Review Practice Exercise 2

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Practice Exercise 2

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Total Questions : 5

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Question 1:

A patient with early cataracts tells the nurse that he is afraid cataract surgery may cause permanent visual damage. What should the nurse teach the patient?

A. The cataracts will only worsen with time and should be removed as early as possible to prevent blindness. B. Cataract surgery is very safe and with the implantation of an intraocular lens, the need for glasses will be eliminated. C. Progression of the cataracts can be prevented by avoidance of ultraviolet (UV) light and good dietary management. D. Vision enhancement techniques may improve vision until surgery becomes an acceptable option to maintain desired activities.

Answer and Explanation

Choice A:

The cataracts will only worsen with time and should be removed as early as possible to prevent blindness: Cataracts do progress, but they do not require immediate removal unless they impair daily function. Early removal is not always necessary.

Choice B:

Cataract surgery is very safe and with the implantation of an intraocular lens, the need for glasses will be eliminated: Surgery is safe, but many patients still need glasses postoperatively for fine vision tasks.

Choice C:

Progression of the cataracts can be prevented by avoidance of ultraviolet (UV) light and good dietary management: These measures may reduce risk but cannot stop or reverse cataract progression once it has begun.

Choice D:

Vision enhancement techniques may improve vision until surgery becomes an acceptable option to maintain desired activities: This teaching reassures the patient and provides practical measures to cope with vision changes until surgery is appropriate.

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Question 2:

A 60-year-old patient is being prepared for outpatient cataract surgery. When obtaining admission data from the patient, what would the nurse expect to find in the patient’s history?

A. A painless, sudden, severe loss of vision B. Blurred vision, colored halos around lights, and eye pain C. A gradual loss of vision with abnormal color perception and glare D. Light flashes, floaters, and a “cobweb” in the field of vision with loss of central or peripheral vision

Answer and Explanation

Choice A:

A painless, sudden, severe loss of vision: This suggests retinal artery occlusion or another acute event, not cataracts.

Choice B:

Blurred vision, colored halos around lights, and eye pain: These are typical of acute angle-closure glaucoma, not cataracts.

Choice C:

A gradual loss of vision with abnormal color perception and glare: This is the hallmark of cataracts. Patients often describe cloudy or dim vision, fading of colors, and difficulty with glare, especially at night.

Choice D:

Light flashes, floaters, and a “cobweb” in the field of vision with loss of central or peripheral vision: These are signs of retinal detachment, not cataracts.

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Question 3:

Which characteristics of glaucoma are associated with only primary open-angle glaucoma (POAG)? Select all that apply

A. Gradual loss of peripheral vision B. Treated with iridotomy or iridectomy C. Causes loss of central vision with corneal edema D. May be caused by increased production of aqueous humor E. Treated with cholinergic agents such as pilocarpine (Pilocar) F. Resistance to aqueous outflow through trabecular meshwork

Answer and Explanation

Choice A:

Gradual loss of peripheral vision: This is a classic sign of POAG, progressing slowly and often unnoticed until advanced.

Choice B:

Treated with iridotomy or iridectomy: This surgical procedure is used in angle-closure glaucoma, not POAG.

Choice C:

Causes loss of central vision with corneal edema: These are features of acute angle-closure glaucoma, which presents suddenly and painfully.

Choice D:

May be caused by increased production of aqueous humor: Overproduction is not the usual cause of POAG; the problem lies with impaired drainage.

Choice E:

Treated with cholinergic agents such as pilocarpine (Pilocar): Medications are the mainstay of POAG treatment, aiming to reduce intraocular pressure.

Choice F:

Resistance to aqueous outflow through trabecular meshwork: This is the underlying pathophysiology of POAG.

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Question 4:

For the patient with a retinal break, what extraocular techniques may be used with sclera buckling to seal the break by creating an inflammatory reaction that causes a chorioretinal adhesion or scar? Select all that apply

A. Cryopexy B. Vitrectomy C. Pneumatic retinopexy D. Laser photocoagulation E. Penetrating keratoplasty

Answer and Explanation

Choice A:

Cryopexy: A freezing probe applied externally over the sclera induces inflammation and scar tissue formation around the retinal break.

Choice B:

Vitrectomy: This is an intraocular procedure that removes the vitreous humor to relieve traction on the retina; it is not an extraocular technique.

Choice C:

Pneumatic retinopexy: Involves injection of a gas bubble inside the vitreous cavity; it is also an intraocular method, not extraocular.

Choice D:

Laser photocoagulation: A laser beam creates small burns around the retinal tear, leading to scar tissue formation that seals the break.

Choice E:

Penetrating keratoplasty: This is a corneal transplant procedure, unrelated to retinal repair.

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Question 5:

What nursing action is most important for the patient with age-related macular degeneration (AMD)?

A. Teach the patient how to use topical eyedrops for treatment of AMD. B. Emphasize the use of vision enhancement techniques to improve what vision is present. C. Encourage the patient to undergo laser treatment to slow the deposit of extracellular debris. D. Explain that nothing can be done to save the patient’s vision because there is no treatment for AMD.

Answer and Explanation

Choice A:

Teach the patient how to use topical eyedrops for treatment of AMD: No effective topical eyedrops exist for AMD treatment.

Choice B:

Emphasize the use of vision enhancement techniques to improve what vision is present: These measures enable patients to adapt to central vision loss and maintain daily functioning despite irreversible damage.

Choice C:

Encourage the patient to undergo laser treatment to slow the deposit of extracellular debris: Laser therapy is not typically used; wet AMD is managed with intravitreal injections, not laser for drusen deposits.

Choice D:

Explain that nothing can be done to save the patient’s vision because there is no treatment for AMD: This is incorrect and discouraging. While AMD cannot be cured, supportive interventions and some treatments for wet AMD can help.

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Practice Exercise 2

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