1.            The nurse evaluates that wearing bifocals improved the patients myopia and presbyopia by assessing for

a.            strength of the eye muscles.

b.            both near and distant vision.

c.             cloudiness in the eye lenses.

d.            intraocular pressure changes.

ANS: B

The lenses are prescribed to correct the patients near and distant vision. The nurse may also assess for cloudiness of the lenses, increased intraocular pressure, and eye movement, but these data do not evaluate whether the patients bifocals are effective.

2.            A nurse should instruct a patient with recurrent staphylococcal and seborrheic blepharitis to

a.            irrigate the eyes with saline solution.

b.            apply cool compresses to the eyes three times daily.

c.             use a gentle baby shampoo to clean the lids as needed.

d.            schedule an appointment for surgical removal of the lesion.

ANS: C

Baby shampoo is used to soften and remove crusts associated with blepharitis. The other interventions are not used in treating this disorder.

3.            When assisting a blind patient in ambulating to the bathroom, the nurse should

a.            take the patient by the arm and lead the patient slowly to the bathroom.

b.            have the patient place a hand on the nurses shoulder and guide the patient.

c.             stay beside the patient and describe any obstacles on the path to the bathroom.

d.            walk slightly ahead of the patient and allow the patient to hold the nurses elbow.

ANS: D

When using the sighted-guide technique, the nurse walks slightly in front and to the side of the patient and has the patient hold the nurses elbow. The other techniques are not as safe in assisting a blind patient.

4.            A nurse should include which instructions when teaching a patient with repeated hordeolum how to prevent further infection?

a.            Apply cold compresses at the first sign of recurrence.

b.            Discard all open or used cosmetics applied near the eyes.

c.             Wash the scalp and eyebrows with an antiseborrheic shampoo.

d.            Be examined for recurrent sexually transmitted infections (STIs).

ANS: B

Hordeolum (styes) are commonly caused by Staphylococcus aureus, which may be present in cosmetics that the patient is using. Warm compresses are recommended to treat hordeolum. Antiseborrheic shampoos are recommended for seborrheic

blepharitis. Patients with adult inclusion conjunctivitis, which is caused by Chlamydia trachomatis, should be referred for sexually transmitted infection (STI) testing.

5.            The nurse developing a teaching plan for a patient with herpes simplex keratitis should include which instruction?

a.            Apply antibiotic drops to the eye several times daily.

b.            Wash hands frequently and avoid touching the eyes.

c.             Apply a new occlusive dressing to the affected eye at bedtime.

d.            Use corticosteroid ophthalmic ointment to decrease inflammation.

ANS: B

The best way to avoid the spread of infection from one eye to another is to avoid rubbing or touching the eyes and to use careful hand washing when touching the eyes is unavoidable. Occlusive dressings are not used for herpes keratitis. Herpes simplex is a virus and antibiotic drops will not be prescribed. Topical corticosteroids are immunosuppressive and typically are not ordered because they can contribute to a longer course of infection and more complications.

6.            Which teaching point should the nurse plan to include when caring for a patient whose vision is corrected to 20/200?

a.            How to access audio books

b.            How to use a white cane safely

c.             Where Braille instruction is available

d.            Where to obtain specialized magnifiers

ANS: D

Various types of magnifiers can enhance the remaining vision enough to allow the performance of many tasks and activities of daily living (ADLs). Audio books, Braille instruction, and canes usually are reserved for patients with no functional vision.

7.            The nurse is developing a plan of care for an adult patient diagnosed with adult inclusion conjunctivitis (AIC) caused by Chlamydia trachomatis. Which action 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 eyedrops to treat the infection

ANS: A

Patients with AIC have a high risk for concurrent genital Chlamydia infection and should be referred for sexually transmitted infection (STI) testing. AIC is treated with antibiotics. Antiviral and corticosteroid medications are not appropriate therapies.

Although some types of Chlamydia infection do cause blindness, AIC does not lead to blindness, so referral for visual rehabilitation is not appropriate.