Chapter 64 Medical Surgical Nursing 2nd Edition By Osborn Wraa Watson

Chapter 64 Medical Surgical Nursing 2nd Edition By Osborn Wraa Watson

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

Question 1

Type: MCSA

Which patient statement would the nurse evaluate as indicating problems with accommodation?

1. “I feel blinded by sunlight.”
2. “I can’t tell the difference between colors as well as I once did.”
3. “I have trouble seeing at night.”
4. “I am having trouble reading the newspaper.”

Correct Answer: 4

Rationale 1: The pupil controls the amount of light entering the eye. This is not a problem with accommodation.

Rationale 2: Color vision is a function of the rods and cone receptors in the retina. Accommodation is not related to color vision.

Rationale 3: Problems seeing at night may be due to cataracts or macular degeneration. It is not a problem with accommodation.

Rationale 4: Accommodation is the ability to focus from distant to near images.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 64-1

Question 2

Type: MCSA

A patient’s eye examination reveals limited central vision. The nurse would conduct further assessment for problems with which structure?

1. Sclera
2. Lens
3. Macula
4. Extraocular muscles

Correct Answer: 3

Rationale 1: The sclera is the outer protective layer of the eyeball that helps maintain its shape. Changes in the sclera would not specifically affect central vision.

Rationale 2: The lens is the focusing structure of the eye. Dysfunction of the lens would cause problems with all vision, not just central vision.

Rationale 3: The center of the retina, called the macula, is where the greatest numbers of cone receptors are located for central and color vision.

Rationale 4: The extraocular muscles move the eyeball. They help the patient fixate on an object but are not associated with central vision.

Global Rationale:

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 64-1

Question 3

Type: MCSA

A patient complains that sometimes there appears to be gnats in the field of vision. The nurse would interpret this statement to mean that the patient has which visual change?

1. Conjunctivitis
2. Floaters
3. Strabismus
4. Nystagmus

Correct Answer: 2

Rationale 1: Conjunctivitis is an inflammation of the conjunctiva. The main symptom is a discharge from the eyes.

Rationale 2: The vitreous gel is made up mainly of water with a collagen framework. The network can be aggregated by vitreous collapse due to aging and form opacities that cast shadows on the retina. These shadows are referred to as floaters. The patient may describe seeing gnats or a fine filament floating in the line of sight.

Rationale 3: Strabismus is a functional misalignment of the extraocular muscles that causes the eyes not to focus together.

Rationale 4: Nystagmus is an involuntary tremor or jerky movement of the eyeball.

Global Rationale:

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 64-1

Question 4

Type: MCSA

The nurse is conducting assessment of a patient’s eye. Which instrument would the nurse obtain to measure intraocular pressure?

1. Snellen chart
2. Ophthalmoscope
3. Tonometer
4. Penlight

Correct Answer: 3

Rationale 1: The Snellen acuity chart is used to measure visual acuity.

Rationale 2: An ophthalmoscope is used to view the fundus of the eye by viewing through the pupil.

Rationale 3: A tonometer is used to measure the intraocular pressure.

Rationale 4: A penlight is used for external examination of the eye.

Global Rationale:

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 64-2

Question 5

Type: MCSA

A patient has been diagnosed with primary glaucoma. What information would the nurse provide about this condition?

1. It was probably caused by a congenital anomaly in the structure of the eye.
2. Primary glaucoma is not as serious as other forms of glaucoma.
3. The disorder has no relation to other ocular conditions.
4. This condition is the result of conjunctival infections in childhood.

Correct Answer: 3

Rationale 1: A congenital anomaly is one cause of secondary, not primary, glaucoma.

Rationale 2: Glaucoma is always serious and can cause blindness because the increased intraocular pressure can cause optic nerve changes.

Rationale 3: Primary glaucoma is not related to other ocular conditions.

Rationale 4: Primary glaucoma is not related to any other ocular condition.

Global Rationale:

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 64-1