[SPECIAL SENSES] PNLE

This is an eye disorder characterized by lessening the effective powers of accommodation:

a. Myopia

b. Presbyopia

C. Hyperopia

d. Astigmatism

b. Presbyopia

What is the purpose of the procedure myringotomy?

a. Provide pathway for drainage

b. Maintain motion of the ear bones

C. Prevent permanent hearing loss

d. Aid in administering medication

a. Provide pathway for drainage

What eye condition results when ray of light focused in front of the retina?

a. Myopia

C. Hyperopia

b. Presbyopia

d. Astigmatism

a. Myopia

Which diagnostic test may help differentiate open from angle- closure glaucoma?

a. Snellen's chart

b. Gonioscopy

C. Tonometry
d. Roentgen exam

b. Gonioscopy

This is to examine the filtration angle of the anterior chamber

Nurse Taylor is preparing to test the visual acuity of Sammy, a 15 year old withmyopia, using a Snellen chart. Which of the following identifies the accurate procedure for this visual acuity test?

A. Both eyes are assessed together, followed by the assessment of the right and then the left eye.

B. The right eye is tested followed by the left eye, and then both eyes are tested.

C. The client is asked to stand at a distance of 40ft. from the chart and is asked to read the largest line on the chart.

D. The client is asked to stand at a distance of 40ft from the chart and to read the line than can be read 200 ft away by an individual with unimpaired vision.

B. The right eye is tested followed by the left eye, and then both eyes are tested.

Myrna felt a dull pressure on her right eye. She rushed to the ER and tonometry is performed on the client with a suspected diagnosis of glaucoma. The nurse analyzes the test results as documented in the client's chart and understands that normal intraocular pressure is:

A. 2-7 mmHg

B. 10-21 mmHg

C. 22-30 mmHg

D. 31-35 mmHg

B. 10-21 mmHg

In preparation for cataract surgery of Gina, a 56 year old with cataract of the lefteye, Nurse Fely is to administer prescribed eye drops. The nurse reviews the physicians orders, expecting which type of eye drops to be instilled?

A. An osmotic diuretic

B. A miotic agent

C. A mydriatic medication

D. A thiazide diuretic

C. A mydriatic medication

dilate the eyes to get a better access to internal structures

You are currently doing a neurologic assessment on a 25 year old male client witha maternal history of rubella during pregnancy. During a hearing assessment, the nurse notes that the sound lateralizes to the clients left ear with the Weber test. The nurse analyzes this result as:

A. A normal finding

B. A conductive hearing loss in the right ear

C. A sensorineural or conductive loss

D. The presence of nystagmus

C. A sensorineural or conductive loss

Danny was diagnosed with severe otitis media of the right ear prompting administration of corticosteroid otic drops.Which of the following interventions is essential when instilling Cortisporin suspension, 2 gtt right ear?

A. Verifying the proper client and route

B. Warming the solution to prevent dizziness

C. Holding an emesis basin under the client's ear

D. Positioning the client in the semi-fowlers position

A. Verifying the proper client and route

D. Lie down with the affected ear facing up toward the ceiling.

SITUATION: Lara X is a farmer in Cabanatuan. She was diagnosed with cataract.

Cataract manifestations include all but one:

I. Blurring of vision

II. Absence of red reflex

III. Appearance of milky white in the eye

IV. Decreased sensitivity to light

a. 1, 2 and 3

b. 2 only

c. 4 only

d. None of the above

c. 4 only

IV: Some people with cataracts find that they are more sensitive to light.

I: Blurring of vision is a common symptom of cataracts. It is caused by the clouding of the lens, which blocks light from reaching the retina.

II: Absence of red reflex is a sign of cataracts. The red reflex is a reflection of light from the retina. When the lens is cloudy, it does not reflect light as well, and the red reflex is absent.

III: Appearance of milky white in the eye is a sign of cataracts. The lens is normally clear, but when it becomes cloudy, it can appear milky white.

The following nursing interventions are non-conformance after cataract extraction except:

I. Place the client in supine or towards the un-operated side

II. Advise to avoid bending stooping, bending, or lifting heavy objects

III. Instruct to limit fluid intake to prevent increase in IOP

IV. Instruct to protect eye with pads or eye shield

a. 1 and 4

b. 3 only

c. 1, 2 and 4

d. 2 and 3

c. 1, 2 and 4

I: Placing the client in supine or towards the un-operated side is correct to minimize pressure on the operated eye.

II: Advising the patient to avoid bending, stooping, or lifting heavy objects is crucial to prevent an increase in intraocular pressure (IOP), which could lead to complications from cataract surgery.

III: Instructing the patient to limit fluid intake is unnecessary after cataract surgery. In fact, maintaining adequate hydration is essential to promote healing.

IV: Instructing the patient to protect their eye with pads or an eye shield is vital to prevent infection and complications.

A client underwent cataract removal with an intraocular lens implant. The nurse is giving the client discharge instructions. These instructions should include which of the following?

I. Avoid lifting objects weighing more than 5 lb (2.27 kg)

II. Lie on your abdomen when in bed

III. Keep rooms brightly lit

IV. Avoid straining during bowel movement or bending at the waist

a. 2 and 3

b. 1, 3 and 4

c. 4

d. 1 and 4

d. 1 and 4

I: Avoiding lifting objects weighing more than 5 lb (2.27 kg) is important to prevent straining and putting pressure on the eye, which could lead to complications.

IV: Avoiding straining during bowel movement or bending at the waist is important to prevent an increase in intraocular pressure (IOP), which could lead to complications from cataract surgery.

II: Lying on the abdomen when in bed is not recommended after cataract surgery, as it puts pressure on the operated eye. It is advised to sleep on the back or on the unoperated side.

III: Keeping rooms brightly lit is not necessary after cataract surgery. In fact, it is sometimes recommended to wear sunglasses indoors to protect the eyes from bright light.

Marina D was admitted for severe boring eye pain. A suspicion of glaucoma was made however further diagnostics is needed to identify if this is an open-angle, from close-angle glaucoma. You know that:

a. Open-angle glaucoma occurs less frequently than closed-angle glaucomab.

b. Open-angle glaucoma's symptoms include pain, severe headache, nausea, and vomiting; whereas closed-angle glaucoma has a slow, silent, and generally painless onset

c. The obstruction of aqueous flow in open-angle glaucoma generally occur somewhere in Schlemm's canal. It does not narrow or close the angle of the anterior chamber, as in closed-angle glaucoma

d. Open-angle glaucoma rarely occurs in families; however, there is a heredity predisposition for closed-angle glaucoma.

c. The obstruction of aqueous flow in open-angle glaucoma generally occur somewhere in Schlemm's canal. It does not narrow or close the angle of the anterior chamber, as in closed-angle glaucoma

Open-angle Glaucoma

- less common

- slow, silent, and painless

- obstruction in Schlemm's canal

- rarely inherited

Closed-angle Glaucoma

- more common

- painful, severe headache, N/V

- iris obstruction causing closure of anterior chamber angle

- inherited

Pilocarpine is the drug of choice in the treatment of open-angle glaucoma. The expected outcome following administration would be:

a. Blocked action of cholinesterase at the cholinergic nerve endings, and therefore increased pupil size

b. Constricted pupil and therefore widened outflow channels and increased flow of aqueous fluid

c. Impaired vision from decreased aqueous humor production

d. Constriction of aqueous veins and therefore decreased venous pooling in the eye

b. Constricted pupil and therefore widened outflow channels and increased flow of aqueous fluid

a. Opposite: Pilocarpine inhibits cholinesterase, which increases the amount of acetylcholine available to bind to muscarinic receptors. This leads to constriction of the pupil, not dilation.

c. Impaired vision from decreased aqueous humor production is not a beneficial effect of pilocarpine. In fact, pilocarpine can actually increase aqueous humor production.

d. Constriction of aqueous veins and therefore decreased venous pooling in the eye is not a mechanism of action of pilocarpine. Pilocarpine constricts the pupil, but it does not directly affect the aqueous veins.

You expect that the initial symptom of open-angle glaucoma that brought the client to the ophthalmologist is what?

a. Seeing colored flashes of light

b. Extreme pain in the eye

c. Decreasing vision

d. Redness and tearing of the eye

c. Decreasing vision

The initial symptom of glaucoma is often decreasing vision, especially in the peripheral (side) vision. This is because glaucoma damages the optic nerve from the outside in, so the peripheral vision is affected first.

Redness and tearing of the eye are not typically early symptoms of glaucoma. They are more common symptoms of other eye conditions, such as conjunctivitis (pink eye).

Extreme pain in the eye is also not a common symptom of glaucoma. It is more common in closed-angle glaucoma, a type of glaucoma that occurs when the drainage angle of the eye narrows or closes suddenly.

Acetazolamide are sometimes used in the treatment of glaucoma because they

a. Dilate the pupil

b. Paralyze the power of accommodation

c. Increase the power of accommodation

d. Depress secretion of aqueous humor

d. Depress secretion of aqueous humor

Acetazolamide is a carbonic anhydrase inhibitor, which means it blocks the action of the enzyme carbonic anhydrase. Carbonic anhydrase is involved in the production of bicarbonate ions, which are essential for the production of aqueous humor.

a. Acetazolamide can cause miosis, or constriction of the pupil.

b. Paralyze the power of accommodation is not a common side effect of acetazolamide.

c. Increase the power of accommodation is also not a common side effect of acetazolamide.

Jordan X reported that he sees"floaters" prior to admission. The nurse should explain to the client that these spots were caused by.

a. Blood cells released into the eye by the detachment

b. Spasms of the retinal blood vessels traumatized by the detachment

c. Pieces of retina floating in the eye

d. Contamination of the aqueous humor

c. Pieces of retina floating in the eye

Floaters are small, dark spots or squiggly lines that float across your vision. They are caused by tiny pieces of vitreous gel that float into your field of vision. The vitreous is a clear, gel-like substance that fills the space between the lens of your eye and the retina. As you age, the vitreous gel shrinks and breaks up, forming these tiny pieces of gel.

Which of the following symptoms would not occur in a client with a detached retina?

I. Floaters

II. Photopsia

III. Eye pain

IV. Curtain vision

a. 2 only

b. 1, 2 and 4

c. 1 and 4

d. 3 only

d. 3 only

III. Retinal detachment is typically painless. However, some people with retinal detachment may experience mild discomfort or pressure in their eye.

I. Floaters: When the retina detaches, small pieces of the retina can break off and float in the vitreous humor, the clear gel that fills the space between the lens and the retina. These floaters may appear as dark specks, cobwebs, or other shapes.

II. Photopsia, also known as flashes of light, is a common symptom of retinal detachment. These flashes are caused by pulling on the retina as it detaches.

IV. Curtain vision is a symptom of retinal detachment that occurs when a large portion of the retina detaches. It appears as a dark curtain or shadow that obscures part of the field of vision.

Scleral buckling, a procedure used to treat retinal detachment, involves:

a. Creating a splint to hold the retina together until a scar can form and seal off the tear.

b. Removing the torn segment of the retina and stitching down the remaining segment.

c. Stitching the retina firmly to the optic nerve to give it support.

d. Replacing the torn segment of the retina with a strip of retina from a donor.

a. Creating a splint to hold the retina together until a scar can form and seal off the tear.

b. VITRECTOMY = Removing the torn segment of the retina and stitching down the remaining segment is not a common treatment for retinal detachment. This is typically only used in cases of severe retinal detachment.

c. Stitching the retina firmly to the optic nerve to give it support is not a possible treatment for retinal detachment. The optic nerve is located at the back of the eye.

d. Replacing the torn segment of the retina with a strip of retina from a donor is not a possible treatment for retinal detachment. Retinal transplants are not currently available for the treatment of retinal detachment.

The nurse would expect the client with Meniere's disease to complain of:

I. Discharge from the ear

II. Ear pain

III. Neurosensory deafness

IV. Conductive deafness

V. Vertigo

VI. Tinnitus

VII.Fever

a. 3, 5 and 6

b. 3, 4 and 6

c. 2, 3, 5 and 6

d. 1, 3, 5 and 7

b. 3, 4 and 6

MENIERE'S SYNDROME (ENDOLYMPHATIC HYDROPS) Dilation of the endolymphatic system by either:

- Overproduction of endolymphatic fluid or

- Decreased reabsorption of endolymphatic fluid

Increased pressure in ears (like glaucoma) Can cause damage in vestibulocochlear nerve (CN VIII)

Characterized by a TRIAD:

Vertigo [Vestibulo → Problem in balance → Vertigo]

Tinnitus [Cochlear → problem in hearing → tinnitus]

Sensorial Hearing loss

The correct nursing management of Meniere's disease is:

I. Take diuretic to excrete excess fluids from the body

II. Encourage a decrease sodium intake

III. Use of bonamine during vertigo episodes

IV. Take acetazolamide as prescribed

a. 1, 2 and 4

b. 1, 2 and 3

c. 2 only

d. All are correct

c. 2 only

d??

Which of the following patient statements would require follow-up by the nurse? (Meniere's disease)

a. "I smoke one pack of cigarette per day."

b. "When I have vertigo, I usually lie down."

c. "I have a continuous, low-pitched roar in my left ear."

d. "I continue to feel dizzy after the vertigo goes away."

a. "I smoke one pack of cigarette per day."

Smoking is a risk factor for various health conditions, including Meniere's disease.

Mayang C was diagnosed with Meniere's disease. While the nurse was doing her rounds, she found her leaning over the table in the room and clutching it with both hands. After determining that the patient is having an acute attack, which of the following actions should the nurse take FIRST?

a. Help the patient back to bed and place a pillow on either side of the patient's head

b. Have the patient lie down where he is and check the patient's vital signs and pupil's response to light.

c. Give the patient an emesis basin and massage the neck over the area of the carotid arteries

d. Notify the physician and prepare to administer atropine sulfate subcutaneously.

a. Help the patient back to bed and place a pillow on either side of the patient's head

Which signs and symptoms are associated with an acoustic neuroma?

a. Profuse ear discharge, fever, erythema

b. Otalgia, sense of fullness in the ear, no hearing loss

c. Ataxia and intention tremor

d. Unilateral hearing loss and tinnitus

d. Unilateral hearing loss and tinnitus

Acoustic neuroma, also known as vestibular schwannoma, is a benign tumor that arises from the Schwann cells of the CN VIII, the vestibulocochlear nerve. This nerve is responsible for both hearing and balance. As a result, the most common symptoms of acoustic neuroma are unilateral hearing loss and tinnitus.

a. Symptoms of acute otitis media, an infection of the middle ear.

b. Impacted cerumen, a build-up of earwax in the ear canal.

c. Cerebellar dysfunction, which can be caused by a variety of conditions, including stroke, multiple sclerosis, and tumors.

The following are considered incorrect about myopia:

I. This is otherwise known as farsightedness

II. The bending of light is in front of the retina

III. Corrected by using a concave lens

IV. 20/10 is the result on Snellen's chart

a. 1, 2

b. 1, 4

c. 2, 3

d. 3, 4

b. 1, 4

I. Nearsighted

II. correct

III. correct

IV. 20/10 is considered better than normal vision. A person with myopia would have a Snellen chart result of something like 20/400, which means they can only see at 20 feet what a person with normal vision can see at 400 feet.

A client's vision is tested with a Snellen's Chart. The results of the test are documented as 20/60. The nurse interprets this as:

a. The client can read at a distance of 60 feet what a client with normal vision can read at 20 feet

b. The client is legally blind

c. The client's vision is normal

d. The client can read at a distance of 20 feet what a client with normal vision can read at 60 feet

d. The client can read at a distance of 20 feet what a client with normal vision can read at 60 feet

b. The client is legally blind is not true. Legal blindness is defined as visual acuity of 20/200 or worse in the better eye, with or without correction.

c. 20/20 is normal

d. 20/200 = legally blind. 20/60 vision is considered impaired vision, but it is not considered legally blind.

Which of the following is the best way for the nurse to communicate with the hearing impaired client?

a. Talked directly into the impaired ear

b. Shout into the good ear

c. Speak directly and clearly facing the person

d. Write out all communications

c. Speak directly and clearly facing the person

A 33-year old client was assessed due to hearing loss. In order to determine what type of hearing loss the client is experiencing, Rinne's test was performed. The nurse observes that the client heard the sound louder when the fork was placed at the mastoid than beside the impaired ear. What type of hearing loss is present with the client?

a. Sensorineural hearing loss

b. Neuro-sensory-conductive hearing loss

c. Conductive hearing loss

d. Normal ear

c. Conductive hearing loss

a. Sensorineural hearing loss is caused by damage to the inner ear or the auditory nerve. Result should be same as normal (AC > BC)

b. Neuro-sensory-conductive hearing loss is not a recognized type of hearing loss.

d. Normal ear would have a normal Rinne's test result (AC > BC)

Sandra Z underwent stapedectomy with fenestration. Which findings show a possible complication of the procedure?

a. A bitter metallic state

b. Dryness of the lips and mouth

c. A sensation of pain behind the ear

d. An inability to wrinkle the forehead

d. An inability to wrinkle the forehead

This is a symptom of facial nerve palsy, which can be caused by a variety of conditions, including stroke, Bell's palsy, and tumors.

a. Dysgeusia, is a rare complication of stapedectomy. It is caused by injury to the chorda tympani nerve, which is responsible for taste sensation.

b. Dryness of the lips and mouth is a common symptom of many conditions, including dehydration, certain medications, and Sjögren's syndrome. It is not a known complication of stapedectomy.

c. This pain is typically caused by irritation of the facial nerve, which runs close to the stapes

Cara D was admitted to the ward due to a ruptured tympanic membrane. She complains of persistent pain at 3rd hospital day. How should the nurse interpret this finding?

a. Expected since drainage takes 24-48 hours to occur

b. Expected because of the trauma of the perforation

c. Disease is progressing since pain should decrease immediately with rupture

d. Secondary infection has occurred as a result of the break in the membrane

c. Disease is progressing since pain should decrease immediately with rupture

a. Drainage from a ruptured tympanic membrane can occur immediately, but it can also take up to 24-48 hours to start.

b. Expected because of the trauma of the perforation is true. The trauma of the perforation can cause pain, but this pain should typically subside within a few days.

D. no other signs of infection?

Clients with ear trauma must be assessed for which of the following problems? (Select all that apply.)

I. Facial nerve damage

II. Sensorineural hearing loss

III. Dizziness

IV. Nystagmus

a. I,II only

b. I,II,III

c. II,III

d. All of the above

d. All of the above

I. The facial nerve runs close to the middle ear, and it can be damaged by ear trauma. This can cause paralysis of the facial muscles, resulting in a drooping face on the affected side.

II. Ear trauma can damage the inner ear, which can lead to sensorineural hearing loss. This type of hearing loss is permanent and cannot be corrected with hearing aids.

III. Vertigo is a feeling of dizziness or spinning that is often associated with ear trauma. It is caused by damage to the balance system in the inner ear.

IV. Nystagmus is a rapid, involuntary movement of the eyes. It can be a symptom of ear trauma, and it can also be a sign of other neurological problems.

Nurse Yana administered prochlorperazine to a Myrna, a patient with Meniere's disease. Which data is the most important for the nurse to obtain?

a. the number of attacks per week

b. the length of time between attacks

c. the duration of an attack

d. the perceived severity of an attack

c. the duration of an attack

Attacks that last for longer periods are more likely to cause significant disability and distress. Additionally, the duration of attacks can provide insight into the effectiveness of current treatment interventions.

Vienna is 17 year old child with chronic otitis media. Myringotomy tubes were put in place. Which of the following patient statements indicate proper understanding on the care of myringotomy tubes?

a. "I will make sure to let the tubes will remain in place until removed by the physician"

b. "It is normal to see small amounts of drainage from the tubes will occur, especially in the morning"

c. "I expect to feel periodic discomfort due to the tubes but I will treat it with acetaminophen"

d. "I need to take prophylactic antibiotics while the tubes are in place

a. "I will make sure to let the tubes will remain in place until removed by the physician"

b & c are correct but not about care of myringotomy tubes

d. antibiotics are not always necessary and should be prescribed first

Which is the best indicator that an acute middle ear infection is resolving?

a. Tinnitus disappears

b. Drainage thins

c. Hearing improves

d. Pain dulls

c. Hearing improves

Acute otitis media is an inflammation of the middle ear, the air-filled space behind the eardrum. Symptoms of otitis media can include pain, fever, hearing loss, and drainage from the ear.

a. Tinnitus is a common symptom of otitis media, but it can persist for some time after the infection has resolved.

b. Drainage from the ear may continue to occur even after the infection has resolved. This is because the eardrum may still be healing, and there may be fluid trapped in the middle ear that is slowly draining out.

d. Pain may also persist for some time after the infection has resolved. This is because the inflammation in the middle ear may still be causing some irritation.

Sherry came to the clinic to seek consult for her 4 month old child who has been screaming at night and tossing his head back and forth on the pillow for the last few nights. Which type of examination would the nurse suggest for the infant?

a. Dental examination

b. Ear examination

c. Throat examination

d. Neurological examination

b. Ear examination

Ear examination would be important to rule out an ear infection, which can cause pain and irritability in infants.

Dental examination would not be necessary unless the infant had other symptoms that suggested dental problems, such as irritability, drooling, or difficulty eating.

Throat examination would be important to rule out a sore throat, which can also cause pain and irritability in infants. However, a sore throat would not typically cause screaming and head banging.

Neurological examination can be done after ear examination is ruled out.

Lola Berlina went to the Eye Center due to blurring of vision. She asks the nurse how can they known if a cataract is blurring her vision. Which is an accurate reply?

a. "Cataracts are seen with an ophthalmoscope."

b. "Decreased central vision is diagnostic of cataracts."

c. "Cataracts are visualized using fluorescein dye."

d. "MRIs of the head are used to make the diagnosis."

a. "Cataracts are seen with an ophthalmoscope."

b. Other conditions, such as macular degeneration, can also cause decreased central vision.

c. Fluorescein dye is used to visualize the retina and optic nerve, not the lens.

d. MRIs of the head are not typically used to diagnose cataracts. They may be used to rule out other conditions that can cause vision problems.

An Amsler grid was requested by the physician to be present during an examination of the patient. Which of the following eye diseases is being considered?

a. Glaucoma

b. Macular degeneration

c. Retinal detachment

d. Uveitis

b. Macular degeneration

Amsler grid is used to detect metamorphopsia

a. Glaucoma is a condition that damages the optic nerve, leading to vision loss. It can cause blind spots in the peripheral vision, but it does not typically cause metamorphopsia.

c. Retinal detachment is a condition that occurs when the retina separates from the choroid, the layer of blood vessels behind the retina. This can cause sudden vision loss, but it does not typically cause metamorphopsia.

d. Uveitis is an inflammation of the uvea, the middle layer of the eye. It can cause redness, pain, and blurred vision, but it does not typically cause metamorphopsia.

Which finding indicates a risk for AMD?

a. Decreased visual fields

b. Sluggish pupillary response to light

c. Presence of drusen

d. IOP measurement of 22

c. Presence of drusen.

Drusen are small, yellow deposits that accumulate between the retinal pigment epithelium and the choroid, the layer of blood vessels behind the retina. They are a hallmark of age-related macular degeneration (AMD), and their presence increases the risk of developing the disease.

a. Decreased visual fields can be a symptom of AMD, but it is not a risk factor for the disease. It is caused by damage to the retina, which can be caused by a variety of conditions, including AMD, glaucoma, and diabetic retinopathy.

b. Sluggish pupillary response to light can be a sign of a neurological problem, such as a stroke or brain tumor. It is not a risk factor for AMD.

d. IOP measurement of 22 is considered elevated intraocular pressure (IOP), which is a risk factor for glaucoma, not AMD.

Wilma D tells the nurse that the eye doctor said the pressure in her right eye was 19 and asks if this is normal. Which is the most appropriate answer?

a. "19 is within the normal range of 10-21."

b. "19 is low but not dangerously so."

c. "19 is borderline high and needs monitoring."

d. "19 is high and treatment is needed."

a. "19 is within the normal range of 10-21."

Normal IOP: 10-21 mmHg

Lola Paulina was diagnosed with cataract of the left eye. She asks when is it appropriate to undergo surgical removal. You reply:

a. "When they reach a diameter of 3 mm or more."

b. "When they have turned from light gray to milky white in color."

c. "When they have a distinct capsule around them."

d. "When they interfere with daily activities."

d. "When they interfere with daily activities."

The decision of when to remove a cataract is based on how much it is interfering with the patient's vision and daily activities. In general, cataracts are not removed until they are mature, which means that they have clouded enough to significantly impair vision. However, if a cataract is causing significant vision problems, even if it is not fully mature, it may be recommended for removal.

a. The size of a cataract is not always a good indicator of its severity. A small cataract can still cause significant vision problems, while a large cataract may not cause any problems at all.

b. The color of a cataract can change over time, but it is not always a reliable indicator of its severity. A light gray cataract can still cause significant vision problems, while a milky white cataract may not cause any problems at all.

c. The presence of a capsule is a normal part

Vivian A sought consult at the eye clinic due to reports of floating spots before the eyes, flashes of light, and loss of an area of vision. Which of the following should be the primary consideration?

a. acute glaucoma

b. wet macular degeneration

c. corneal abrasion

d. retinal detachment

d. retinal detachment

Retinal detachment occurs when the retina, the light-sensitive tissue at the back of the eye, peels away from the underlying tissue. This can cause a sudden loss of vision, floating spots, and flashes of light.

a. Acute glaucoma is a sudden increase in intraocular pressure (IOP), the fluid pressure inside the eye. It can cause pain, redness, and blurred vision.

b. Wet macular degeneration is a condition that affects the macula, the part of the retina that is responsible for central vision. It can cause blurred vision, distortion of vision, and blind spots.

c. Corneal abrasion is a scratch or scrape on the cornea, the clear front surface of the eye. It can cause pain, redness, and blurred vision.

Jober A has been diagnosed with an inner ear infection. He complains of frequent tinnitus. What advice is appropriate for the nurse to give to the client?

a. "You can block it with a white noise machine."

b. "A radio set at low volume will help."

c. "Wearing ear plugs is a very effective solution."

d. "Obtaining a hearing aid can help."

a. "You can block it with a white noise machine."

While white noise can help to mask tinnitus, it may not be effective for everyone.

b. Similarly, a radio set at low volume can help to mask tinnitus, but it may not be effective for everyone. Additionally, a radio can be distracting and may not be practical to use in all situations.

c. Ear plugs can be helpful in some cases of tinnitus, but they can also make other sounds muffled. Additionally, ear plugs can be uncomfortable to wear for long periods of time.

d. Not the first resort

Emily just had a cataract surgery and she has been advised to avoid too bright lights. Which measure would the nurse recommend for a client who needs to reduce glare?

a. Use of fluorescent lighting in the home

b. Use of 60-watt bulb in a lamp directly aimed at the reading surface

c. Use of a hand-held magnifier

d. Use of a yellow plastic overlay for reading

d. Use of a yellow plastic overlay for reading

Yellow plastic overlays can help to reduce glare by filtering out blue light, which can be particularly bothersome for people who have recently had cataract surgery.

a. Fluorescent lighting can actually increase glare, as fluorescent lights emit a lot of blue light.

b. 60-watt bulb can also increase glare, as it can create a bright spot in the visual field.

c. Hand-held magnifier can help to improve vision, but it will not reduce glare.

Jerry H underwent laser surgery for retinal tears. Post-operatively, she complained about sensitivity to light. Which is an appropriate response by the nurse?

a. "This sometimes occurs. If it continues over the next 8 hours you will need to be checked."

b. "This is normal. Let me review some things you can do to avoid exposure to direct light."

c. "Apply cool compresses; if you do not have relief in 2 hours, call me back."

d. "You need to come in right away to check for abnormal swelling in your eye."

b. "This is normal. Let me review some things you can do to avoid exposure to direct light."

It is caused by the inflammation that occurs during the healing process. The inflammation can make the eyes more sensitive to light, and this sensitivity can last for a few days to a few weeks.

a. This response is not reassuring to the patient and does not provide any information on how to manage the sensitivity to light.

c. While cool compresses can help to reduce inflammation and discomfort, they are not the only intervention that is needed. The patient should also avoid exposure to direct light.

d. This response is not necessary unless the patient is also experiencing other symptoms, such as pain, redness, or vision changes.

Nurse Gela is taking care of a client with macular degeneration. Which of the following is the most appropriate nursing diagnosis in the plan of care?

a. Self-Care Deficit

b. Imbalanced Nutrition

c. Disturbed Sensory Perception

d. Anxiety

c. Disturbed Sensory Perception

Miranda was diagnosed with a cataract of both eyes. You would expect in her health history which chief clinical manifestation during the early stages of cataract formation?

a. Eye pain

b. Floating spots

c. Blurred vision

d. Diplopia

c. Blurred vision

Cataracts are a clouding of the lens of the eye, which is the clear part of the eye that helps to focus light. As cataracts develop, the lens becomes cloudy, which can cause blurred vision.

Other symptoms of cataracts can include halos around lights, difficulty seeing at night, and fading or yellowing of colors.

Eye pain and diplopia are late-stage cataracts.

Floating spots can be caused by a variety of other conditions such as retinal detachment

Terry G was scheduled for a cataract surgery. In preparation for cataract surgery, you are aware that an eye drops medication will be administered. Which type of eye drops is indicated for the patient?

a. An osmotic diuretic

b. A miotic agent

c. A mydriatic medication

d. A thiazide diuretic

c. A mydriatic medication

for better access to internal eye structures

Mydriatic medications, also known as dilating drops, are used to widen the pupil, the black opening in the center of the iris. This is done in preparation for cataract surgery to allow the surgeon to better visualize the lens of the eye and perform the surgery more safely and effectively.

a. An osmotic diuretic is used to reduce fluid buildup in the body, such as in the case of heart failure or liver disease. It is not typically used in preparation for cataract surgery.

b. A miotic agent is used to constrict the pupil, which is the opposite of what is desired for cataract surgery. It is typically used to treat conditions such as glaucoma.

d. A thiazide diuretic is used to lower blood pressure and reduce fluid buildup in the body. It is not typically used in preparation for cataract surgery.

During the early postoperative period, the client who had a cataract extraction complains of nausea and severe eye pain over the operative site. The initial nursing action is to

a. Call the physician

b. Administer the ordered pain medication and anti emetic

c. Reassure the client that this is normal

d. Turn the client on his or her operative side

a. Call the physician

Nausea and severe eye pain are common side effects of cataract surgery. The initial nursing action is to administer the ordered pain medication and antiemetic as prescribed by the physician. This will help to relieve the patient's pain and nausea and make them more comfortable. Wait for doctor's orders.

Terry G was being discharged from the ambulatory care unit for following cataract removal. The nurse provides instruction regarding home care. Which of the following, if stated by the client, indicates of understanding of the instructions?

a. "I will take aspirin if i have any discomfort."

b. "I will sleep on the side that i was operated on."

c. "I will wear my eye shield at night and my glasses during the day."

d. "I will not lift anything if it weighs more than 10 pounds."

c. "I will wear my eye shield at night and my glasses during the day."

Wearing an eye shield at night will help to prevent accidental injury to the eye, and wearing glasses during the day will help to improve vision.

a. Aspirin is not typically prescribed for pain relief after cataract surgery. It can increase the risk of bleeding, which is a concern after eye surgery.

b. Sleeping on that operated side could increase pressure on the eye and cause discomfort.

d. 5 lbs is the limit

Kelly complained of boring eye pain of the right eye until vision loss in some areas was experienced. She was diagnosed with glaucoma. She asks the nurse if complete vision will return. The most appropriate response is

a. "Although some vision has been lost and cannot be restored, further lost may be prevented by adhering to the treatment plan."

b. "Your vision will return soon as the medication begins to work."

c. "Your vision will never return to normal."

d. "Your vision loss is temporary and will return in about 3 to 4 weeks."

a. "Although some vision has been lost and cannot be restored, further lost may be prevented by adhering to the treatment plan."

The most appropriate answer is a. "Although some vision has been lost and cannot be restored, further lost may be prevented by adhering to the treatment plan.".

This response is truthful and empathetic, acknowledging the patient's loss of vision while also offering hope that further vision loss can be prevented with treatment.

b. This is overly optimistic and may not be realistic. Glaucoma is a chronic condition that can cause permanent vision loss, even with treatment.

c. This is unnecessarily pessimistic and may discourage the patient from following their treatment plan. While it is true that some vision loss from glaucoma cannot be restored, there is still a chance of preserving remaining vision with treatment.

d. This is inaccurate and could give the patient false hope.

The nurse is caring for a hearing-impaired client. Which of the following approaches will facilitate communication?

a. Speak loudly.

b. Speak frequently.

c. Speak at a normal volume.

d. Speak directly into the impaired ear

c. Speak at a normal volume.

Hannah B was diagnosed with Menière's disease. Which diet most likely would be prescribed for the client?

a. Low-fat diet

b. Low-sodium diet

c. Low-cholesterol diet

d. Low-carbohydrate diet

b. Low-sodium diet

A low-sodium diet is typically prescribed for people with Menière's disease to help reduce fluid retention and alleviate symptoms such as vertigo, tinnitus, and hearing loss. The recommended daily sodium intake for people with Menière's disease is typically less than 2,000 milligrams.

Rosanna H was diagnosed with presbycusis by the physician. She asked the home care nurse on what it means. The accurate reply is:

a. Tinnitus that occurs with aging

b. Nystagmus that occurs with aging

c. A conductive hearing loss that occurs with aging

d. A sensorineural hearing loss that occurs with aging

d. A sensorineural hearing loss that occurs with aging

Presbycusis is a sensorineural hearing loss that is caused by damage to the hair cells in the inner ear. This damage is a natural part of the aging process, and it can start as early as the age of 40. Presbycusis is characterized by a gradual loss of hearing in the higher frequencies, which makes it difficult to understand speech, especially in noisy environments.

a. Tinnitus is a ringing or buzzing in the ears that can occur at any age

b. Nystagmus is a rapid, involuntary movement of the eyes that can be caused by a variety of conditions, including neurological disorders and eye trauma.

c. Conductive hearing loss is a type of hearing loss that is caused by a problem with the transmission of sound through the middle ear.

Gerry G is a 9 year old child complaining of pain behind the ear, fever, and chills. There is a suspicion of mastoiditis. Upon otoscopic examination, you would expect:

a. A pink-colored tympanic membrane

b. A pearly colored tympanic membrane

c. A transparent and clear tympanic membrane

d. A red, dull, thick and immobile tympanic membrane

d. A red, dull, thick and immobile tympanic membrane

This is because the inflammation from the middle ear has spread to the mastoid bone, causing the tympanic membrane to become inflamed and thickened.

Mastoiditis is an inflammation of the mastoid bone, which is located behind the ear. It is typically caused by a bacterial infection that spreads from the middle ear.

a. A pink-colored tympanic membrane is a normal finding.

b. A pearly colored tympanic membrane is a sign of a perforated eardrum.

c. A transparent and clear tympanic membrane is a normal finding.

Lou Y was diagnosed with a disorder involving the inner ear. Which of the following is the most common client complaint associated with a disorder involving this part of the ear?

a. Pruritus

b. Tinnitus

c. Hearing loss

d. Burning in the ear

b. Tinnitus

Pruritus is itching of the ear canal, which is more commonly caused by allergies or dry skin.

Hearing loss is a decrease in the ability to hear, and it can be caused by a variety of conditions, including inner ear disorders, aging, and noise exposure. Late sign.

Burning in the ear is pain that is characterized by a burning sensation. It can be caused by a variety of conditions, including ear infections, eczema, and allergies.

Marky D was diagnosed with glaucoma and was prescribed with eye drops. Which of the following instructions would the nurse include in the plan of care?

a. Avoid overuse of the eyes.

b. Decrease the amount of salt in the diet.

c. Eye medications will need to be administered for the client's entire life.

d. Decrease fluid intake to control the intraocular pressure.

c. Eye medications will need to be administered for the client's entire life.

Glaucoma is a chronic eye condition that can damage the optic nerve, which is responsible for sending images from the eye to the brain. If left untreated, glaucoma can lead to permanent vision loss. There is no cure for glaucoma, but it can be controlled with medication, eye drops, or surgery.

a. There is no evidence to suggest that avoiding overuse of the eyes can help to prevent or control glaucoma.

b. While a low-sodium diet may be recommended for some people with high blood pressure, option C is much more important and effective.

d. Decreasing fluid intake could actually make the condition worse.

A patient came to the ER and the physician is currently suspecting retinal detachment. Which of the following is associated with this eye disorder?

a. Total loss of vision

b. Pain in the affected eye

c. A yellow discoloration of the sclera

d. A sense of a curtain falling across the field of vision

d. A sense of a curtain falling across the field of vision

a. Total loss of vision can occur in severe cases of retinal detachment, but it is not a common symptom.

b. Pain in the affected eye is not a common symptom of retinal detachment. In fact, retinal detachment is usually painless.

c. A yellow discoloration of the sclera is usually a sign of jaundice, which is a condition that affects the liver.

Ailla D was about to undergo cryosurgery, to treat retinal detachment. You explain to the client that the goal of the treatment is to

a. Creates a splint

b. Stimulate an inflammatory response

c. Attached the separated layer of the choroid

d. Prevent increased IOP

b. Stimulate an inflammatory response.

Cryosurgery is a procedure that uses cold temperatures to destroy tissue. In the case of retinal detachment, cryosurgery is used to create a scar around the tear in the retina. This scar helps to seal the tear and prevent further detachment.

a. Scleral buckling is not an accurate description of the goal of cryosurgery. Cryosurgery does not create a splint in the traditional sense. Instead, it creates a scar that helps to hold the retina in place.

c. Attached the separated layer of the choroid is not accurate. The choroid is a layer of tissue that lies beneath the retina. Cryosurgery is not used to treat detachment of the choroid.

d. While cryosurgery can sometimes help to reduce intraocular pressure (IOP), this is not its primary purpose.

Which of the ff. is true regarding the Optic nerve?

I. mediates general sensation of the auricle

II. responsible for pupil constriction

III. mediates vision

IV. functions for corneal blink reflex

a. 1, 2, 3, 4

b. 1,2,3

c. 2 only

d. 3 only

d. 3 only

The optic nerve is responsible for transmitting visual information from the retina to the brain.

It does not mediate general sensation of the auricle (trigeminal), mediate pupil constriction (PNS), or function for corneal blink reflex (trigeminal and facial nerve).

During the early postoperative period, a client who has undergone a cataract extraction complains of nausea and severe eye pain over the operative site. What should be the initial nursing action?

a. Call the physician.

b. Reassure the client that this is normal.

c. Turn the client onto his or her operative side.

d. Administer the prescribed pain medication and antiemetic

a. Call the physician.

impending glaucoma

The nurse is developing a teaching plan for a client with glaucoma. Which instruction should the nurse include in the plan of care?

a. Avoid overuse of the eyes.

b. Decrease the amount of salt in the diet.

c. Eye medications will need to be administered for life.

d. Decrease fluid intake to control the intraocular pressure.

c. Eye medications will need to be administered for life.

all are correct but miotic eyedrops are the priority

The nurse is performing an admission assessment on a client with a diagnosis of detached retina. Which sign or symptom is associated with this eye disorder?

a. Total loss of vision

b. Pain in the affected eye

c. A yellow discoloration of the sclera

d. A sense of a curtain falling across the field of vision

d. A sense of a curtain falling across the field of vision

b. retinal detachment is painless

A client is diagnosed with a disorder involving the inner ear. Which is the most common client complaint associated with a disorder involving this part of the ear?

a. Pruritus

b. Tinnitus

c. Hearing loss

d. Burning in the ear

b. Tinnitus

tinnitus first before hearing loss

The nurse is performing an assessment on a client with a suspected diagnosis of cataract. Which clinical manifestation should the nurse expect to note in the early stages of cataract formation?

a. Diplopia

b. Eye pain

c. Floating spots

d. Blurred vision

d. Blurred vision

a. diplopia - late

b. painless

A client with Meniere's disease is experiencing severe vertigo. Which instruction should the nurse give to the client to assist in controlling the vertigo?

a. Increase sodium in the diet.

b. Avoid sudden head movements.

c. Lie still and watch the television.

d. Increase fluid intake to 3000 mL a day.

b. Avoid sudden head movements.

A client's vision is tested with a Snellen chart. The results of the tests are documented as 20/60. What action should the nurse implement based on this finding?

a. Provide the client with materials on legal blindness.

b. Instruct the client that he or she may need glasses when driving.

c. Inform the client of where he or she can purchase a white cane with a red tip.

d. Inform the client that it is best to sit near the back of the room when attending lectures.

b. Instruct the client that he or she may need glasses when driving.

pt is near-sighted

A nurse speaks with a client who recently learned he has beginning cataracts in both eyes. Which statement made by the client should a nurse correct?

a. "It is important that I have surgery done as soon as possible to prevent permanent damage to my vision."

b. "Cataracts are corrected by surgery, with each eye done at different times."

c. "The surgical treatment of a cataract involves the removal of the client's own lens from the eye."

d. "An intraocular lens is placed in the eye at the time of surgery.

a. "It is important that I have surgery done as soon as possible to prevent permanent damage to my vision."

pharma management before surgery

A nurse is discharging a client who underwent outpatient cataract surgery. Which intervention should NOT be included in the discharge instructions to the client and family member?

a. Wear eye shield at night.

b. Cough and deep breathe every 2 hours.

c. Rest in the bed while the head of the elevated at 30 degrees.

d. Avoid getting water in the client's eye when washing client's hair.

b. Cough and deep breathe every 2 hours.

increased pressure

A nurse working in a long-term care facility suspects a client is experiencing detachment of the retina. A nurse should:

a. Patch both eyes and place the client in a prone position.

b. Flush the eye thoroughly with saline solution and apply a pressure bandage.

c. Apply an eye shield to the affected eye and administer the prescribed oral analgesic medication.

d. Notify doctor and have the client transported promptly to a facility for ophthalmologic referral and treatment.

d. Notify doctor and have the client transported promptly to a facility for ophthalmologic referral and treatment.

A client is seen in an emergency department and is diagnosed with closed-angle glaucoma. In a review of the client's medical record, which documented finding should the nurse question?

a. Eye pain

b. Nausea and vomiting

c. Sudden onset of symptoms

d. Normal intraocular pressure

d. Normal intraocular pressure

A nurse, teaching a client with open-angle glaucoma, should instruct the client to:

a. include foods high in omega 3 fatty acids in the diet.

b. restrict oral intake to lessen the need for glaucoma medications.

c. remain under the care of and have regular eye examinations by an eye specialist physician.

d. administer prescribed eye drop medication when feeling pressure within the eyes.

c. remain under the care of and have regular eye examinations by an eye specialist physician.

d. not PRN

A client tells a nurse that he has been diagnosed with macular degeneration, "wet type." Based on the nurse's knowledge of this diagnosis, the nurse, examining this client's eyes using an ophthalmoscope, should expect to observe:

a. clouding of the lens of the eye.

b. atrophy of structures in the macula.

c. growth of abnormal blood vessels in the macula.

d. a thin, grayish-white area on the edge of the cornea.

c. growth of abnormal blood vessels in the macula.

A client diagnosed with macular degeneration is told the condition is progressing to an advanced stage. When completing the client's health assessment, which findings should the nurse expect the client to report?

a. Curtain appearance over part of the visual field

b. Visual distortions in the central vision

c. Loss of peripheral vision

d. Clouding of the lens

b. Visual distortions in the central vision

a. retinal detachment

c. open angle glaucoma

d. cataract

A client with macular degeneration is scheduled for photodynamic therapy with the use of verteporfin. Which of the following items should the client bring before procedure?

a. Moisturizer

b. Reading glass

c. Cotton underwear

d. Wide brimmed hat

d. Wide brimmed hat

photosensitivity

Tonometry is performed on a client with a suspected diagnosis of glaucoma. The nurse looks at the documented test results and notes an intraocular pressure (IOP) value of 23. What would be the nurse's initial action?

a. Apply normal saline drops

b. Note the time of day the test was done

c. Contact the primary health care provider (PHCP)

d. Instruct the client to sleep with the head of the bed flat

b. Note the time of day the test was done

IOP in morning before reporting

d. semi-fowler's

The nurse notes that the primary health care provider has documented a diagnosis of presbycusis on a client's chart. Based on this information what action would the nurse take?

a. Speak loudly but mumble or slur the words

b. Speak loudly and clearly while facing the client

c. Speak at normal tone and pitch, slowly and clearly

d. Speak loudly and directly into the client's affected ear

c. Speak at normal tone and pitch, slowly and clearly

presbycusis = age-related hearing loss

other choices are loudly

The nurse is preparing to test the visual acuity of a client, using a Snellen chart. Which identifies the accurate procedure for this visual acuity test?

a. The right eye is tested, followed by the left eye, and then both eyes are tested

b. Both eyes are assessed together, followed by an assessment of the right eye and then the left eye.

c. The client is asked to stand at a distance of 40 feet (12 meters) from the chart and to read the largest line on the chart.

d. The client is asked to stand at a distance of 40 feet (12 meters) from the chart and to read the line that can be read 200 feet (60 meters) away by an individual with unimpaired vision.

a. The right eye is tested, followed by the left eye, and then both eyes are tested

The client arrives in the emergency department with a penetrating eye injury from wood chips that occurred while cutting wood. The nurse assesses the eyes and notes a piece of wood protruding from the eye. What is the initial nursing action?

a. Apply an eye patch

b. Perform visual acuity tests.

c. Irrigate the eye with sterile saline

d. Remove the piece of wood using a sterile clamp

b. Perform visual acuity tests.

acd causes more damage

wood cannot be diluted by flushing

The nurse is caring for a hearing-impaired client. Which approach will facilitate communication?

a. Speak loudly

b. Speak frequently

c. Speak at a normal volume

d. Speak directly into the impaired ear

c. Speak at a normal volume