NUR 155 Test 1 - Answered with Rationales (Complete Solutions)

NUR 155 Test 1 - Answered with Rationales (Complete Solutions) In your patient's health history you read that the patient has a cataract in the right eye. You know that this eye disorder can be best described by which statement below? A. This eye disorder is caused by increased intraocular pressure that results in damage to the optic nerve. B. This eye disorder occurs in the eye when the macula of the retina become damaged and impair the central vision. C. This eye disorder occurs when the lens of the eye loses its transparency. D. This eye disorder occurs from uncontrolled high blood glucose levels which lead to retinal damage. In your patient's health history you read that the patient has a glaucoma in the right eye. You know that this eye disorder can be best described by which statement below? A. This eye disorder is caused by increased intraocular pressure that results in damage to the optic nerve. B. This eye disorder occurs in the eye when the macula of the retina become damaged and impair the central vision. C. This eye disorder occurs when the lens of the eye loses its transparency. D. This eye disorder occurs from uncontrolled high blood glucose levels which lead to retinal damage. In your patient's health history you read that the patient has a macular degeneration. You know that this eye disorder can be best described by which statement below? A. This eye disorder is caused by increased intraocular pressure that results in damage to the optic nerve. B. This eye disorder occurs in the eye when the macula of the retina become damaged and impair the central vision. C. This eye disorder occurs when the lens of the eye loses its transparency. D. This eye disorder occurs from uncontrolled high blood glucose levels which lead to retinal damage. In your patient's health history you read that the patient has a diabetic retinopathy. You know that this eye disorder can be best described by which statement below? A. This eye disorder is caused by increased intraocular pressure that results in damage to the optic nerve. B. This eye disorder occurs in the eye when the macula of the retina become damaged and impair the central vision. C. This eye disorder occurs when the lens of the eye loses its transparency. D. This eye disorder occurs from uncontrolled high blood glucose levels which lead to retinal damage. What is the most common cause of cataracts? A. Congenital B. Aging C. Trauma D. Uncontrolled blood glucose levels Rationale: You may say the others can cause cataracts... And you would be correct, but this question is looking for the most common cause, which is aging. What is the most common cause of retinopathy? A. Congenital B. Aging C. Trauma D. Uncontrolled blood glucose levels Rationale: Can also be caused by Hypertension(HTN) Diabetic Retinopathy - Diabetes = Treat the Diabetes but usually laser photocoagulation is required. Hypertensive Retinopathy - High BP aka Hypertension = Treat the high BP to restore vision What is the most common cause of glaucoma? A. Congenital B. Trauma C. Aging D. Uncontrolled blood glucose levels What is the most common cause of macular degeneration? A. Congenital B. Uncontrolled blood glucose levels C. Trauma D. Aging What is the most common cause of retina detachment? A. Congenital B. Aging C. Trauma D. Uncontrolled blood glucose levels Rationale: While trauma is a major contributor, especially in younger patients, it's not the most common. Remember Time is our Enemy... Cataracts causes light to be scattered and preventing it's proper travel to the retina's _______________, and this leads to visual impairment. A. ganglion cells B. amacrine cells C. cones and rods D. crystalline proteins Rationale: Cones and Rods are the photoreceptors in the retina that allow us to see and discern light from dark and colors. Which patient finding below is associated with the development of cataracts? A. Loss of central vision B. Loss of peripheral vision C. Cloudy, hazy vision D. Black Spots in vision(floater) Which patient finding below is associated with the development of glaucoma? A. Loss of central vision B. Loss of peripheral vision C. Cloudy, hazy vision D. Black Spots in vision(floater) Which patient finding below is associated with the development of macular degeneration? A. Loss of central vision B. Loss of peripheral vision C. Cloudy, hazy vision D. Black Spots in vision(floater) Which patient finding below is associated with the development of retinopathy? A. Loss of central vision B. Loss of peripheral vision C. Black spots in vision D. Cloudy, hazy vision Rationale: Diabetic Retinopathy has a version called nonproliferative that has loss of central vision but that is due to the spots. MD is the main one to display central vision loss. A patient is being evaluated for cataracts. The Dr uses a slit-lamp to assess the patient's eyes. As the nurse you know that this device will? A. help test the patient's visual acuity B. test the strength of the ciliary muscles C. enlarge the front area of the eye (cornea, iris, lens etc.) D. help for visualization of the fundus Pt is having a phacoemulsification for treatment of a cataract. You're providing education about the procedure. Which statement by the patient demonstrates he understood the educational material provided about this procedure? A. "The cloudy lens in my eye will be broken up with sound waves and removed. Then a new permanent lens, called an intraocular lens, will be placed in my eye." B. "A small air bubble is injected into the eye to help push the retina back into position to help the lens refract light." C. "An incision is made to remove the trabecular meshwork and this will help drain fluid out of the cloudy lens." D. "The surgeon will remove parts of the iris and lens. Pt is having a retinopexy for treatment of a retina detachment. You're providing education about the procedure. Which statement by the patient demonstrates he understood the educational material provided about this procedure? A. "The cloudy lens in my eye will be broken up with sound waves and removed. Then a new permanent lens, called an intraocular lens, will be placed in my eye." B. "A small air bubble is injected into the eye to help push the retina back into position to help the lens refract light." C. "An incision is made to remove the trabecular meshwork and this will help drain fluid out of the cloudy lens." D. "The surgeon will remove parts of the iris and lens. Pt is having a trabeculectomy for treatment of a chronic open-angle glaucoma. You're providing education about the procedure. Which statement by the patient demonstrates he understood the educational material provided about this procedure? A. "The cloudy lens in my eye will be broken up with sound waves and removed. Then a new permanent lens, called an intraocular lens, will be placed in my eye." B. "A small air bubble is injected into the eye to help push the retina back into position to help the lens refract light." C. "An incision is made to remove the trabecular meshwork and this will help drain fluid out of the cloudy lens." D. "The surgeon will remove parts of the iris and lens. Rationale: C and D could be used to treat Glaucoma. The key here is Chronic Open-Angle glaucoma treatment is usually trabeculectomy where Acute Angle-Closure Glaucoma utilizes the iridectomy procedure. Pt is having a iridectomy for treatment of a acute angle-closure glaucoma. You're providing education about the procedure. Which statement by the patient demonstrates he understood the educational material provided about this procedure? A. "The cloudy lens in my eye will be broken up with sound waves and removed. Then a new permanent lens, called an intraocular lens, will be placed in my eye." B. "A small air bubble is injected into the eye to help push the retina back into position to help the lens refract light." C. "An incision is made to remove the trabecular meshwork and this will help drain fluid out of the cloudy lens." D. "The surgeon will remove parts of the iris and lens. Rationale: C and D could be used to treat Glaucoma. The key here is Chronic Open-Angle glaucoma treatment is usually trabeculectomy where Acute Angle-Closure Glaucoma utilizes the iridectomy procedure. (T or F)If a patient has bilateral cataracts and needs surgery, both eyes can be surgically treated at the same time. True False (T or F)If a patient has bilateral cataracts and needs surgery, they will need to wait about a week to do the second eye. True False A patient has a cataract in the left eye and has decided to prolong having surgery as long as possible until her activities of daily living are affected. What are some measures the patient can take to help manage the cataract at this time? (Select All That Apply) 1. Wearing sunglasses with UVA protection. 2. Enlarging text or visual images with a magnifier. 3. Adding more light when reading. 4. Wearing anti-glare glasses. A. 1, 2, and 3 B. 2, 3, and 4 C. 1 only D. 2 and 3 E. 3 and 4 F. All of them B. 2, 3, and 4 Rationale: Option 1 is wrong because sunglasses that provide UVA and UVB protection should be used (not just UVA) A patient has a cataract in the left eye and has decided to prolong having surgery as long as possible until her activities of daily living are affected. What are some measures the patient can take to help manage the cataract at this time? (Select All That Apply) 1. Wearing sunglasses with UVA and UVB protection. 2. Enlarging text or visual images with a magnifier. 3. Adding more light when reading. 4. Wearing anti-glare glasses. A. 1, 2, and 3 B. 2, 3, and 4 C. 1 only D. 2 and 3 E. 3 and 4 F. All of them A patient has a cataract in the left eye and has decided to prolong having surgery as long as possible until her activities of daily living are affected. What are some measures the patient can take to help manage the cataract at this time? (Select All That Apply) 1. Wearing sunglasses with UVA and UVB protection. 2. Enlarging text or visual images with a magnifier. 3. Dimming light when reading. 4. Wearing anti-glare glasses. A. 1, 2, and 4 B. 2, 3, and 4 C. 1 only D. 2 and 3 E. 3 and 4 F. All of them A patient has arrived for a post-op visit to the clinic after cataract surgery in the left eye. Which statement by the patient causes concern and requires further investigation? A. "My left eye has experienced some itchiness." B. "The vision in my left eye was blurry for a few days." C. "I have been experiencing flashes of light in my left eye." D. "I had pain in my left eye after surgery and took Acetaminophen." Rationale: A possible complication after cataract surgery is retinal detachment. This could present with the patient experiencing flashes of light or seeing floaters in the vision. The nurse should report this to the surgeon who will further evaluate the patient. A patient has arrived for a post-op visit to the clinic after cataract surgery in the left eye. Which statement by the patient causes concern and requires further investigation? A. "My left eye has experienced some itchiness." B. "I have been seeing floaters in my left eye." C. "The vision in my left eye was blurry for a few days." D. "I had pain in my left eye after surgery and took Acetaminophen." Rationale: A possible complication after cataract surgery is retinal detachment. This could present with the patient experiencing flashes of light or seeing floaters in the vision. The nurse should report this to the surgeon who will further evaluate the patient. Which activity below is allowed after cataract surgery? A. Bending B. Running C. Watching TV D. Swimming In a patient with a hemorrhage in the posterior cavity of the eye, the nurse knows that blood is accumulating: A. in the aqueous humor B. between lens and retina C. between lens and cornea D. in the space between the iris and the lens Increased IOP may occur due to: A. edema of the corneal stroma B. dilation of the retinal arterioles C. blockage of the lacrimal canals and ducts D. increased aqueous humor production by ciliary process Always assess the patient with eye problems for: A. visual acuity B. pupillary reactions C. intraocular pressure D. confrontation visual fields Ask patients using eyedrops to treat their glaucoma about A. use of corrective lenses. B. their usual sleep pattern. C. a history of heart or lung disease. D. sensitivity to opioids or depressants. (Bonus Question)When examining a patient's eyes, which finding would be of most concern to the nurse? A. Intraocular pressure of 16 mm Hg B. Slightly yellowish cast of the sclera C. Outward turning of the lower lid margin D. Small, white nodule on the upper lid margin Rationale: -IOP of 16mm Hg is normal -Outward turning of the lower lid margin isn't a major concern -Yellow in the sclera indicates jaundice aka liver failure but not the most concerning. -The white nodule is from infection and if it gets into the tear duct it could go systemic. That's why it's of the most concern. (Bonus Question)Presbyopia occurs in older individuals because A. the eyeball elongates. B. the lens becomes inflexible. C. the corneal curvature becomes irregular. D. light rays are focusing in front of the retina. (Bonus Question) Before injecting fluorescein for angiography, it is important for the nurse to: (Select All That Apply) 1. obtain an emesis basin. 2. ask if the patient is fatigued. 3. administer a topical anesthetic. 4. inform patient that skin may turn yellow. 5. assess for allergies to iodine-based contrast media. A. 1 and 4 B. 3 and 5 C. 2, 3, and 4 D. 1, 2, and 5 E. 3 only F. All of these A patient says she was diagnosed with astigmatism. When she asks what that is, what is the best explanation the nurse can give to the patient? A. It happens because the lens of the eye is absent B. People with astigmatism have abnormally long eyeballs C. The cornea of the eye is uneven or irregular with astigmatism D. Astigmatism occurs because the eye muscles weaken with age Which intervention would be part of the plan of care for a patient who has new vision loss? A. Allow the patient to express feelings of grief and anger. B. Have the AP perform all self-care activities for the patient. C. Address any family present first when discussing care concerns. D. Speak loudly and clearly, addressing the patient with each contact. Which patient behaviors would the nurse promote for healthy eyes? (Select All That Apply) 1. Protective sunglasses when bicycling 2. Taking part in a smoking cessation program 3. Supplementing diet intake of vitamin C and beta-carotene 4. Washing hands thoroughly before putting in or taking out contact lenses 5. A woman avoiding pregnancy for 4 weeks after receiving MMR immunization A. 1 and 4 B. 3 and 5 C. 2, 3, and 4 D. 1, 2, and 5 E. 1,2,3, and 4 F. All of these The most important intervention for the patient with epidemic keratoconjunctivitis is: A. cleansing the affected area with baby shampoo B. monitoring spread of infection to the opposing eye C. regular instillation of artificial tears to the affected eye. D. teaching the patient and caregivers good hygiene techniques What should be included in the discharge teaching for the patient who had cataract surgery? (Select All That Apply) 1. Eye discomfort is often relieved with mild analgesics 2. A decline in visual acuity is common for the first month 3. Stay on bed rest and limit activity for the first few weeks 4. Notify the provider if an increase in redness or drainage occurs 5. Following activity restrictions is essential to reduce IOP A. 1,4, and 5 B. 3 and 5 C. 2, 3, and 4 D. 1, 2, and 5 E. 1,2,3, and 4 F. All of these What is the main purpose of Glucose? A) insulation B) structural C) repair D) energy (T or F) Beta cells in the pancreas are responsible for the creation of insulin. True False Rationale: -Beta Cells create insulin which lowers BGL - Think Beta level clearance is lower than Alpha level clearance. -Alpha Cells create glucagon which increases BGL (T or F) Beta cells are responsible for the creation of glucagon. True False Rationale: -Beta Cells create insulin which lowers BGL - Think Beta level clearance is lower than Alpha level clearance. -Alpha Cells create glucagon which increases BGL (T or F) Alpha cells are responsible for the creation of insulin. True False Rationale: -Beta Cells create insulin which lowers BGL - Think Beta level clearance is lower than Alpha level clearance. -Alpha Cells create glucagon which increases BGL (T or F) Alpha cells are responsible for the creation of glucagon. True False