Adult Health WGU D444 Complete with 100% accurate solutions + rationales

The nurse has instructed a patient prescribed antibiotics for conjunctivitis to follow up in 1 week. Which assessment finding at the follow-up visit indicates improvement?

The inner lining of the eye is pink and moist.

Rationale: A pink and moist conjunctiva following antibiotic therapy for conjunctivitis is an expected finding and indicates improvement.

Which description defines ptosis?

Drooping eye

Rationale: Ptosis is drooping of the eye.

Which condition in the patient's health history increases the patient's risk of becoming blind?

Hyperglycemia

Rationale: High blood glucose levels can lead to retinal damage and cause blindness.

Which test would the nurse perform when assessing the patient's color perception?

Ishihara test

Rationale: The Ishihara test determines ability to distinguish colors.

Which visual assessment finding is most concerning when caring for a patient who is 75 years old?

Sudden flashes of light

Rationale: Sudden flashes of light are a clinical manifestation of retinal detachment. This is a medical emergency that the nurse would immediately report to the provider.

Match the visual diagnostic test to its description.

Monitors macular problems - Amsler Grid test

Measures refractive error - Refractometry

Provides information about flow of blood through retinal vessels - Fluorescein angiography

Detects changes in central and peripheral vision - Perimetry testing

Which response from the nurse would be important to include when providing discharge instructions to a patient with a bacterial conjunctivitis who uses contact lenses?

"Discard all opened or used lens care products."

Which action would the nurse take when preparing to admit a visually impaired patient to the hospital after abdominal surgery?

Take note of the furniture placement in the room.

Which information would the nurse ensure the patient understands when educating a patient with a chronic visual sensory perception problem? Select all that apply. One, some, or all responses may be correct.

- Details of the treatment regimen

- Long-term effects of the disease process

- How to recognize emergency care needs

- How food preferences and nutritional habits can affect eyesight

Which action would the nurse take when providing initial care to a patient who got bleach in their eye at work?

Begin eye irrigation immediately.

Which information would the nurse include in discharge teaching for a patient with viral conjunctivitis? Select all that apply. One, some, or all responses may be correct.

- How to perform proper hand hygiene

- Applying ice packs, artificial tears, and dark glasses may provide comfort

- How to instill topical corticosteroids, if prescribed

Rationale:

- Careful hand washing is essential to prevent spread of infection from one eye to the other eye or transmission to others.

- For serious ocular viral conjunctivitis palliative treatment includes ice packs, artificial tears, and dark glasses. Mild cases are typically self-limiting.

- Severe cases of viral conjunctivitis may include treatment with mild topical corticosteroids.

Which eye safety measure would the nurse recommend to the woodshop worker during a routine occupational health visit?

- Wear protective eyewear

Rationale: Wearing appropriate eyewear can prevent many eye injuries that can occur in this work environment such as blunt or penetrating trauma.

Which education would the nurse provide to the patient newly diagnosed with Acanthamoeba keratitis? Select all that apply. One, some, or all responses may be correct.

- Notify the provider if symptoms do not improve or worsen.

- Discard any opened and used contact lens solutions and lens case.

- Avoid homemade contact lens solutions.

Rationales:

-Treatment is difficult and if the therapy fails the patient may need a corneal transplant. It is important to ensure therapy is effective.

-Discard any opened and used contact lens solutions and lens case.

It is important to discard any potentially contaminated contact lens solutions and lens case.

- Homemade contact lens solutions can easily become contaminated with the parasite and should be avoided.

Which action would the nurse take when caring for a patient requiring the instillation of 2 eye drops hourly?

Establish a schedule of giving 1 drop on the hour and 1 drop on the half hour

Rationale: Proper spacing of the eye drop installation ensures maximum absorption.

Which response would the nurse initially give to a patient expressing anxiety over having a corneal transplant?

Why are you worried?

Rationale: Assessment is the first part of the nursing process. It is important for the nurse to find out why the patient is anxious about the procedure to ensure they are addressing the underlying issue.

Which statement from the nurse reflects understanding of the patient’s condition when admitting a patient experiencing exotropia? Select all that apply. One, some, or all responses may be correct.

- The patient will likely complain of double vision.

- This condition can be caused by thyroid disease

- Both eyes cannot focus on an object together

Rationales:

-Double vision is the primary complaint associated with strabismus and exotropia.

- Exotropia is when 1 eye deviates outward and may occur with thyroid disease.

- Exotropia is a symptom exhibited with the condition called strabismus.

Which statement from the 65-year-old patient diagnosed with glaucoma shows an understanding of the education provided by the nurse?

I will need to follow my treatment plan to prevent damage to the optic nerve.

Which preventative recommendation would the nurse make to a patient with a family history of age-related macular degeneration (AMD)? Select all that apply. One, some, or all responses may be correct.

- Reduce or quit smoking cigars

- Keep your blood pressure under control.

Which action would the nurse take when preparing a patient with acute angle-closure glaucoma for surgery when the patient consents for a lens removal procedure?

Contact the surgeon for revision of the consent form.

Which sign of acute angle-closure glaucoma (AACG) would the nurse monitor for when caring for a patient with prolonged pupil dilation related to ophthalmic medication usage?

Nausea, vomiting, and acute eye pain

Which statement would the nurse include when teaching a patient with glaucoma about pilocarpine?

It is important not to do activities requiring visual acuity immediately after administration.

Which statement by the patient would cause the nurse to notify the provider and not administer Timolol eye drops for treatment of glaucoma?

I have chronic obstructive pulmonary disease

Which diagnostic test would the nurse anticipate when caring for a patient reporting peripheral vision loss that developed over time? Select all that apply. One, some, or all responses may be correct.

- Tonometry

- Gonioscopy

Which patient education would the nurse include when creating the teaching plan for a patient recovering from eye surgery? Select all that apply. One, some, or all responses may be correct.

- Signs and symptoms of an infection

- Eye medication installation

- Take prescribed pain medications

Which education would the nurse include when caring for a patient 6 weeks post-enucleation surgery?

How to remove, cleanse, and insert the prosthesis

At which frequency would the nurse advise a 66-year-old patient to have preventative eye examinations?

Every 1 to 2 years

A patient with glaucoma is prescribed timolol after using other medications for increased intraocular pressure. The patient says, "I think there has been a mistake. Isn't that medicine for heart problems?" Which response by the nurse would be appropriate?

"This drug in oral form is prescribed for other health issues."

The nurse would monitor a postoperative ophthalmic surgery patient for which outcome after administering loteprednol?

Reduced postoperative pain and inflammation

A patient is prescribed gatifloxacin drops for an eye infection. Which is the action of this drug?

Inhibits DNA synthesis in susceptible gram-positive and some gram-negative bacteria

A patient comes to the emergency department complaining of eye pain and excessive tearing. The nurse suspects eye trauma and secures fluorescein sodium drops. Which is the rationale for using fluorescein?

Stains the eye for better visualization

A patient admitted to the intensive care unit after neurosurgery has lost the eye-blink reflex. Which drug would the nurse anticipate administering to protect the eye and minimize drying?

Cyclosporine

A patient is prescribed timolol drops for glaucoma. Which information would the nurse include when teaching about the pharmacodynamics of this drug?

It may take a few weeks of taking the drug to get the full effect.

The nurse is teaching a patient about using timolol for glaucoma. Which safety concerns would the nurse emphasize?

- When moving from a light room to a dark room, pause a few minutes to allow vision to adjust.

- Use caution when driving because vision may be blurred with this drug.

- Dizziness may occur with this drug. Move slowly from a sitting to a standing position.

A patient prescribed latanoprost for the treatment of glaucoma calls the nurse to report a headache and intense eye pain. Which action would the nurse take?

Instruct the patient to immediately go to the clinic or emergency department.

After administering ophthalmic drops, which instructions would the nurse give the patient?

Use punctual pressure for 2 to 3 minutes.

A patient is prescribed loteprednol, a corticosteroid, for inflammation after eye surgery. Which information is important to convey to the patient to minimize adverse effects of this drug?

Continue this drug only for the length of time specified by your health care provider.

The nurse is observing a nursing student administer eye ointment. In which situation would the nurse intervene?

The patient is instructed to keep the eye open for 1 minute.

Which response would the nurse expect to find when assessing a patient 4 weeks after starting timolol, 1 drop daily, for glaucoma?

Intraocular pressure is in normal range.

The patient's hands are shaking while trying to administer eye drops. To promote self-care for a patient who is having difficulty instilling eye drops, which action would the nurse take?

Indicate that adaptive eye devices might help with instillation.

Which part of the ear contains the bony labyrinth?

Inner ear

Atrophy of which structure occurs with aging and can result in diminished sound transmission?

The tympanic membrane (TM)

Which type of sound conduction transmits sound directly to the inner ear?

Bone conduction

Which health pattern is affected by hearing loss when the patient describes complications related to family life, work responsibilities, and friendships?

Role-relationship pattern

Which measure can aid in preventing hearing loss?

Wear protective ear coverings in noisy environments.

Which drug would the nurse ask the provider to discontinue if ototoxicity was suspected?

Erythromycin

Which assessment finding is suggestive of hearing loss? Select all that apply. One, some, or all responses may be correct.

- Loud speech

- Leaning forward while listening

- Complains that everyone mumbles

- Difficulty talking on the phone

Which action would the nurse take when performing a physical assessment of the ear?

Observe the amount and type of earwax.

Which diagnostic test measures electrical peaks along the auditory pathway of the inner ear to the brain?

Auditory brainstem response

Which instruction would the nurse provide to the patient using ear drops?

Do not touch the dropper to the ear.

Which measure is useful in preventing malignancies of the external ear?

Use of hats and sunscreen

Which procedure involves an incision in the tympanic membrane (TM) to release increased pressure and exudate from the middle ear?

Myringotomy

Which complication of chronic otitis media can occur with sudden pressure changes in the ear and postoperative infections?

Facial nerve paralysis

Which diagnostic test helps diagnose otosclerosis? Select all that apply. One, some, or all responses may be correct.

- Tympanometry

- Audiometry

- Weber Test

- Rinne Test

- Otoscope examination

Which statement regarding Ménière disease is accurate?

It is a progressive disorder.

Which mechanism is responsible for vertigo in benign paroxysmal positional vertigo?

Ear rocks in the semicircular canal

Which organization sets the standards for hearing loss related to noisy work environments?

Occupational Safety and Health Administration (OSHA)

Which benefit applies to use of a cochlear implant? Select all that apply. One, some, or all responses may be correct.

- Provides sound.

- Improves speech-reading ability.

- Improves sense of security.

- Decreases feelings of isolation.

Which type of presbycusis is caused by atrophy of the auditory nerve?

Sensory

A 2-year-old child is diagnosed with acute otitis media. The nurse would anticipate incorporating which antibiotic into the plan of care?

Amoxicillin oral suspension

A 3-year-old child, who is brought to the clinic with ear pain, nasal congestion, and low-grade fever, is diagnosed with mild otitis media. The parent becomes upset when an antibiotic is not prescribed immediately. Which statements describe the rationale behind withholding antibiotics?

- Acute otitis media usually resolves within 72 hours.

- Immediate prescription of antibiotics is limited to infants and children with severe illness.

- Supportive care for pain and fever is usually sufficient for acute otitis media.

- Side effects and adverse effects can occur with antibiotics.

A child taking amoxicillin has occasional diarrhea. The parent calls the clinic inquiring if the drug should be stopped. Which response would the nurse provide?

Reassure the parent that occasional diarrhea may occur, but the drug should not be stopped because of this response.

After the nurse instills ear drops, the patient complains of stinging. Which action would the nurse take?

Reassure the patient that this is a typical response.

The school nurse is conducting a health class about preventing "swimmer's ear." Which instructions would be included in the class?

- Dry the outer ear completely after swimming or bathing.

- Remove moisture by using a towel-covered finger to wipe the external ear.

- Tilt the head to the side to drain moisture from the ear.

- Use a hair dryer to help keep the ear canal dry.

A parent contacts the clinic regarding a child who is receiving amoxicillin for acute otitis media. The parent states that the child is not eating and has developed white patches in the mouth. Which action would the nurse take?

Ask the parent to bring the child to the clinic because this is probably thrush and needs to be treated.

A child is brought to the clinic with possible otitis externa. Which finding would indicate a contraindication for using antibiotic otic drops?

Child less than 6 months of age

When preparing to administer hydrocortisone ear drops, the nurse finds that the patient has a ruptured tympanic membrane. Which action would the nurse take?

Hold the ear drops and notify the health care provider.

Which type of headache is generally located bilaterally and is described as a band-like pressure at the base of the skull?

Tension-type headache (TTH)

Which diagnostic tool is most helpful in diagnosing headaches?

Health history

Which description is used to describe a cluster headache?

Severe, bone crushing

Which alternative therapy might be considered for the patient with a headache? Select all that apply. One, some, or all responses may be correct.

- Cognitive-behavioral therapy

- Sleep modification therapy

- Relaxation therapy

- Biofeedback

- Acupuncture

- Hypnosis

Which drug would be avoided in the treatment of headaches for patients with a history of ischemic cardiac or peripheral vascular problems?

Sumatriptan (Imitrex)

Which drug might be associated with a medication overuse headache (MOH)? Select all that apply. One, some, or all responses may be correct.

- Acetaminophen

- Aspirin

- Nonsteroidal antiinflammatory drugs (NSAIDs)

- Triptans

- Barbiturates

Which goal is part of the nursing management plan for a patient with headaches? Select all that apply. One, some, or all responses may be correct.

- Patient will have reduced or no pain.

- Patient will understand triggering events.

- Patient will identify positive coping strategies to deal with pain.

- Patient will have an increased quality of life.

Which alternative treatment option may be used to treat cluster headaches?

High-flow 100% O2

Which snack selection would indicate understanding of dietary changes for a patient with chronic headaches?

Grilled chicken with steamed spinach

The tonic phase of a tonic-clonic seizure lasts from__seconds. Enter your answer as a range, using a dash and omitting all spaces.

10-20

Which therapy would be utilized in the management of a seizure disorder? Select all that apply. One, some, or all responses may be correct.

- Medication management

- Surgery

- Counseling

An EEG should be performed within__hours of a seizure to help identify any abnormalities.

24

Which diagnostic tool is most helpful in diagnosing seizure activity?

Comprehensive description of seizures and the patient's health history

Which initial intervention would be performed when caring for a patient who had a seizure? Select all that apply. One, some, or all responses may be correct.

- Ensure patient airway.

- Pad side rails.

- Establish intravenous (IV) access.

Which education would be given to a patient taking antiseizure medication? Select all that apply. One, some, or all responses may be correct.

- Abrupt withdrawal is not recommended.

- Weaning can be done with a prolonged period of seizure-free activity.

- Side effects may include drowsiness, gastrointestinal (GI) distress, or suicidal thoughts.

Which instruction is important to include when educating a patient with epilepsy on safety measures used to prevent seizures? Select all that apply. One, some, or all responses may be correct.

- Wear helmets.

- Avoid excess alcohol use.

- Find ways to handle stress.

- Identify events that can cause seizures.

Which diagnostic study may help distinguish restless legs syndrome (RLS) from other problems that can disturb sleep?

Polysomnography

Which medication would the nurse suspect a patient is taking for seizures when presenting to the clinic with gingival hyperplasia and hirsutism?

Phenytoin

Which class of medications can worsen symptoms of restless legs syndrome (RLS)?

Antihistamines

Multiple sclerosis (MS) affects women __times more than men. Enter your answer as a range, using a dash and omitting all spaces.

2-3

Which vitamin has been shown to reduce the risk of multiple sclerosis (MS)?

Vitamin D

Which clinical manifestation is often the first sign of multiple sclerosis (MS)?

Vision changes, such as blurred or double vision, red-green color distortion, or blindness in 1 eye

Which cells are first activated in the inflammatory process of multiple sclerosis (MS)?

T cells

Which is important to include when educating the patient on drug therapy for multiple sclerosis (MS)? Select all that apply. One, some, or all responses may be correct.

- Avoid pregnancy

- Monitor blood pressure and pulse rate.

- Avoid contact with large crowds and infected persons.

- Follow cancer screening guidelines.

Which therapy might be considered if tremors are unmanageable after other therapies failed in a patient with multiple sclerosis (MS)?

Thalamotomy

Which complication is commonly seen in Parkinson disease (PD)? Select all that apply. One, some, or all responses may be correct.

- Impaired swallowing

- Orthostatic hypotension

- Weakness

- Depression

- Dementia

Which diagnostic tool is used to confirm the diagnosis of Parkinson disease (PD)?

Response to medication

The deep brain stimulation (DBS) procedure is indicated for patients with Parkinson disease for over __years plus dyskinesias and intolerance to drug therapy.

5

Which side effect would the patient be instructed to inform the health care provider (HCP) about when taking carbidopa/levodopa (Sinemet)? Select all that apply. One, some, or all responses may be correct.

- Dyskinesia

- Uncontrolled movements

- Mental changes

- Palpitations

- Problems urinating

Which clinical manifestation is considered the key feature of myasthenia gravis (MG)?

Fluctuating weakness of skeletal muscles

Which muscle group causes the most problems for patients with myasthenia gravis (MG)?

Swallowing and breathing

__% of patients with myasthenia gravis (MG) will show improvement when treated with steroids.

80

Which objective data would be collected when caring for a patient with myasthenia gravis (MG) to assess the severity of the disease? Select all that apply. One, some, or all responses may be correct.

- Respiratory rate and depth

- Oxygen saturation

- Arterial blood gas (ABG) analysis

- Pulmonary function tests

- Cough and gag reflexes

Weakness may be seen within__ hour(s) of ingestion of an anticholinesterase drug during an anticholinergic crisis.

1