H. CH 58 Eye and Vision DO

Question 1

A nurse taking shift report learns that an assigned patient is blind. How should the nurse best communicate with this patient?
A) Provide instructions in simple, clear terms.
B) Introduce herself in a firm, loud voice at the doorway of the room.
C) Lightly touch the patients arm and then introduce herself.
D) State her name and role immediately after entering the patients room.

Answer 1

D) State her name and role immediately after entering the patients room.

Question 2

The nurse has taken shift report on her patients and has been told that one patient has an ocular condition that has primarily affected the rods in his eyes. Considering this information, what should the nurse do while caring for the patient?
A) Ensure adequate lighting in the patients room.
B) Provide a dimly lit room to aid vision by limiting contrast.
C) Carefully point out color differences for the patient.
D) Carefully point out fine details for the patient.

Answer 2

A) Ensure adequate lighting in the patients room.

Question 3

A patient who presents for an eye examination is diagnosed as having a visual acuity of 20/40. The patient asks the nurse what these numbers specifically mean. What is a correct response by the nurse?

A) A person whose vision is 20/40 can see an object from 40 feet away that a person with 20/20 vision can see from 20 feet away.
B) A person whose vision is 20/40 can see an object from 20 feet away that a person with 20/20 vision can see from 40 feet away.
C) A person whose vision is 20/40 can see an object from 40 inches away that a person with 20/20 vision can see from 20 inches away.
D) A person whose vision is 20/40 can see an object from 20 inches away that a person with 20/20 vision can see from 40 inches away.

Answer 3

B) A person whose vision is 20/40 can see an object from 20 feet away that a person with 20/20 vision can see from 40 feet away.

Question 3

A patient who presents for an eye examination is diagnosed as having a visual acuity of 20/40. The patient asks the nurse what these numbers specifically mean. What is a correct response by the nurse?

A) A person whose vision is 20/40 can see an object from 40 feet away that a person with 20/20 vision can see from 20 feet away.
B) A person whose vision is 20/40 can see an object from 20 feet away that a person with 20/20 vision can see from 40 feet away.
C) A person whose vision is 20/40 can see an object from 40 inches away that a person with 20/20 vision can see from 20 inches away.
D) A person whose vision is 20/40 can see an object from 20 inches away that a person with 20/20 vision can see from 40 inches away.

Answer 3

B) A person whose vision is 20/40 can see an object from 20 feet away that a person with 20/20 vision can see from 40 feet away.

Question 4

During discharge teaching the nurse realizes that the patient is not able to read medication bottles accurately and has not been taking her medications consistently at home. How should the nurse intervene most appropriately in this situation?

A) Ask the social worker to investigate alternative housing arrangements.
B) Ask the social worker to investigate community support agencies.
C) Encourage the patient to explore surgical corrections for the vision problem.
D) Arrange for referral to a rehabilitation facility for vision training.

Answer 4

B) Ask the social worker to investigate community support agencies.

Question 5

The nurse is providing health education to a patient newly diagnosed with glaucoma. The nurse teaches the patient that this disease has a familial tendency. The nurse should encourage the patients immediate family members to undergo clinical examinations how often?
A) At least monthly
B) At least once every 2 years
C) At least once every 5 years
D) At least once every 10 years

Answer 5

B) At least once every 2 years

Question 6

A patient is exploring treatment options after being diagnosed with age-related cataracts that affect her vision. What treatment is most likely to be used in this patients care?
A) Antioxidant supplements, vitamin C and E, beta-carotene, and selenium
B) Eyeglasses or magnifying lenses
C) Corticosteroid eye drops
D) Surgical intervention

Answer 6

D) Surgical intervention

Question 7

A patient presents at the ED after receiving a chemical burn to the eye. What would be the nurses initial
A) Generously flush the affected eye with a dilute antibiotic solution.
B) Generously flush the affected eye with normal saline or water.
C) Apply a patch to the affected eye.
D) Apply direct pressure to the affected eye.

Answer 7

B) Generously flush the affected eye with normal saline or water.

Question 8

The nurse is administering eye drops to a patient with glaucoma. After instilling the patients first medication, how long should the nurse wait before instilling the patients second medication into the same eye?
A) 30 seconds
B) 1 minute
C) 3 minutes
D) 5 minutes

Answer 8

D) 5 minutes

Question 9

The nurse is administering eye drops to a patient with glaucoma. After instilling the patients first medication, how long should the nurse wait before instilling the patients second medication into the same eye?
A) 30 seconds
B) 1 minute
C) 3 minutes
D) 5 minutes

Answer 9

D) 5 minutes

Question 10

A patient is being discharged home from the ambulatory surgical center after cataract surgery. In reviewing the discharge instructions with the patient, the nurse instructs the patient to immediately call the office if the patient experiences what?

A) Slight morning discharge from the eye
B) Any appearance of redness of the eye
C) A scratchy feeling in the eye
D) A new floater in vision

Answer 10

D) A new floater in vision

Question 11

A patient is being discharged home from the ambulatory surgical center after cataract surgery. In reviewing the discharge instructions with the patient, the nurse instructs the patient to immediately call the office if the patient experiences what?

A) Slight morning discharge from the eye
B) Any appearance of redness of the eye
C) A scratchy feeling in the eye
D) A new floater in vision

Answer 11

D) A new floater in vision

Question 12

A patient comes to the ophthalmology clinic for an eye examination. The patient tells the nurse that he often sees floaters in his vision. How should the nurse best interpret this subjective assessment finding?

This is a normal aging process of the eye.
Glasses will minimize this phenomenon.
The patient may be exhibiting signs of glaucoma.
This may be a result of weakened ciliary muscles

Answer 12

This is a normal aging process of the eye.

Question 13

A patients ocular tumor has necessitated enucleation and the patient will be fitted with a prosthesis. The nurse should address what nursing diagnosis when planning the patients discharge education?

A) Disturbed body image
B) Chronic pain
C) Ineffective protection
D) Unilateral neglect

Answer 13

A) Disturbed body image

Question 14

The nurses assessment of a patient with significant visual losses reveals that the patient cannot count fingers. How should the nurse proceed with assessment of the patients visual acuity?
A) Assess the patients vision using a Snellen chart.
B) Determine whether the patient is able to see the nurses hand motion.
C) Perform a detailed examination of the patients external eye structures.
D) Palpate the patients periocular regions.

Answer 14

B) Determine whether the patient is able to see the nurses hand motion.

Question 15

The nurse on the medicalsurgical unit is reviewing discharge instructions with a patient who has a history of glaucoma. The nurse should anticipate the use of what medications?
A) Potassium-sparing diuretics
B) Cholinergics
C) Antibiotics
D) Loop diuretics

Answer 15

B) Cholinergics

Question 16

A nurse is teaching a patient with glaucoma how to administer eye drops to achieve maximum absorption. The nurse should teach the patient to perform what action?
A) Instill the medication in the conjunctival sac.
B) Maintain a supine position for 10 minutes after administration.
C) Keep the eyes closed for 1 to 2 minutes after administration.
D) Apply the medication evenly to the sclera

Answer 16

A) Instill the medication in the conjunctival sac.

Question 17

A patient with chronic open-angle glaucoma is being taught to self-administer pilocarpine. After the patient administers the pilocarpine, the patient states that her vision is blurred. Which nursing action is most appropriate?

a. Holding the next dose and notifying the physician
b. Treating the patient for an allergic reaction
c. Suggesting that the patient put on her glasses
d. Explaining that this is an expected adverse effect

Answer 17

d. Explaining that this is an expected adverse effect

Question 18

The nurse should recognize the greatest risk for the development of blindness in which of the following patients?
A) A 58-year-old Caucasian woman with macular degeneration
B) A 28-year-old Caucasian man with astigmatism
C) A 58-year-old African American woman with hyperopia
D) A 28-year-old African American man with myopia

Answer 18

A) A 58-year-old Caucasian woman with macular degeneration

Question 19

The nurse is admitting a 55-year-old male patient diagnosed with a retinal detachment in his left eye. While assessing this patient, what characteristic symptom would the nurse expect to find?

A) Flashing lights in the visual field
B) Sudden eye pain
C) Loss of color vision
D) Colored halos around lights

Answer 19

A) Flashing lights in the visual field

Question 20

The nurse is teaching a patient to care for her new ocular prosthesis. What should the nurse emphasize during the patients health education?

A) The need to limit exposure to bright light
B) The need to maintain a low Fowlers position when removing the prosthesis
C) The need to perform thorough hand hygiene before handling the prosthesis
D) The need to apply antiviral ointment to the prosthesis daily

Answer 20

C) The need to perform thorough hand hygiene before handling the prosthesis

Question 21

A patient has been diagnosed with glaucoma and the nurse is preparing health education regarding the patients medication regimen. The patient states that she is eager to beat this disease and looks forward to the time that she will no longer require medication. How should the nurse best respond?

A) You have a great attitude. This will likely shorten the amount of time that you need medications.
B) In fact, glaucoma usually requires lifelong treatment with medications.
C) Most people are treated until their intraocular pressure goes below 50 mm Hg.
D) You can likely expect a minimum of 6 months of treatment.

Answer 21

B) In fact, glaucoma usually requires lifelong treatment with medications.

Question 22

A public health nurse is teaching a health promotion workshop that focuses on vision and eye health. What should this nurse cite as the most common causes of blindness and visual impairment among adults over the age of 40? Select all that apply.

Diabetic retinopathy 
Trauma
Macular degeneration 
Cytomegalovirus 
Glaucoma

Answer 22

Diabetic retinopathy
Macular degeneration
Glaucoma

Question 23

The nurse is providing discharge education to an adult patient who will begin a regimen of ocular medications for the treatment of glaucoma. How can the nurse best determine if the patient is able to self-administer these medications safely and effectively?

a. Assess the patient for any previous inability to self-manage medications.
b. Ask the patient to demonstrate the instillation of her medications.
c. Determine whether the patient can accurately describe the appropriate method of administering her
d. Assess the patients functional status.

Answer 23

b. Ask the patient to demonstrate the instillation of her medications.