Deck 21: Visual and Auditory Problems

Question 1

To determine whether treatment is effective for a patient with primary open-angle glaucoma (POAG),the nurse can evaluate the patient for improvement by

A)questioning the patient about blurred vision.
B)noting any changes in the patient's visual field.
C)asking the patient to rate the pain using a 0 to 10 scale.
D)assessing the patient's depth perception when climbing stairs.

Answer 1

noting any changes in the patient's visual field.

Question 2

A patient with a right retinal detachment had a pneumatic retinopexy procedure. Which information will be included in the discharge teaching plan?

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

Answer 2

The purpose of maintaining the head resting in a prescribed position

Question 3

The nurse evaluates that wearing bifocals improved the patient's myopia and presbyopia by assessing for

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

Answer 3

both near and distant vision.

Question 4

The nurse will instruct a patient who has undergone a left tympanoplasty to

A)remain on bed rest.
B)keep the head elevated.
C)avoid blowing the nose.
D)irrigate the left ear canal.

Question 5

The nurse is completing the admission database for a patient admitted with abdominal pain and notes a history of hypertension and glaucoma. Which prescribed medication should the nurse question?

A)Morphine sulfate 4 mg IV
B)Diazepam (Valium) 5 mg IV
C)Betaxolol (Betoptic) 0.25% eyedrops
D)Scopolamine patch (Transderm Scop) 1.5 mg

Question 6

Which topic will the nurse teach after a patient has had outpatient cataract surgery and lens implantation?

A)Use of oral opioids for pain control
B)Administration of corticosteroid drops
C)Importance of coughing and deep breathing exercises
D)Need for bed rest for the first 1 to 2 days after the surgery

Question 7

A 72-yr-old patient with age-related macular degeneration (AMD)has just had photodynamic therapy. Which statement by the patient indicates that the discharge teaching has been effective?

A)"I will use drops to keep my pupils dilated until my appointment."
B)"I will need to use brighter lights to read for at least the next week."
C)"I will not use facial lotions near my eyes during the recovery period."
D)"I will cover up with long-sleeved shirts and pants for the next 5 days."

Question 8

A patient with glaucoma who has been using timolol (Timoptic)drops for several days tells the nurse that the eye drops cause eye burning and visual blurriness for a short time after administration. The best response to the patient's statement is

A)"Those symptoms may indicate a need for a change in dosage of the eye drops."
B)"The drops are uncomfortable, but it is important to use them to retain your vision."
C)"These are normal side effects of the drug, which should be less noticeable with time."
D)"Notify your health care provider so that different eye drops can be prescribed for you."

Question 9

The nurse is assessing a patient who was recently treated with amoxicillin for acute otitis media of the right ear. Which finding is a priority to report to the health care provider?

A)The patient has a temperature of 100.6° F.
B)The patient complains of "popping" in the ear.
C)Clear fluid is visible through the tympanic membrane.
D)The patient frequently asks the nurse to repeat information.

Question 10

The safest technique for the nurse to use when assisting a blind patient in ambulating to the bathroom is to

A)have the patient place a hand on the nurse's shoulder and guide the patient.
B)lead the patient slowly to the bathroom, holding on to the patient by the arm.
C)stay beside the patient and describe any obstacles on the path to the bathroom.
D)walk slightly ahead of the patient, allowing the patient to hold the nurse's elbow.

Question 11

Which teaching point should the nurse plan to include when caring for a patient whose vision is corrected to 20/200?

A)How to access audio books
B)How to use a white cane safely
C)Where Braille instruction is available
D)Where to obtain hand-held magnifiers

Question 12

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

A)Dim the lights in the patient's room.
B)Encourage increased oral fluid intake.
C)Change the patient's position every 2 hours.
D)Keep the head of the bed elevated 45 degrees.

Question 13

The nurse developing a teaching plan for a patient with herpes simplex keratitis should include which instruction?

A)Wash hands frequently and avoid touching the eyes.
B)Apply antibiotic drops to the eye several times daily.
C)Apply a new occlusive dressing to the affected eye at bedtime.
D)Use corticosteroid ophthalmic ointment to decrease inflammation.

Question 14

A nurse should instruct a patient with recurrent staphylococcal and seborrheic blepharitis to

A)irrigate the eyes with saline solution.
B)schedule an appointment for eye surgery.
C)use a gentle baby shampoo to clean the eyelids.
D)apply cool compresses to the eyes three times daily.

Question 15

A nurse should include which instructions when teaching a patient with repeated hordeolum how to prevent further infection?

A)Apply cold compresses.
B)Discard used eye cosmetics.
C)Wash the scalp and eyebrows with an antiseborrheic shampoo.
D)Be examined for recurrent sexually transmitted infections (STIs).

Question 16

The nurse is developing a plan of care for an adult patient diagnosed with adult inclusion conjunctivitis (AIC)caused by Chlamydia trachomatis. Which action should be included in the plan of care?

A)Applying topical corticosteroids to decrease inflammation
B)Discussing the need for sexually transmitted infection testing
C)Educating about the use of antiviral eyedrops to treat the infection
D)Assisting with applying for community visual rehabilitation services

Question 17

In reviewing a patient's medical record,the nurse notes that the last eye examination revealed an intraocular pressure of 28 mm Hg. The nurse will plan to assess

A)visual acuity.
B)pupil reaction.
C)color perception.
D)peripheral vision.

Question 18

A patient who has bacterial endophthalmitis in the left eye is restless,frequently asking whether the eye is healing and whether removal of the eye will be necessary. Based on the assessment data,which nursing diagnosis is appropriate at this time?

A)Grieving related to current loss of functional vision
B)Ineffective health management related to inability to see
C)Anxiety related to the possibility of permanent vision loss
D)Situational low self-esteem related to loss of visual function

Question 19

To decrease the risk for future hearing loss,which action should the nurse implement with college students at the on-campus health clinic?

A)Perform tympanometry.
B)Schedule otoscopic examinations.
C)Administer influenza immunizations.
D)Discuss exposure to amplified music.

Question 20

A patient diagnosed with external otitis is being discharged from the emergency department with an ear wick in place. Which statement by the patient indicates a need for further teaching?

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

Question 21

Which statement by a patient with bacterial conjunctivitis indicates a need for further teaching?

A)"I will wash my hands often during the day."
B)"I will remove my contact lenses at bedtime."
C)"I will not share towels with my friends or family."
D)"I will monitor my family for eye redness or drainage."

Question 22

Which nursing activity is appropriate for the registered nurse (RN)working in the eye clinic to delegate to experienced unlicensed assistive personnel (UAP)?

A)Instilling antiviral drops for a patient with a corneal ulcer
B)Application of a warm compress to a patient's hordeolum
C)Instruction about hand washing for a patient with herpes keratitis
D)Looking for eye irritation in a patient with possible conjunctivitis

Question 23

Which prescribed medication should the nurse give first to a patient who has just been admitted to a hospital with acute angle-closure glaucoma?

A)Morphine sulfate 4 mg IV
B)Mannitol (Osmitrol) 100 mg IV
C)Betaxolol (Betoptic) 1 drop in each eye
D)Acetazolamide (Diamox) 250 mg orally

Question 24

Which statement by the patient to the home health nurse indicates a need for more teaching about self-administering eardrops?

A)"I will leave the ear wick in place while administering the drops."
B)"I will hold the tip of the dropper above the ear to administer the drops."
C)"I will refrigerate the medication until I am ready to administer the drops."
D)"I should lie down before and for 5 minutes after administering the drops."

Question 25

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

A)Assess cranial nerve functions.
B)Administer the prescribed analgesic.
C)Check the patient's oxygen saturation.
D)Examine the eye for evidence of trauma.

Question 26

Which finding in an emergency department patient who reports being struck in the right eye with a fist is a priority for the nurse to communicate to the health care provider?

A)The patient complains of a right-sided headache.
B)The sclera on the right eye has broken blood vessels.
C)The area around the right eye is bruised and tender to the touch.
D)The patient complains of "a curtain" over part of the visual field.

Question 27

Which action could the registered nurse (RN)who is working in the eye and ear clinic delegate to a licensed practical/vocational nurse (LPN/LVN)?

A)Evaluate a patient's ability to administer eye drops.
B)Check a patient's visual acuity using a Snellen chart.
C)Inspect a patient's external ear for signs of irritation caused by a hearing aid.
D)Teach a patient with otosclerosis about use of sodium fluoride and vitamin D.

Question 28

Unlicensed assistive personnel (UAP)perform all the following actions when caring for a patient with Ménière's disease who is experiencing an acute attack. Which action by UAP indicates that the nurse should intervene?

A)UAP raise the side rails on the bed.
B)UAP turn on the patient's television.
C)UAP place an emesis basin at the bedside.
D)UAP helps the patient turn to the right side.

Question 29

Which information will the nurse include for a patient contemplating a cochlear implant?

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 extensive training in order to reach the full benefit.

Question 30

The nurse learns that a newly admitted patient has functional blindness and that the spouse has cared for the patient for many years. During the initial assessment of the patient,it is most important for the nurse to

A)obtain more information about the cause of the patient's vision loss.
B)obtain information from the spouse about the patient's special needs.
C)make eye contact with the patient and ask about any need for assistance.
D)perform an evaluation of the patient's visual acuity using a Snellen chart.

Question 31

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

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

Question 32

During the preoperative assessment of a patient scheduled for a right cataract extraction and intraocular lens implantation,it is important for the nurse to assess

A)the visual acuity of the patient's left eye.
B)how long the patient has had the cataract.
C)for presence of a white pupil in the right eye.
D)for a history of reactions to general anesthetics.

Question 33

Which information will the nurse include when teaching a patient with herpes simplex type 1 keratitis?

A)Use of natamycin (Natacyn) antifungal eyedrops
B)Application of corticosteroid ophthalmic ointment
C)Avoidance of nonsteroidal antiinflammatory drugs (NSAIDs)
D)Completion of the prescribed series of oral acyclovir (Zovirax)

Question 34

The occupational health nurse is caring for an employee who is complaining of bilateral eye pain after a cleaning solution splashed into the employee's eyes. Which action will the nurse take?

A)Apply cool compresses.
B)Flush the eyes with saline.
C)Apply antiseptic ophthalmic ointment to the eyes.
D)Cover the eyes with dry sterile patches and shields.

Question 35

The nurse at the eye clinic made a follow-up telephone call to a patient who underwent cataract extraction and intraocular lens implantation the previous day. Which information is the priority to communicate to the health care provider?

A)The patient requests a prescription refill for next week.
B)The patient feels uncomfortable wearing an eye patch.
C)The patient complains that the vision has not improved.
D)The patient reports eye pain rated 5 (on a 0 to 10 scale).

Question 36

The charge nurse observes a newly hired nurse performing all the following interventions for a patient who has just undergone right cataract removal and an intraocular lens implant. Which one requires that the charge nurse intervene?

A)The nurse leaves the eye shield in place.
B)The nurse encourages the patient to cough.
C)The nurse elevates the patient's head to 45 degrees.
D)The nurse applies corticosteroid drops to the right eye.

Question 37

Which information about a patient who had a stapedotomy yesterday is most important for the nurse to communicate to the health care provider?

A)Oral temperature is 100.8° F (38.1° C).
B)The patient complains of ear "fullness."
C)Small amount of dried drainage on dressing.
D)The patient reports that hearing has gotten worse.

Question 38

The nurse at the outpatient surgery unit obtains the following information about a patient who is scheduled for cataract extraction and implantation of an intraocular lens. Which information is important to report to the health care provider at this time?

A)The patient has had blurred vision for 3 years.
B)The patient has not eaten anything for 8 hours.
C)The patient takes 2 antihypertensive medications.
D)The patient gets nauseated with general anesthesia.

Question 39

An older patient who is being admitted to the hospital repeatedly asks the nurse to "speak up so that I can hear you." Which action should the nurse take?

A)Increase the speaking volume.
B)Overenunciate while speaking.
C)Speak normally but more slowly.
D)Use more facial expressions when talking.

Question 40

A 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?

A)Keep the volume low on the hearing aids for the first week.
B)Experiment with volume and hearing in a quiet environment.
C)Add the second hearing aid after making adjustments to the first hearing aid.
D)Begin wearing the hearing aids for an hour a day, gradually increasing the use.

Question 41

Which action will the nurse take when performing ear irrigation for a patient with cerumen impaction?

A)Assist the patient to a supine position for the irrigation.
B)Fill the irrigation syringe with body-temperature solution.
C)Use a sterile applicator to clean the ear canal before irrigating.
D)Occlude the ear canal completely with the syringe while irrigating.

Question 42

A patient who received a corneal transplant 2 weeks ago calls the ophthalmology clinic to report that his vision has not improved with the transplant. Which action should the nurse take?

A)Suggest the patient arrange a ride to the clinic immediately.
B)Ask about the presence of "floaters" in the patient's visual field.
C)Remind the patient it may take months to restore vision after transplant.
D)Teach the patient to continue using prescribed pupil-dilating medications.

Question 43

The nurse is working in an urgent care clinic that has standardized treatment protocols for implementation by nursing staff. After reviewing the history,physical assessment,and vital signs for a 60-yr-old patient as shown in the accompanying figure,which action should the nurse take first?

A)Check the patient's blood glucose level.
B)Take the blood pressure on the left arm.
C)Use an irrigating syringe to clean the ear canals.
D)Report a vision change to the health care provider.

Question 44

When teaching a patient about the treatment of acoustic neuroma,the nurse will include information about

A)applying sunscreen.
B)preventing fall injuries.
C)decreasing dietary sodium.
D)chemotherapy side effects.

Question 45

A 75-yr-old patient who lives alone at home tells the nurse,"I am afraid of losing my independence because my eyes don't work as well they used to." Which action should the nurse take first?

A)Discuss the increased risk for falls that is associated with impaired vision.
B)Ask the patient about what type of vision problems are being experienced.
C)Explain that there are many ways to compensate for decreases in visual acuity.
D)Suggest ways of improving the patient's safety, such as using brighter lighting.

Question 46

Which action will the nurse include in the plan of care for a patient with benign paroxysmal positional vertigo (BPPV)?

A)Teach the patient about use of medications to reduce symptoms.
B)Place the patient in a dark, quiet room to avoid stimulating BPPV attacks.
C)Teach the patient that canalith repositioning may be used to reduce dizziness.
D)Speak with a low-pitched voice so that the patient is able to hear instructions.

Question 47

Which patient arriving at the urgent care center will the nurse assess first?

A)Patient with purulent left eye discharge and conjunctival inflammation
B)Patient with acute right eye pain that began while using home power tools
C)Patient who is complaining of intense discomfort after an insect crawled into the right ear
D)Patient who has Ménière's disease and is complaining of nausea, vomiting, and dizziness