Deck 24: Nursing Management Visual and Auditory Problems

Question 1

The nurse is assessing a client who has recently been treated with amoxicillin for acute otitis media of the right ear. Which of the following assessment data obtained by the nurse is of most concern?

A)The client has a temperature of 38.1°C (100.6°F).
B)The client complains of "popping" in the ear.
C)The client frequently asks the nurse to repeat information.
D)The client states that the right ear has a feeling of fullness.

Answer 1

The client has a temperature of 38.1°C (100.6°F).

Question 2

A client with glaucoma who has been using timolol drops for several days tells the nurse that the eye drops cause eye burning and visual blurriness for a short time after administration. Which of the following responses by the nurse is most appropriate?

A)"These are normal adverse effects of the drug, which should become less noticeable with time."
B)"If you occlude the puncta after you administer the drops, it will help relieve these adverse effects."
C)"The drops are uncomfortable, but it is very important for you to use them as prescribed to retain your vision."
D)"These symptoms are caused by glaucoma and may indicate a need for an increased dosage of the eye drops."

Answer 2

"The drops are uncomfortable, but it is very important for you to use them as prescribed to retain your vision."

Question 3

Aclient is seen in the ophthalmology clinic and diagnosed with recurrent staphylococcal and seborrheic blepharitis. Which of the following topics should the nurse include in the teaching plan?

A)Saline irrigation of the eyes
B)Surgical removal of the lesion
C)Using baby shampoo to clean the lids
D)The use of cool compresses to the eyes

Answer 3

Using baby shampoo to clean the lids

Question 4

Aclient has been seen at a clinic for repeated hordeolum of the eyes during the last 6 months. Which of the following actions should the nurse recommend to the client to help prevent further infection?

A)Apply cold compresses at the first sign of recurrence.
B)Discard all open or used cosmetics used near the eyes.
C)Wash the scalp and eyebrows with an anti-seborrheic shampoo.
D)Seek evaluation for the presence of sexually transmitted infections (STIs).

Question 5

The nurse is caring for a client with a left retinal detachment who had a pneumatic retinopexy procedure. Which of the following information should be included in the discharge teaching plan?

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

Question 6

Which of the following topics will the nurse include in client teaching following outpatient cataract surgery and lens implantation?

A)Use of oral opioids for pain control
B)Administration of antibiotic eye drops
C)Importance of coughing and deep-breathing exercises
D)Need for bed rest for the first 24 hours after the surgery

Question 7

The nurse is admitting a client to the hospital with severe COPD and a history of glaucoma. Which of the following prescribed medications should the nurse question?

A)Morphine sulphate 4 mg IV
B)Diazepam 5 mg IV
C)Betaxolol 0.25% eye drops
D)Levobunolol 0.5% eye drops

Question 8

The nurse is assessing a client in the outpatient eye clinic who has myopia and presbyopia. Which of the following assessments should the nurse implement to evaluate the effectiveness of the prescribed bifocals?

A)Strength of the eye muscles
B)Both near and distant vision
C)Cloudiness in the eye lenses
D)Intraocular pressure changes

Question 9

The nurse is assessing a client with primary open-angle glaucoma (POAG) to evaluate if the treatment has been effective. Which of the following parameters should the nurse assess to determine if there has been improvement?

A)Eye pain
B)Visual field
C)Blurred vision
D)Depth perception

Question 10

The nurse is reviewing a client's medical record and notes that the last eye examination revealed an intraocular pressure of 28 mm Hg. Which of the following parameters should the nurse assess?

A)Visual acuity
B)Pupil reaction
C)Colour perception
D)Peripheral vision

Question 11

The nurse is caring for a client who has bacterial endophthalmitis in the left eye, is restless, frequently asking whether the eye is healing and whether removal of the eye will be necessary. Based on the assessment data, which of the following nursingdiagnoses is appropriate?

A)Hopelessness related to stressors (current loss of functional vision)
B)Anxiety related to threat to current status (uncertainty of outcome of treatment)
C)Situational low self-esteem related to decrease in control over environment (loss of visual function)
D)Risk for falls as evidenced by impaired vision

Question 12

The nurse is preparing a client with chronic otitis media for a tympanoplasty. Which of the following information should the nurse include in preoperative teaching related to postoperative expectations?

A)Keeping the head elevated
B)The need for prolonged bed rest
C)Avoidance of coughing or blowing the nose
D)Continuous antibiotic irrigation of the ear canal

Question 13

Which of the following actions should the nurse take when assisting a totally blind client to walk to the bathroom?

A)Take the client by the arm and lead the client slowly to the bathroom.
B)Have the client place a hand on the nurse's shoulder and guide the client.
C)Stay beside the client and describe any obstacles on the path to the bathroom.
D)Walk slightly ahead of the client and allow the client to hold the nurse's elbow.

Question 14

A client with external otitis has an ear wick placed and a new prescription for antibiotic otic drops. After the nurse provides client teaching, which of the following client statements indicates that more instruction is needed?

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

Question 15

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

A)Arrange to include otoscopic examinations for all clients.
B)Administer rubella immunizations to all students at the clinic.
C)Discuss the importance of limiting exposure to very high amplified music.
D)Teach clients to regularly irrigate the ear to decrease cerumen impaction.

Question 16

The nurse is admitting a client with Ménière's disease who has vertigo, nausea, and vomiting. Which of the following nursing interventions should be included in the care plan?

A)Keep the client's room darkened.
B)Encourage oral fluids to 3 000 mL daily.
C)Change the client's position every 2 hours.
D)Keep the head of the bed elevated 30 degrees.

Question 17

The nurse is caring for a client in the eye clinic who has 20/200 vision with the use of corrective lenses. Which of the following information should the nurse include when providing client teaching?

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

Question 18

Which of the following topics should the nurse plan to include when teaching the client with herpes simplex keratitis of the left eye about management of the infection?

A)How to apply an occlusive dressing to the affected eye
B)Need for frequent handwashing and avoiding touching the eyes
C)Application of antibiotic drops to the left eye several times daily
D)Use of corticosteroid ophthalmic ointment to decrease inflammation

Question 19

The nurse is caring for a client with age-related macular degeneration who has just had photodynamic therapy. Which of the following statements by the client indicates that the discharge teaching has been effective?

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

Question 20

The nurse is caring for a client with adult inclusion conjunctivitis (AIC) caused by Chlamydia trachomatis. Which of these actions should be included in the plan of care?

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

Question 21

Which of the following nursing diagnoses is priority when caring for a client who is experiencing an acute attack of Ménière's disease?

A)Risk for falls as evidenced by impaired balance
B)Impaired verbal communication related to vulnerability (tinnitus)
C)Bathing self-care deficit related to weakness (vertigo)
D)Imbalanced nutrition: less than body requirements related to insufficient dietary intake (nausea)

Question 22

A client with hearing loss asks the nurse about the use of a cochlear implant. Which of the following information will the nurse include when replying to the client?

A)Cochlear implants require training in order to receive the full benefit.
B)Cochlear implants are not useful for clients with congenital deafness.
C)Cochlear implants are most helpful as an early intervention for presbycusis.
D)Cochlear implants improve hearing in clients with conductive hearing loss.

Question 23

Which of the following actions is an example of an approach magnification?

A)Using a telescopic lens
B)Sitting closer to a television while watching it
C)Using a black-tipped felt marker when writing
D)Reading books with large-type print

Question 24

The charge nurse observes a newly hired nurse caring for a client who has just arrived in the postanaesthesia care unit after having right cataract removal and an intraocular lens implant. Which of the following interventions requires that the charge nurseintervene?

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

Question 25

The nurse is caring for a client with an acute attack of Ménière's disease. Which of the following actions carried out by a family member that is visiting the client should the nurse intervene?

A)Raises the side rails on the bed
B)Turns on the client's television
C)Turns the client to the right side
D)Places an emesis basin at the bedside

Question 26

The nurse is caring for a client with neural presbycusis. Which of the following hearing changes should the nurse expect with this type of presbycusis?

A)Loss of high-pitched sounds
B)Loss of speech discrimination
C)Uniform loss for all frequencies
D)Range of hearing loss with low frequencies

Question 27

The nurse is admitting a client with a head injury after a motor vehicle accident who has shortness of breath and severe eye pain. Which of the following actions should the nurse take first?

A)Elevate the head to 45 degrees.
B)Administer the ordered analgesic.
C)Check the client's oxygen saturation.
D)Examine the eye for evidence of trauma.

Question 28

The nurse is admitting a client for surgery who has functional blindness for several years and is cared for by the client's spouse. Which of the following actions is most important to implement during the initial assessment?

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

Question 29

The home health nurse observes a client taking these actions when self-administering eardrops. Which of the following client actions indicates a need for more teaching?

A)The client leaves the ear wick in place while administering the drops.
B)The client lies down before and for 2 minutes after administering the drops.
C)The client gets the eardrops out of the refrigerator just before administering the drops.
D)The client holds the tip of the dropper 1 cm above the ear while administering the drops.

Question 30

The camp nurse is caring for a client who is complaining of bilateral eye pain after a campfire log exploded, sending sparks into the client's eyes. Which of the following actions should the nurse take first?

A)Apply ice packs to the eyes.
B)Flush the eyes with sterile saline.
C)Cover the eyes with dry sterile patches and protective eye shields.
D)Apply antiseptic ophthalmic ointment from the first-aid kit to the eyes.

Question 31

The nurse is assessing the presence or absence of contact lenses in an unconscious client. Which of the following directions should the nurse shine a pen light?

A)Parallel to the eye
B)At a 90-degree angle to the eye
C)Obliquely into the eye
D)Toward the centre of the nasal bridge

Question 32

The nurse is caring for a client who had a stapedotomy yesterday. Which of the following findings is most important for the nurse to communicate to the health care provider?

A)The client complains of "congestion" in the ear.
B)The client's oral temperature is 38.1°C (100.6°F).
C)The client says "My hearing is worse now than it was right after surgery."
D)There is a small amount of dried bloody drainage on the client's dressing.

Question 33

An older-adult client with presbycusis is fitted with binaural hearing aids. Which of the following information should the nurse include when teaching the client how to use the hearing aids?

A)Experiment with volume and hearing ability in a quiet environment initially.
B)Keep the volume low on the hearing aids for the first week while adjusting to them.
C)Add the second hearing aid after making the initial adjustment to the first hearing aid.
D)Wear the hearing aids for about an hour a day at first, gradually increasing the time of use.

Question 34

The nurse is admitting an older-adult client and the client repeatedly asks the nurse to "speak up so that I can hear you." Which of the following actions should the nurse take?

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

Question 35

Which of the following information should the nurse include when teaching a client with keratitis caused by herpes simplex type 1?

A)Application of corticosteroid ophthalmic ointment to the eyes
B)Application of povidone-iodine gel around the eye
C)Avoidance of nonsteroidal anti-inflammatory drugs (NSAIDs)
D)Importance of taking all of the ordered oral acyclovir

Question 36

The nurse is admitting a client to the outpatient surgery unit who is scheduled for cataract extraction and implantation of an intraocular lens. Which of the following information has the most immediate implications for the client's care?

A)The client has not eaten anything for 8 hours.
B)The client takes three antihypertensive medications.
C)The client gets nauseated with general anaesthesia.
D)The client has had blurred vision for several years.

Question 37

Which of the following interventions should the nurse implement for a client who has just been diagnosed with viral conjunctivitis?

A)Explain the purpose of antiviral eye drops.
B)Show how to perform eye irrigation safely.
C)Instruct about how to insert soft contact lenses.
D)Demonstrate appropriate handwashing technique.

Question 38

Which of the following assessment findings in a client who was struck in the right eye with a baseball is a priority for the nurse to communicate to the health care provider in the emergency department?

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

Question 39

These medications are prescribed by the health care provider for a client who has just been admitted to hospital with acute angle-closure glaucoma. Which of the following medications should the nurse give first?

A)Morphine sulphate 4 mg intravenously
B)Betaxolol 1 drop in each eye
C)Acetazolamide 250 mg orally
D)Mannitol 100 mg intravenously

Question 40

A client who had cataract extraction and intraocular lens implantation the previous day calls the eye clinic and gives the nurse all of this information. Which of the following information is the priority to communicate to the health care provider?

A)The client has eye pain rated at a 5 (on a 0-10 scale).
B)The client has questions about the ordered eye drops.
C)The client has poor depth perception when wearing an eye patch.
D)The client complains that the vision has "not improved very much."

Question 41

The nurse is caring for a client with chronic otitis media. Which of the following findings should the nurse expect to assess? (Select all that apply.)

A)Pinked-tinged exudate
B)Pain
C)Nausea
D)Dizziness
E)Hearing loss