Tiêu đề Care of Clients with Problems in Sensory and Perception.pdf ✅

NURSES LICENSURE EXAMINATION (NLE) Controlled Copy 2023 Rev. 00 CLASSIFIED EXAMINATION FOR CRITICAL TEST ANALYSIS Care of Clients with Problems in Sensory and Perception Philippine Nurses Licensure Examination Warning: This material is protected by Copyright Laws. Unauthorized use shall be prosecuted in the full extent of the Philippine Laws. For exclusive use of CBRC reviewees only. 1. The registered nurse taking shift report learns that an assigned patient is blind. How should the nurse BEST communicate with this patient? A. Provide instructions in simple, clear terms. B. Introduce herself in a firm, loud voice at the doorway of the room. C. Lightly touch the patients arm and then introduce herself. D. State her name and role immediately after entering the patient’s room. 2. Tonometry is performed on the client with a suspected diagnosis of glaucoma. The nurse analyzes the test results as document in the client's chart and understands that NORMAL intraocular pressure is: A. 2 to 7 mmHg C. 22 to 30 mmHg B. 10 to 21 mmHg D. 31 to 35 mmHg 3. The client glaucoma asks the nurse if complete vision will return. The MOST appropriate response is: A. “Although some vision has been lost and cannot be restored, further loss may be prevented by adhering to the treatment plan.” B. "Your vision will never return as soon as the medication begins to work. " C. "Your vision will never return to normal." D. "Your vision loss is temporary and will return in about 3 to 4 weeks." 4. The client diagnosed with glaucoma is prescribed a miotic cholinergic medication. Which data support that the medication has been EFFECTIVE? A. No redness or irritation of the eyes. B. A decrease in intraocular pressure C. The pupil reacts briskly to light. D. The client denies any type of floaters. 5. The 65-year-old male client who is complaining of blurred vision reports that he thinks his glasses need to be cleaned all the time. He denies any type of pain in his eyes. Based on these signs and symptoms, which eye disorder would the nurse suspect the client has? A. Corneal dystrophy B. Conjunctivitis C. Diabetic retinopathy D. Cataracts 6. 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? A. Ensure adequate lighting in the patient’s room. B. Provide a dimly lit room to aid vision by limiting contrast. C. Carefully point out color differences for the patient. D. Carefully point out fine details for the patient. 7. 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? 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. 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. 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. 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. 8. 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? A. At least monthly B. At least once every 2 years C. At least once every 5 years D. At least once every 10 years 9. The nurse is administering eye drops to a patient with glaucoma. After instilling the patients first medication, how long should the nurse wait before instilling the patients second medication into the same eye? A. 30 seconds C. 3 minutes B. 1 minute D. 5 minutes 10. A patient comes to the ophthalmology clinic for an eye examination. The patient tells the nurse that he often sees floaters in his vision. How should the nurse BEST interpret this subjective assessment finding? A. This is a normal aging process of the eye. B. Glasses will minimize this phenomenon. C. The patient may be exhibiting signs of glaucoma. D. This may be a result of weakened ciliary muscles. 11. The nurse’s assessment of a patient with significant visual losses reveals that the patient cannot count fingers. How should the nurse proceed with assessment of the patient’s visual acuity? A. Assess the patients vision using a Snellen chart. B. Determine whether the patient is able to see the nurses hand motion. C. Perform a detailed examination of the patients’ external eye structures. D. Palpate the patient’s periocular regions.