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MSN Exam for Cataract

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1) Cataracts result in opacity of the crystalline lens. Which of the following best explains the functions of the lens?

  1. The lens controls stimulation of the retina.
  2. The lens orchestrates eye movement.
  3. The lens focuses light rays on the retina.
  4. The lens magnifies small objects.
2) Hyperopia is corrected with that type of lens?
  1. Concave lens
  2. Convex lens
  3. Aphakic lens
  4. Bifocal lens
3) A sterile chronic granulomatous inflammation of the meibomian gland is:
  1. Chalazion
  2. Hordeulum
  3. Uveitis
  4. Keratoconjunctivitis
4) What statement by the client recovering from cataract surgery would indicate to the nurse need for additional teaching?
  1. “I’ll call if I have a significant amount of pain.”
  2. “I’ll continue to take my Metamucil for another week.”
  3. “I’ll just do some laundry this afternoon instead of going to work.”
  4. “I’ll take my acetazolamide (Diamox) drops with my other morning medications
5) Pterygium is caused primarily by:
  1. Exposure to sunlight
  2. Exposure to dust
  3. Exposure to wind
  4. Exposure to chemicals
6) Which of the following statement is true regarding the visual changes associated with cataracts?
  1. Both eyes typically cataracts at the same time
  2. The loss of vision is experienced as a painless, gradual blurring
  3. The patient is suddenly blind
  4. The patient is typically experiences a painful, sudden blurring of vision.
7) A client who had cataract should be told to call his MD if he has which of the following situations?
  1. Blurred Vision
  2. Eye Pain
  3. Glare
  4. Glare
8) A 55-year old client underwent cataract removal with intraocular lens implant. Nurse Oliver is giving the client discharge instructions. These instructions should include which of the following?
  1. Avoid lifting objects weighing more than 5 lb (2.25 kg).
  2. Lie on your abdomen when in bed
  3. Keep rooms brightly lit.
  4. Avoiding straining during bowel movement or bending at the waist.
9) The primary reason for performing iridectomy after cataract extraction is:
  1. To prevent secondary glaucoma
  2. To improve the vision of the client
  3. To prevent postop hemorrhage
  4. To reduce eye discomfort
10) Which of the following statement is true regarding the visual changes associated with cataracts?
  1. Both eyes typically cataracts at the same time
  2. The loss of vision is experienced as a painless, gradual blurring
  3. The patient is suddenly blind
  4. The patient is typically experiences a painful, sudden blurring of vision.
11) The primary problem in cataract is:
  1. Blurring of vision
  2. Loss of peripheral vision
  3. Presence of floaters
  4. Halos around light
12) The nurse has just completed teaching about postoperative activity to a client who is going to have a cataract surgery. The nurse knows the teaching has been effective if the client:
  1. coughs and deep breathes postoperatively
  2. ties his own shoes
  3. asks his wife to pick up his shirt from the floor after he drops it.
  4. States that he doesn’t need to wear an eyepatch or guard to bed
13) The nurse is assigned to care for a 57-year-old female client who had a cataract surgery an hour ago. The nurse should:
  1. Advise the client to refrain from vigorous brushing of teeth and hair.
  2. Instruct the client to avoid driving for 2 weeks.
  3. Encourage eye exercises to strengthen the ocular musculature.
  4. Teach the client coughing and deep-breathing techniques.
14) The nurse is preparing a client for cataract surgery. The nurse is aware that the procedure will use:
  1. Mydriatics to facilitate removal
  2. Miotic medications such as Timoptic
  3. A laser to smooth and reshape the lens
  4. Silicone oil injections into the eyeball
15) A female patient is being discharged after cataract surgery. After providing medication teaching, the nurse asks the patient to repeat the instructions. The nurse is performing which professional role?
  1. Manager
  2. Educator
  3. Caregiver
  4. Patient advocate
16) Which instruction should be included in the discharge teaching for the client with cataract surgery?
  1. Over-the-counter eyedrops can be used to treat redness and irritation.
  2. The eye shield should be worn at night.
  3. It will be necessary to wear special cataract glasses.
  4. A prescription for medication to control post-operative pain will be needed.
17) The following are appropriate nursing interventions after cataract extraction EXCEPT:
  1. Place the client in supine position or turn towards unoperated side
  2. Advise the client to avoid bending, stooping or lifting heavy objects for several weeks postop
  3. Instruct the client to limit fluid intake
  4. Advise the client to protect his eyes with eye pad and eye shield for a week
18) Which of the following terms refers to the decrease in lens flexibility that occurs with age, resulting in the near point of focus getting farther away?
  1. Presbyopia
  2. Presbycusis
  3. Cataract
  4. Glaucoma
19) The following are nursing interventions for a blind person EXCEPT:
  1. When approaching the client, talk before touching
  2. Orient the client to the environment
  3. When assisting the client during ambulation, the nurse stays beside the client
  4. Promote the independence in activities of daily living
20) Which of the ff test assesses visual acuity
  1. Snellen’s Tes
  2. Ishihara Plate
  3. Retinoscopy
  4. Tonometry
Answers and Rationales
  1. C. The lens focuses light rays on the retina. The lens allows light to pass through the pupil and focus light on the retina. The lens does not stimulate the retina, assist with eye movement, or magnify small objects, so answers A, B, and D are incorrect.
  2. B. Convex lens 
  3. A. Chalazion 
  4. C. “I’ll just do some laundry this afternoon instead of going to work.”
  5. B. Exposure to dust 
  6. B. The loss of vision is experienced as a painless, gradual blurring . Typically, a patient with cataracts experiences painless, gradual loss of vision. Although both eyes may develop at different rates.
  7. B. Eye Pain 
  8. D. Avoiding straining during bowel movement or bending at the waist. The client should avoid straining, lifting heavy objects, and coughing harshly because these activities increase intraocular pressure. Typically, the client is instructed to avoid lifting objects weighing more than 15 lb (7kg) – not 5lb. instruct the client when lying in bed to lie on either the side or back. The client should avoid bright light by wearing sunglasses.
  9. A. To prevent secondary glaucoma 
  10. B. The loss of vision is experienced as a painless, gradual blurring . Typically, a patient with cataracts experiences painless, gradual loss of vision. Although both eyes may develop at different rates.
  11. A. Blurring of vision 
  12. C. asks his wife to pick up his shirt from the floor after he drops it. Bending to pick up something from the floor would increase intraocular pressure, as would bending to tie his shoes. The client needs to wear eye protection to bed to prevent accidental injury during sleep.
  13. A. Advise the client to refrain from vigorous brushing of teeth and hair. Activities such as rigorous brushing of hair and teeth cause increased intraocular pressure and may lead to hemorrhage in the anterior chamber
  14. A. Mydriatics to facilitate removal . Before cataract removal, the client will have Mydriatic drops instilled to dilate the pupil. This will facilitate removal of the lens. Miotics constrict the pupil and are not used in cataract clients. A laser is not used to smooth and reshape the lens; the diseased lens is removed.
  15. B. Educator . When teaching a patient about medications before discharge, the nurse is acting as an educator. The nurse acts as a manager when performing such activities as scheduling and making patient care assignments. The nurse performs the care giving role when providing direct care, including bathing patients and administering medications and prescribed treatments. The nurse acts as a patient advocate when making the patient’s wishes known to the doctor.
  16. B. The eye shield should be worn at night. The eye shield should be worn at night or when napping, to prevent accidental trauma to the operative eye. Prescription eyedrops, not over-the-counter eyedrops, are ordered for the client. The client might or might not require glasses following cataract surgery. A prescription for medication to control post-operative pain will be needed is incorrect because cataract surgery is pain free.
  17. C. Instruct the client to limit fluid intake 
  18. A. Presbyopia . Presbyopia usually begins in the fifth decade of life, when reading glasses are required to magnify objects.
  19. C. When assisting the client during ambulation, the nurse stays beside the client
  20. A. Snellen’s Tes

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