Brunner & Suddarth Med-Surg 13th Ed. Ch. 63

A client is color blind. The nurse understands that this client has a problem with:

The nurse is reviewing the medical record of a client with glaucoma. Which of the following would alert the nurse to suspect that the client was at increased risk for this disorder?
Prolonged use of corticosteroids

Which client statement would lead the nurse to suspect that the client is experiencing bacterial conjunctivitis?
“My eyelids were stuck together this morning.”

The nurse is giving a visual field examination to a 55-year-old male client. The client asks what this test is for. What would be the nurse’s best answer?
“This test measures peripheral vision and detects gaps in the visual field.”

To avoid the side effects of corticosteroids, which medication classification is used as an alternative to treating inflammatory conditions of the eyes?
Nonsteroidal anti-inflammatory drugs (NSAIDs)

A 13-year-old client is visiting the ophthalmologist after severe eye injuries. The client suffered trauma to her sclera and is being treated for a subsequent infection. During your client education, you indicate where the sclera is attached. Which of the following structures would you NOT include?

The nurse is establishing a visual test using the Snellen chart for a client experiencing visual changes. At which distance should the nurse instruct the client to stand?
A 20-feet distance

The nurse is assisting the eye surgeon in completing an examination of the eye. Which piece of equipment would the nurse provide to the physician to examine the fundus and interior of the eye?

An older adult patient informs the nurse, “I don’t see as well as I used to.” What should the nurse explain to the patient about why vision becomes less efficient with age? (Select all the apply.)
There is a decrease in pupil size.
There is an increase in lens opaqueness.
There is slowing of accommodation.

A major role for nursing in the management of glaucoma is health education. Which of the following is the most important teaching point that the nurse should advise the patient of?
Adhere to the medication regimen.

When the patient tells the nurse that his vision is 20/200, and asks what that means, the nurse informs the patient that a person with 20/200 vision
sees an object from 20 feet away that a person with normal vision sees from 200 feet away.

Which of the following is the term for swelling of the optic disc due to increased IOP?

Which of the following types of conjunctivitis is preceded by symptoms of an upper respiratory infection?

A client has undergone enucleation. What complication of enucleation should be addressed by the nurse?

An elderly client is scheduled for cataract surgery and asks the nurse, “Will I need to wear pop-bottle lenses after surgery?” Which is the most appropriate response from the nurse?
“An implanted lens has replaced the need for corrective glasses.”

A patient’s vision is assessed at 20/200. The patient asks what that means. Which of the following is the most appropriate response by the nurse?
“You see an object from 20 feet away that a person with normal vision sees from 200 feet away.”

A patient presents to the ED complaining of a chemical burn to both eyes. Which of the following is the priority nursing intervention?
Irrigate both eyes.

The nurse is performing an assessment of the visual fields for a patient with glaucoma. When assessing the visual fields in acute glaucoma, what would the nurse expect to find?
Marked blurring of vision

On ocular examination, the health care provider notes severely elevated IOP, corneal edema, and a pupil that is fixed in a semi-dilated position. The nurse knows that these clinical signs are diagnostic of the type of glaucoma known as:
Acute angle-closure.

A patient has been diagnosed with bacterial conjunctivitis that was sexually transmitted. The nurse informs the patient that the isolated organism is which of the following?
Chlamydia trachomatis

Which of the following terms refers to the absence of the natural lens?

The nurse asks a client to follow the movement of a pencil up, down, right, left, and both ways diagonally. The nurse is assessing which of the following?
Extraocular muscle function

Viewed through the pupil, the landmarks of the retina are which of the following? Select all that apply.
Optic disk
Retinal vessels

Which of the following medications needs to be withheld for 5 to 7 days prior to cataract surgery?

Which of the following is an accurate statement regarding refractive surgery?
Refractive surgery is an elective cosmetic surgery performed to reshape the cornea.

The nurse should monitor for which of the following manifestations in a patient who has had LASIK surgery?
Halos and glare

To avoid the side effects of corticosteroids, which of the following medication classifications is used as an alternative to treating inflammatory conditions of the eyes?
Nonsteroidal anti-inflamatory drugs (NSAIDS)

A patient is to have an angiography done using fluorescein as a contrast agent to determine if the patient has macular edema. What laboratory work should the nurse monitor prior to the angiography?
BUN and creatinine

A nurse conducted a history and physical for a newly admitted patient who states, “My arms are too short. I have to hold my book at a distance to read.” The nurse knows that the patient is most likely experiencing:
Loss of accommodative power in the lens.

There are four major types of ophthalmitic procedures to complete a glaucoma examination. If the health care provider wants to inspect the optic nerve, the nurse would prepare the patient for:

Assessment of visual acuity reveals that the client has blurred vision when looking at distant objects but no difficulty seeing near objects. The nurse documents this as which of the following?

Which of the following is the role of the nurse toward a patient who is to undergo eye examinations and tests?
Ensuring that the patient receives eye care to preserve his or her eye function and prevent further visual loss

Which of the following surgical procedures involves taking a piece of silicone plastic or sponge and sewing it onto the sclera at the site of a retinal tear?
Scleral buckle

A 57-year-old corrections officer is being seen at the ophthalmic group where you practice nursing. The client is concerned about his vision changes because recently, he has started to see distance much more clearly than nearby sights. What is the term used to describe his visual condition?

A 7-year-old second grader is being seen by the pediatric ophthalmologist due to a recent skateboarding accident that resulted in trauma to his right cornea and he is now at risk of developing an infection. Of the following nursing interventions, which one would be contraindicated for a client at risk for infection?
To ensure correct application of antibiotic ointment, gently drag tip of tube along lower lid while squeezing ointment on to lid.

A nurse in a primary care office is getting a client ready for an examination with a health care provider. While talking to the client, she notices that her left upper eyelid is drooping. She records on the client’s record that she observed which of the following?

A client with multiple sclerosis is being seen by a neuroophthalmologist for her routine eye exam. The nurse explains to the client that during the examination, she will be asked to fix her gaze on a stationary point while an object is moved from a point on the side, where it can’t be seen, toward the center. The client will indicate when she can see the object. The nurse further explains that the test being performed is called a ________.
perimetry test

The nurse is caring for a client ordered for multiple eye screening. Following which procedure will the nurse instruct the client on a yellow coloring to the skin and urine as being normal?
Retinal Angiography

Which of the following surgical procedures involves flattening the anterior curvature of the cornea by removing a stromal lamella layer?
Laser-assisted stromal in situ keratomileusis (LASIK)

The nurse is explaining metastatic rhabdomyosarcoma to a group of parents with children diagnosed with the disease. The most common site of metastasis in patients diagnosed with rhabdomyosarcoma is which of the following?

A client has just been diagnosed with early glaucoma. During a teaching session, the nurse should:
demonstrate eyedrop instillation.

To avoid the side effects of corticosteroids which medication classification is used as an alternative to treating inflammatory conditions of the eyes?

Which of the following is the main refracting surface of the eye?

Which type of cataract is caused by central opacity of the lens?

A 43-year-old woman tripped on a toy in her home, fell, and hit her head on the corner of a table. Shortly after her accident, she arrives at the ED, unable to see out of her left eye. She tells the nurse caring for her that her symptoms began with seeing spots or moving particles in her field of vision but she didn’t think anything was wrong because she wasn’t having any pain in her eye. Now, she is very upset that her vision will not return. What is the most likely cause of this client’s symptoms?
Retinal detachment

A 63-year-old client has developed diabetic retinopathy and is seeing the physician regularly to prevent further loss of sight. From where do the nerve cells of the retina extend?
Optic nerve

A nurse is performing an eye examination. Which of the following questions would not be included in the examination?
“Are you able to raise both eyebrows?”

During a routine eye examination, a patient complains that she is unable to read road signs at a distance when driving her car. What should the patient be assessed for?

A patient visits a clinic for an eye examination. He describes his visual changes and mentions a specific diagnostic clinical sign of glaucoma. What is that clinical sign?
The presence of halos around lights

A major role for nursing in the management of glaucoma is health education. Which of the following is the most important teaching point that the nurse should advise the patient of?
Adhere to the medication regimen.

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