(Test Bank) Medical Surgical Nursing by Linton Matterson

Linton,Matterson, 1

Nursing

Test Bank

1st Edition

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Test Bank for Medical Surgical Nursing by Linton Matterson, The downloadable file consists of 441 pages, and the total size of the file is 2.45 MB. Purchase now only for highly discounted price.

Author(s): Linton, Matterson

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Study Note Preview

Chapter 63 Eye and Vision Disorders Question 1 See full question 30s Report this Question The nurse realizes that a client understands how to correctly instill ophthalmic medications when the client: You Selected:  pulls the tissue near the cheek downward to instill medication. Correct response:  pulls the tissue near the cheek downward to instill medication. Explanation: Pull the cheek downward to form a sack in the lower lid. Instill the drops into the conjunctival pocket. The lid and lashes would be wiped in a direction away from the nose to avoid contamination. The tip of the container will be contaminated if it touches eye or eyelid. Do not rub the eye because it may irritate the eye. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical- Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 63: Assessment and Management of Patients With Eye and Vision Disorders, Chart 63-4, p. 1889. Chapter 63: Assessment and Management of Patients With Eye and Vision Disorders - Page 1889 Add a Note Question 2 See full question 15s Report this Question A nurse is assessing a pediatric client in a public health clinic. The parent states that the client has been sneezing and rubbing the eyes. The nurses observes the client’s eyes and documents objective symptoms of watery and red eyes. When reporting to the physician the assessment findings, which word is appropriate?You Selected:  Signs and symptoms of conjunctivitis Correct response:  Signs and symptoms of conjunctivitis Explanation: Conjunctivitis often stems from an allergy causing inflammation of the conjunctiva, which is a thin, transparent mucous membrane. Conjunctivitis can cause symptoms of itchiness, redness, and watery eyes. Ptosis is drooping of the upper eyelid. Proptosis is an extended and upper eyelid that delays in closing or remains partially open. Nystagmus is an uncontrolled oscillating movement of the eyeball. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical- Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 63: Assessment and Management of Patients With Eye and Vision Disorders, Assessment and Diagnostic Findings, p. 1906. Chapter 63: Assessment and Management of Patients With Eye and Vision Disorders - Page 1906 Add a Note Question 3 See full question 58s Report this Question A client is diagnosed with blepharitis. What symptoms should a nurse monitor in this client? You Selected:  Patchy flakes clinging to the eyelashes Correct response:  Patchy flakes clinging to the eyelashes Explanation: Blepharitis is an inflammation of the lid margins. The nurse monitors visible patchy flakes clinging to the eyelashes and about the lids. The condition does not cause redness or a halo around the pupil. In case of a sty, the nurse would observe a red pustule in the internal tissue of the eyelid.Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical- Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 63: Assessment and Management of Patients With Eye and Vision Disorders, Table 63-7: Common Infections and Inflammatory Disorders of Eye Structures, p. 1906. Chapter 63: Assessment and Management of Patients With Eye and Vision Disorders - Page 1906 Add a Note Question 4 See full question 1m 26s Report this Question Which surgical procedure involves flattening the anterior curvature of the cornea by removing a stromal lamella layer? You Selected:  Laser-assisted stromal in situ keratomileusis (LASIK) Correct response:  Laser-assisted stromal in situ keratomileusis (LASIK) Explanation: LASIK involves flattening the anterior curvature of the cornea by removing a stromal lamella or layer. PRK is used to treat myopia and hyperopia with or without astigmatism. Keratoconus is a cone-shaped deformity of the cornea. Keratoplasty involves replacing abnormal host tissue with healthy donor (cadaver) corneal tissue. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical- Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 63: Assessment and Management of Patients With Eye and Vision Disorders, p. 1899. Chapter 63: Assessment and Management of Patients With Eye and Vision Disorders - Page 1899 Add a Note Question 5 See full question1m 3s Report this Question During an intial assessment, the nurse notes a symptom of a mild case of bacterial conjunctivitis and documents in the electronic medical record that the client is displaying which of the following ? You Selected:  Mucopurulent ocular discharge Correct response:  Mucopurulent ocular discharge Explanation: Bacterial conjunctivitis manifests with an acute onset of redness, burning, and discharge. Purulent discharge occurs in severe acute bacterial infections, whereas mucopurulent discharge appears in mild cases. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical- Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 63: Assessment and Management of Patients With Eye and Vision Disorders, Microbial Conjunctivitis, p. 1907. Chapter 63: Assessment and Management of Patients With Eye and Vision Disorders - Page 1907 Question 1 See full question 24s Report this Question Which surgical procedure involves flattening the anterior curvature of the cornea by removing a stromal lamella? You Selected:  Laser-assisted in situ keratomileusis (LASIK) Correct response:  Laser-assisted in situ keratomileusis (LASIK) Explanation: LASIK involves flattening the anterior curvature of the cornea by removing a stromal lamella or layer. PRK is used to treat myopia and hyperopia with or without astigmatism. Keratoconus is a cone-shaped deformity of the cornea. Keratoplasty involves replacing abnormal host tissue with healthy donor (cadaver) corneal tissue. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical- Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 63: Assessment and Management of Patients With Eye and Vision Disorders, p. 1899. Chapter 63: Assessment and Management of Patients With Eye and Vision Disorders - Page 1899 Add a Note Question 2 See full question 25s Report this Question 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? You Selected:  Scleral buckle Correct response:  Scleral buckle Explanation: The scleral buckle is a procedure in which a piece of silicone plastic or sponge is sewn onto the sclera at the site of the retinal tear. The buckle holds the retina against the sclera until scarring seals the tear. The other surgeries do not use this type of procedure. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical- Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 63: Assessment and Management of Patients With Eye and Vision Disorders, Scleral Buckle, p. 1900. Chapter 63: Assessment and Management of Patients With Eye and Vision Disorders - Page 1900 Add a Note Question 3 See full question 25s Report this Question A nurse is performing an eye examination. Which question would not be included in the examination? You Selected:  "Are you able to raise both eyebrows?" Correct response:  "Are you able to raise both eyebrows?" Explanation: Asking to raise both eyebrows is a test for cranial nerve VII, the facial nerve, and would not be included in an eye assessment. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical- Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 63: Assessment and Management of Patients With Eye and Vision Disorders, p. 1880. Chapter 63: Assessment and Management of Patients With Eye and Vision Disorders - Page 1880 Add a Note Question 4 See full question 37s Report this Question The nurse is caring for geriatric clients who state that they are prescribed reading glasses. Some individuals state needing assistance with seeing writing far away, and others need assistance with closer vision. The nurse is correct to understand that the aging visual changes relate to which of the following? You Selected: Changes in accommodation Correct response:  Changes in accommodation Explanation: The changes that occur in vision during aging, which include difficulty reading and the need for reading glasses, include changes in accommodation. Accommodation occurs when the ciliary muscles contract or relax to focus an image on the retina. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical- Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 63: Assessment and Management of Patients With Eye and Vision Disorders, Anatomic and Physiologic Overview, p. 1878. Chapter 63: Assessment and Management of Patients With Eye and Vision Disorders - Page 1878 Add a Note Question 5 See full question 1m 12s Report this Question A nurse practitioner examines a patient and documents a best corrected visual acuity (BCVA) ratio in his better eye that qualifies him for government financial assistance based on the definition of legal blindness. What is that ratio? You Selected:  20/200 Correct response:  20/200 Explanation: Legal blindness is a condition of impaired vision in which a person has a BCVA that does not exceed 20/200 in the better eye or whose widest visual field diameter is 20 degrees or less. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical- Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 63: Assessment and Management of Patients With Eye and Vision Disorders, Vision Impairment and Blindness, p. 1883. Chapter 63: Assessment and Management of Patients With Eye and Vision Disorders - Page 1883 Question 1 See full question 36s Report this Question A nurse is reviewing the medical records of several patients who have had their intraocular pressure (IOP) measured: Patient A: IOP 12 mm Hg Patient B: IOP 15 mm Hg Patient C: IOP 21 mm Hg Patient D: IOP 24 mm Hg Which patient would the nurse identify as having increased IOP suggesting glaucoma? You Selected:  Patient D Correct response:  Patient D Explanation: When IOP is in balance, the pressure ranges from 10 to 21 mm Hg. Increased IOP greater than 21 mm Hg suggests glaucoma. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical- Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 63: Assessment and Management of Patients With Eye and Vision Disorders, Glaucoma, p. 1890. Chapter 63: Assessment and Management of Patients With Eye and Vision Disorders - Page 1890 Add a Note Question 2 See full question34s Report this Question 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 optic disc under magnification? You Selected:  Ophthalmoscope Correct response:  Ophthalmoscope Explanation: The nurse is correct to provide an ophthalmoscope to the surgeon for examination of theoptic disc. A retinoscope is used to determine errors in refraction. A tonometer measures intraocular pressure. An Amsler grid tests for problems with the macula. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical- Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 63: Assessment and Management of Patients With Eye and Vision Disorders, Direct Ophthalmoscopy, p. 1881. Chapter 63: Assessment and Management of Patients With Eye and Vision Disorders - Page 1881 Add a Note Question 3 See full question 5m 14s Report this Question The nurse is obtaining a visual history from a client who has noted an increase in glare and changes in color perception. Which assessment would the nurse anticipate to confirm a definitive diagnosis? You Selected:  Identification of opacities on the lens Correct response:  Identification of opacities on the lens Explanation: The client states an increased glare and changes in color perception, which indicates a cataract. Identification of opacities on the lens confirms that diagnosis. A white circle around the cornea and a yellowish aging spot are also symptoms of aging but with different symptoms. Redness of the sclera indicates irritation. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical- Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 63: Assessment and Management of Patients With Eye and Vision Disorders, Table 63-1: Age-Related Changes in the Eye, p. 1884. Chapter 63: Assessment and Management of Patients With Eye and Vision Disorders - Page 1884 Add a Note Question 4 See full question 18s Report this Question 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? You Selected:  Marked blurring of vision Correct response:  Marked blurring of vision Explanation: Glaucoma is often called the “silent thief of sight” because most patients are unaware that they have the disease until they have experienced visual changes and vision loss. The patient may not seek health care until he or she experiences blurred vision or “halos” around lights, difficulty focusing, difficulty adjusting eyes in low lighting, loss of peripheral vision, aching or discomfort around the eyes, and headache. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical- Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 63: Assessment and Management of Patients With Eye and Vision Disorders, Assessment and Diagnostic Findings, p. 1892. Chapter 63: Assessment and Management of Patients With Eye and Vision Disorders - Page 1892 Add a Note Question 5 See full question 16s Report this Question 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: You Selected:  Acute angle-closure. Correct response:  Acute angle-closure. Explanation: Acute angle-closure glaucoma is characterized by the symptoms listed, as well as by being rapidly progressive and accompanied by pain. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical- Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 63: Assessment and Management of Patients With Eye and Vision Disorders, Table 63-4, p. 1891. Chapter 63: Assessment and Management of Patients With Eye and Vision Disorders - Page 1891 Question 1 See full question 18s Report this Question Which term refers to the absence of the natural lens? You Selected:  AphakiaCorrect response:  Aphakia Explanation: When a cataract is extracted and an intraocular lens implant is not used, the client demonstrates aphakia. Scotoma refers to a blind or partially blind area in the visual field. Keratoconus refers to a cone-shaped deformity of the cornea. Hyphema refers to blood in the anterior chamber of the eye. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical- Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 63: Assessment and Management of Patients With Eye and Vision Disorders, p. 1900. Chapter 63: Assessment and Management of Patients With Eye and Vision Disorders - Page 1900 Add a Note Question 2 See full question 13s Report this Question Which type of glaucoma presents an ocular emergency? You Selected:  Acute angle-closure glaucoma Correct response:  Acute angle-closure glaucoma Explanation: Acute angle-closure glaucoma results in rapid progressive visual impairment. Normal tension glaucoma is treated with topical medication. Ocular hypertension is treated with topical medication. Chronic open-angle glaucoma is treated initially with topical medications, with oral medications added later. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical- Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 63: Assessment and Management of Patients With Eye and Vision Disorders, Table 63-4, p. 1891. Chapter 63: Assessment and Management of Patients With Eye and Vision Disorders - Page 1891 Add a Note Question 3 See full question 15s Report this Question 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? You Selected:  Myopia Correct response:  Myopia Explanation: Myopia, or nearsightedness, refers to the condition in which the client can see near objects but has blurred distant vision. Astigmatism is an irregularity in the curve of the cornea, which can affect both near and distant vision. Hyperopia, or farsightedness, refers to the client's ability to see distant objects clearly, but sees near objects as blurry. Emmetropia refers to normal eyesight in which the image focuses precisely on the retina. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical- Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 63: Assessment and Management of Patients With Eye and Vision Disorders, Refractive Errors, p. 1883. Chapter 63: Assessment and Management of Patients With Eye and Vision Disorders - Page 1883 Add a Note Question 4 See full question 1m 16s Report this QuestionA client who is blind is awaiting elective surgery. What should the nurse do to promote this client's control over their hospital environment? You Selected:  Ask the client where to store his or her self-care items. Correct response:  Ask the client where to store his or her self-care items. Explanation: Ask the client's preference for where to store hygiene articles and other objects needed for self-care. Involving the client promotes his or her control over the environment. Personal care items should be kept in the same location at all times to provide the client with the ability to locate toiletries easily. At mealtime, describe where food is on the plate using the positions on the face of a clock. This measure assists the client to identify the location of food. Allow the client to open containers and offer help if needed. Having a choice facilitates independence. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical- Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 63: Assessment and Management of Patients With Eye and Vision Disorders, Chart 63-3, p. 1886. Chapter 63: Assessment and Management of Patients With Eye and Vision Disorders - Page 1886 Add a Note Question 5 See full question 22s Report this Question A patient was recently diagnosed with a cortical cataract in his left eye. His wife asks the nurse for information about his diagnosis. The nurse explains that: You Selected:  The cataract should have little or no effect on his vision. Correct response:  The cataract should have little or no effect on his vision. Explanation:A cortical cataract involves the anterior, posterior, or equatorial cortex of the lens. A cataract in the equator or periphery of the cortex does not interfere with the passage of light through the center of the lens and has little effect on vision. Cortical cataracts progress at a highly variable rate. Vision is worse in very bright light. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical- Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018. Add a Note Question 1 See full question 27s Report this Question When assessing the pressure of the anterior chamber of the eye, a nurse normally expects to find a pressure of: You Selected:  10 to 20 mm Hg. Correct response:  10 to 20 mm Hg. Explanation: Normally, pressure in the anterior chamber of the eye remains relatively constant at 10 to 20 mm Hg. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical- Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 63: Assessment and Management of Patients With Eye and Vision Disorders, Anatomic and Physiologic Overview, p. 1878. Chapter 63: Assessment and Management of Patients With Eye and Vision Disorders - Page 1878 Add a Note Question 2 See full question 1m