicate a need for an increased dosage of the eyedrops." 
D)  "The drops are uncomfortable, but it is very important for you to use them as prescribed to retain your vision."

Question 8

The priority nursing diagnosis for a patient with Ménière's disease who is experiencing an acute attack is

Accepted Answer

A)  risk for falls related to dizziness. 
B)  impaired verbal communication related to tinnitus. 
C)  self-care deficit: bathing and hygiene related to vertigo. 
D)  imbalanced nutrition: less than body requirements related to nausea.

Question 9

A patient with an extensive left retinal detachment is scheduled for a scleral buckling with cryopexy and pneumatic retinopexy. Which information will be included in the discharge teaching plan?

Accepted Answer

A)  The need to wear dark or tinted glasses to protect the eyes from ultraviolet light 
B)  The use of bilateral eye patches to reduce movement of the operative eye 
C)  The procedure for sterile dressing changes when the eye dressing is saturated 
D)  The purpose of maintaining the head in a prescribed position for several weeks

Question 10

A patient who had cataract extraction and intraocular lens implantation the previous day calls the eye clinic and gives the nurse all of the following information. Which information will be of most concern to the nurse?

Accepted Answer

A)  The patient has eye pain rated at a 5 (on a 0-10 scale). 
B)  The patient complains that the vision has "not improved very much." 
C)  The patient has poor depth perception when wearing an eye patch. 
D)  The patient has questions about the ordered eyedrops.

Question 11

A new patient with 20/200 vision (with the use of corrective lenses) is being cared for by the nurse in the eye clinic. The nurse will plan to teach the patient about

Accepted Answer

A)  how to access audio books. 
B)  where Braille instruction is available. 
C)  how to use a cane safely. 
D)  where to obtain specialized magnifiers.

Question 12

A patient with otosclerosis has a stapedectomy for treatment of hearing loss. Two days after the surgery, the patient tells the nurse, "I do not hear as well now as I did right after the surgery." Which response by the nurse is most appropriate?

Accepted Answer

A)  "You may have a different kind of hearing loss that is not related to the otosclerosis." 
B)  "The dressing over your incision most likely is decreasing your hearing in that ear." 
C)  "Postoperative accumulation of fluid and blood in your middle ear will temporarily decrease your hearing." 
D)  "I will let the health care provider know about this because you could have a fistula or other complication of the surgery."

Question 13

A patient who is hospitalized with bacterial endophthalmitis resulting from a penetrating eye injury is noticeably restless, frequently asking whether the eye is healing and whether removal of the eye is necessary. Based on the patient's behavior, the nurse identifies a nursing diagnosis of

Accepted Answer

A)  grieving related to current loss of functional vision. 
B)  anxiety related to the possibility of permanent vision loss. 
C)  self-esteem disturbance related to loss of visual function. 
D)  risk for injury and falls related to inability to see environment.

Question 14

A patient with hearing loss asks the nurse about the use of a cochlear implant. Which information will the nurse include when replying to the patient?

Accepted Answer

A)  Cochlear implants are not useful for patients with congenital deafness. 
B)  Cochlear implants are most helpful as an early intervention for presbycusis. 
C)  Cochlear implants improve hearing in patients with conductive hearing loss. 
D)  Cochlear implants require training in order to receive the full benefit.

Question 15

A 78-year-old patient is hospitalized with a fractured femur. During the nursing assessment, the patient repeatedly asks the nurse to "speak up so that I can hear you." The best action by the nurse is to

Accepted Answer

A)  increase the volume of the nurse's voice. 
B)  speak normally but more slowly. 
C)  over enunciate while speaking. 
D)  use more facial expressions when talking.

Question 16

The nurse is caring for a patient with herpes simplex type I keratitis of the left eye who has eyedrops prescribed for use in the affected eye. The nurse explains that to prevent spread of the infection, the patient should

Accepted Answer

A)  apply an occlusive dressing to the affected eye. 
B)  avoid touching the eyes and wash the hands frequently. 
C)  use the prescribed eyedrops in the right eye as well as the left eye as a prophylactic measure. 
D)  apply corticosteroid ophthalmic ointment to the right eye to decrease the risk for inflammation.

Question 17

A patient has bilateral senile cataracts and is scheduled for a right cataract extraction and intraocular lens implantation at an ambulatory surgical center. During the preoperative assessment of the patient, it is most important for the nurse to assess

Accepted Answer

A)  the visual acuity of the patient's left eye. 
B)  for a history of reactions to general anesthetic agents. 
C)  for a white pupil in the patient's right eye. 
D)  pupillary response to preoperative antibiotic eyedrops.

Question 18

The nurse at the outpatient surgery unit obtains all of this information about a patient who is scheduled for cataract extraction and implantation of an intraocular lens. Which information has the most immediate implications for the patient's care?

Accepted Answer

A)  The patient has not eaten anything for 8 hours. 
B)  The patient takes 3 antihypertensive medications. 
C)  The patient has had blurred vision for several years. 
D)  The patient gets nauseated with general anesthesia.

Question 19

The health care provider places an ear wick in the external ear canal and prescribes antibiotic otic drops for a patient with external otitis. After the nurse does patient teaching about the disorder, which patient statement indicates that more instruction is needed?

Accepted Answer

A)  "I may use aspirin or acetaminophen (Tylenol) for pain relief." 
B)  "I should clean my ear canal daily with a cotton-tipped applicator." 
C)  "I may use warm compresses to the outside of my ear for comfort." 
D)  "I should apply the eardrops to the cotton wick in my ear canal."

Question 20

An older adult patient with presbycusis is fitted with binaural hearing aids. Which information will the nurse include when teaching the patient how to use the hearing aids?

Accepted Answer

A)  Experiment with volume and hearing ability in a quiet environment initially. 
B)  Wear the hearing aids for about an hour a day at first, gradually increasing the time of use. 
C)  Keep the volume low on the hearing aids for the first week while adjusting to them. 
D)  Add the second hearing aid after making the initial adjustment to the first hearing aid.

Exam 22: Nursing Management: Visual and Auditory Problems