Chapter 13 Care of the Patient with a Visual or Auditory Disorder

Chapter 13  Care of the Patient with a Visual or Auditory Disorder

MULTIPLE CHOICE

1. A patient visits the physician for a routine physical examination that involves testing distance vision. As she faces the Snellen chart, the nurse is to instruct the patient to

1. use both eyes to read the chart.
2. read the chart from right to left.
3. cover one eye while testing the other.
4. use any one eye since they will be the same.

ANS: C
A major diagnostic eye test is the Snellen test. While instructing a patient to perform this test, the nurse will have the patient stand or sit 20 feet from the chart and cover one eye to read the letters on the chart.

DIF: Cognitive Level: Application REF: Page 608, Table 13-2 OBJ: 7 TOP: Physical examination
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity

2. The patient tells the nurse that he is legally blind. This information provides the nurse with which information to use in planning care?

1. No vision enhancement techniques would be appropriate for this patient, because

   he is totally blind.

2. This patient probably has some light perception, but no usable vision.
3. This patient has some usable vision, which enables him to function at an

   acceptable level.

4. Further questioning is needed to determine how this patient’s visual impairment

   affects his normal functioning.

ANS: D
“Legal blindness” refers to individuals with a maximum visual acuity of 20/200 with corrective eyewear and/or visual field sight capacity reduced by 20 degrees. Categories have been established to help determine the exact extent of the vision loss and what assistive measures are appropriate for the individual. The nurse will need more information as to the exact extent of the vision loss for this patient.

DIF: Cognitive Level: Analysis REF: Page 609 OBJ: 7 TOP: Blindness KEY: Nursing Process Step: Planning
MSC: NCLEX: Physiological Integrity

3. A patient is cleaning the garage and splashes a chemical in his eyes. The initial priority after the chemical burn is to

Mosby items and derived items © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

Test Bank 13-2

1. transport to a physician immediately.
2. cover the eyes with a sterile gauze.
3. irrigate with H2O for 15 minutes or longer.
4. irrigate with normal saline solution for 1 to 5 minutes.

ANS: C
Burns are medically treated with a prolonged, 15- to 20-minute or longer tap-water flush immediately after burn exposure.

DIF: Cognitive Level: Analysis REF: Page 628 OBJ: 9 TOP: Trauma KEY: Nursing Process Step: Planning
MSC: NCLEX: Physiological Integrity

4. The patient, age 42, notices that she is having difficulty reading typed print. The nurse would explain that the decreased ability to accommodate for near vision is called
a. senility.
b. presbyopia.

c. myopia. d. refraction.

ANS: B
Measurement of visual acuity can determine refractory errors such as presbyopia, the inability to focus on close objects.

DIF: Cognitive Level: Application REF: Page 607, Table 13-2 OBJ: 6 TOP: Vision KEY: Nursing Process Step: Implementation
MSC: NCLEX:PhysiologicalIntegrity

5. Sjögren’s syndrome is associated with which eye disorder?

1. Keratoconjunctivitis sicca
2. Conjunctivitis
3. Blepharitis
4. Opaque lens disorder

ANS: A
If the patient with keratoconjunctivitis sicca has associated dry mouth, the patient has Sjögren’s syndrome (an immunologic disorder characterized by deficient fluid production by the lacrimal, salivary, and other glands, resulting in abnormal dryness of the mouth, eyes, and other mucous membranes). Complaints of dry eye are caused by a variety of ocular disorders characterized by decreased tear secretion or increased tear film evaporation.

DIF: Cognitive Level: Application REF: Pages 615-616
OBJ: 4 TOP: Dry eye disorders
KEY: Nursing Process Step: Assessment MSC: NCLEX: Physiological Integrity

6. A patient is scheduled for a stapedectomy. Appropriate postoperative teaching should include:

Mosby items and derived items © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

Test Bank 13-3

1. Hourly changing cotton from external ear canal
2. Gently blowing both nares simultaneously
3. Teaching patient to open mouth when sneezing or coughing
4. Limiting activities for 3 weeks

ANS: C
The nurse must include patient teaching about opening the mouth when sneezing or coughing or blowing the nose gently on one side at a time for 1 week.

DIF: Cognitive Level: Analysis REF: Page 644, Patient Teaching box OBJ: 20 TOP: Stapedectomy
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity