Chapter 63 Brunner & Suddarth’s Textbook of Medical-Surgical Nursing 13Th Edition

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Chapter 63  Brunner & Suddarth’s Textbook of Medical-Surgical Nursing 13Th Edition

 

 

Complete Chapter Questions And Answers
 

Sample Questions

 

1. The registered nurse taking shift report learns that an assigned patient is blind. How should the nurse best communicate with this patient?

  1. A)  Provide instructions in simple, clear terms.
  2. B)  Introduce herself in a firm, loud voice at the doorway of the room.
  3. C)  Lightly touch the patient’s arm and then introduce herself.
  4. D)  State her name and role immediately after entering the patient’s room.

Ans: D

Feedback:

There are several guidelines to consider when interacting with a person who is blind or has low vision. Identify yourself by stating your name and role, before touching or making physical contact with the patient. When talking to the person, speak directly at him or her using a normal tone of voice. There is no need to raise your voice unless the person asks you to do so and there is no particular need to simplify verbal instructions.

2. The nurse has taken shift report on her patients and has been told that one patient has an ocular condition that has primarily affected the rods in his eyes. Considering this information, what should the nurse do while caring for the patient?

  1. A)  Ensure adequate lighting in the patient’s room.
  2. B)  Provide a dimly lit room to aid vision by limiting contrast.
  3. C)  Carefully point out color differences for the patient.
  4. D)  Carefully point out fine details for the patient.

Ans: A

Feedback:

The nurse should provide adequate lighting in the patient’s room, as the rods are mainly responsible for night vision or vision in low light. If the patient’s rods are impaired, the patient will have difficulty seeing in dim light. The cones in the eyes provide best vision for bright light, color vision, and fine detail.

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3. A patient who presents for an eye examination is diagnosed as having a visual acuity of 20/40. The patient asks the nurse what these numbers specifically mean. What is a correct response by the nurse?

  1. A)  “A person whose vision is 20/40 can see an object from 40 feet away that a person with 20/20 vision can see from 20 feet away.”
  2. B)  “A person whose vision is 20/40 can see an object from 20 feet away that a person with 20/20 vision can see from 40 feet away.”
  3. C)  “A person whose vision is 20/40 can see an object from 40 inches away that a person with 20/20 vision can see from 20 inches away.”
  4. D)  “A person whose vision is 20/40 can see an object from 20 inches away that a person with 20/20 vision can see from 40 inches away.”

Ans: B

Feedback:

The Snellen chart is a tool used to measure visual acuity. It is composed of a series of progressively smaller rows of letters and is used to test distance vision. The fraction 20/20 is considered the standard of normal vision. Most people can see the letters on the line designated as 20/20 from a distance of 20 feet. A person whose vision is 20/40 can see an object from 20 feet away that a person with 20/20 vision can see from 40 feet away.

4. During discharge teaching the nurse realizes that the patient is not able to read medication bottles accurately and has not been taking her medications consistently at home. How should the nurse intervene most appropriately in this situation?

  1. A)  Ask the social worker to investigate alternative housing arrangements.
  2. B)  Ask the social worker to investigate community support agencies.
  3. C)  Encourage the patient to explore surgical corrections for the vision problem.
  4. D)  Arrange for referral to a rehabilitation facility for vision training.

Ans: B

Feedback:

Managing low vision involves magnification and image enhancement through the use of low-vision aids and strategies and referrals to social services and community agencies serving those with visual impairment. Community agencies offer services to patients with low vision, which include training in independent living skills and a variety of assistive devices for vision enhancement, orientation, and mobility, preventing patients from needing to enter a nursing facility. A rehabilitation facility is generally not needed by the patients to learn to use the assistive devices or to gain a greater degree of independence. Surgical options may or may not be available to the patient.

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5. The nurse is providing health education to a patient newly diagnosed with glaucoma. The nurse teaches the patient that this disease has a familial tendency. The nurse should encourage the patient’s immediate family members to undergo clinical examinations how often?

  1. A)  At least monthly
  2. B)  At least once every 2 years
  3. C)  At least once every 5 years
  4. D)  At least once every 10 years

Ans: B

Feedback:

Glaucoma has a family tendency and family members should be encouraged to undergo examinations at least once every 2 years to detect glaucoma early. Testing on a monthly basis is not necessary and excessive.

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