Exemplars 18.2, 3, & 5: Cataracts, Eye Injuries, and Macular Degeneration

Olivia McRitchie
Quiz by , created 12 months ago

NCLEX Nursing (Medical-Surgical) Quiz on Exemplars 18.2, 3, & 5: Cataracts, Eye Injuries, and Macular Degeneration, created by Olivia McRitchie on 12/09/2018.

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Olivia McRitchie
Created by Olivia McRitchie 12 months ago
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Question 1

Question
Your grandmother comes to you one day and informs you that her doctor diagnosed her with cataracts. She didn't ask what those were because she knew the doctor would give her "smart person jargon". So she asks you what cataracts are. Select the correct teaching about cataracts that you can give to your grandmother
Answer
  • "Scientists don't really know what causes cataracts."
  • "Doctors will generally want to treat cataract very early on."
  • "Cataracts are very common in the elderly. By age 75, most people will have cataracts that affect vision."
  • "Cataracts start at the middle of the lens and move out."

Question 2

Question
Select the risk factors for cataracts.
Answer
  • Age
  • Long-term exposure to UVB rays
  • Cigarette smoking
  • Heavy alcohol consumption
  • Injury to the lens capsule, blunt trauma, and exposure to heat or radiation.
  • Diabetes mellitus
  • Corticosteroids
  • Antibiotics
  • Obesity

Question 3

Question
Which of the following would you usually NOT see when assessing a patient with age-related cataracts?
Answer
  • Cataract present unilaterally
  • Decreased visual acuity
  • "Glare" in the eyes.
  • Impaired color discrimination
  • Cloudy gray or white pupil.

Question 4

Question
You have been tasked with procuring informed consent and teaching a patient about an extracapsular extraction for her bilateral cataracts. Which of the following statements made by the patient shows that more teaching is needed?
Answer
  • "My lens will be extracted and replaced with an artificial lens."
  • "It is likely that I will not need another surgery on my eyes."
  • "This surgery will be outpatient with local anesthesia."
  • "Complications of cataract surgery rarely happen."
  • "I will have my husband drive me here and drive me home."

Question 5

Question
Your patient is scheduled to undergo surgery to fix her cataracts. You want to make sure your patient really understands her preoperative and postoperative instructions. Select correct teaching you can give to this patient.
Answer
  • "Make sure you maximize lighting for indoor activities."
  • "You can continue to drive at night, but be aware that your visual acuity is not as good."
  • "It is normal to experience discharge for up to a week after surgery."
  • "It will take 7-8 weeks for your eyes to completely heal. In the meantime, wear eye protection and avoid rubbing the eye."
  • "After surgery, limit activities such as reading, lifting, bending to pick up objects, strenuous activities, and sleeping on the operative side."
  • "Eye pain, vision changes, headache, nausea, itching, and redness of affected eye are normal 1-2 days postoperatively. Call your doctor if these symptoms last for longer than 1 week."

Question 6

Question
You are providing teaching about eye injuries to a group of individuals at a community center. These individuals are from a wide array of careers; you know that most of these people are only here because their workplace is requiring them to be here. Which of the following statements made by a person in the audience shows that more teaching may be needed?
Answer
  • "Eye safety is important in all settings. Outside of workplace injuries, we can sustain eye injuries doing recreational sports, lighting fireworks, in car accidents, and in home accidents."
  • "Chemicals, flying objects, particles, and tools are sources of eye trauma in the work place."
  • "Contractors, woodworkers, welders, and electricians are at the greatest risk of eye injuries, but that doesn't mean it can't happen in other work places."
  • "Individuals of both genders and every age group are equally likely to acquire an eye injury."
  • "Eye protection is estimated to prevent most eye injuries."

Question 7

Question
You have a young male patient presenting with intense pain and redness, light sensitivity, and tearing that began not long after cleaning out his father's attic. What type of eye injury might this person have?
Answer
  • Corneal abrasion
  • Penetrating injury
  • Perforating injury
  • Blunt trauma

Question 8

Question
You have a patient presenting to the ER with a contact lens dried into his eye. He's in intense pain and looks like he's been crying. He's also complaining about how bright the hospital lights are. Select appropriate interventions to enact for this patient.
Answer
  • Irrigation with sterile saline.
  • Set up a sterile field, with sterile tweezers.
  • Procure an eye patch.
  • Advise the patient to keep the eye patch on for 24 hours.
  • Rise eye with sterile saline for 30 minutes.
  • Patch both the affected and the unaffected eye.

Question 9

Question
Burns from alkaline substances are particularly serious.
Answer
  • True
  • False

Question 10

Question
You have a patient in the emergency room complaining of acute vision loss in her eyes, accompanied by intense pain. Her eyelids are swollen and her conjunctiva is red and edematous. Her entire eye appears milky. She reports to you that she works as a housekeeper. Which eye injury might this patient have?
Answer
  • Corneal abrasion
  • Burn
  • Penetrating injury
  • Perforating injury
  • Foreign body on conjunctiva

Question 11

Question
What interventions might you enact for a patient suffering from a burn in one eye?
Answer
  • Remove any clothing that may still contain the chemical.
  • Ask the patient, or a witness of the incident if the patient isn't conscious, if they know what got into the patient's eye.
  • Procure a Morgan lens, unit or make your own out of a bottle of normal saline and IV tubing.
  • Keep the eyelid in place as you irrigate the eye.
  • Irrigate from the inner canthus to the outer canthus of the eye,
  • Do not move the eyeball during irrigation
  • Tip the head to the unaffected side.
  • Apply tetracaine drops before irrigation and gentamicin ophthalmic after irrigation,

Question 12

Question
When irrigating the eye of a patient with a burn, you'll want to continue irrigation until the pH of the eye is 7.2-7.4
Answer
  • True
  • False

Question 13

Question
You are giving a lecture to employees at a chemical plant following a horrific incident with one of their coworkers. Which of the following statements made by an employee shows that more teaching is needed?
Answer
  • "If we get splashed, we should remove any clothing that may still contain the chemical."
  • "If it's safe, we should bring the container with the chemical information to the hospital. At the very least, we should write down what the name of the chemical is."
  • "Once a chemical is in the eye, we need to start rinsing it out immediately."
  • "Eye rinsing only needs to last 15 minutes."

Question 14

Question
An individual comes into your emergency room with a fishing hook stuck in his eye. You can visualize where the hook went into the eye and where it comes out of the eye. This person came to the ER immediately after the hook got stuck in the eye, but informs you that the vision in that eye has been gradually declining. You can see blood pooling at the bottom of the eye. Which eye injury does this individual have?
Answer
  • Penetrating
  • Perforating
  • Corneal abrasion
  • Detached retina

Question 15

Question
Select the proper interventions you can enact for a patient with a small staple from a stapler gun embedded into the eye.
Answer
  • Set up a sterile field and remove the stable with sterile tweezers.
  • Irrigate the eye with normal saline
  • Procure an order for morphine
  • Immobilize the object and the eye
  • Place a metal eye shield over the eye.
  • Place an eye patch on the unaffected eye.
  • Procure an order for acetazolamide.

Question 16

Question
You have a patient in your emergency room following a car crash. Her right eye is black, and she is complaining of double vision and "seeing red". She is reporting 8/10 pain in the affected eye, with the pain worsening when she looks up. Whereas she reportedly had 20/20 vision before the accident, now she cannot read the sign 20 feet in front of her in the ER. Her eye appears sunken. What type of eye injury does this person have?
Answer
  • Blunt trauma
  • Burn
  • Penetrating
  • Perforating

Question 17

Question
What interventions might you enact for a patient with blunt trauma andto the eye following a particularly brutal boxing match?
Answer
  • Place in semi-Fowler's position
  • Cover only the affected eye.
  • Procure a prescription for methazolamide
  • Acquire a bottle of normal saline and IV tubing
  • Irrigate the eye.

Question 18

Question
You have an elderly female at your urgent care complaining of "vision problems". Her vision in her right eye is blurry, as if she's "had a curtain drawn across" her vision, but she can still see floaters and flashes of light. She reports that her vision in that eye has been steadily decreasing since she woke up that morning. She does not report any prior eye trauma. What eye injury might this patient have?
Answer
  • Detached retina
  • Blunt trauma
  • Penetrating trauma
  • Corneal abrasion.

Question 19

Question
If a patient is experiencing a retinal detachment, positioning cannot help him or her.
Answer
  • True
  • False

Question 20

Question
Your grandmother is telling you about one of her friends. She said that this friend has macular degeneration and told her (jokingly) that because she's old, she might be next. Since this individual is a friend, your grandmother wants to know what this disorder is and how she can help her friend. Select the statements that are correct.
Answer
  • "The macula is the area of the retina that receives light from the center of the visual field."
  • "Macular degeneration can be exudative or nonexudative. The exudative form is the most common."
  • "Macular degeneration is the number one cause of severe vision loss and legal blindness in individuals over the age of 60."
  • "Your friend may benefit from vitamin C, vitamin E, vitamin A, zinc, and copper supplements."
  • "Your friend may needed magnifiers and large print books. However, high -intensity lighting is unlikely to be helpful."
  • "Over time, your friend may have difficulty recognizing your face."