Test bank for new ebersole and hess toward healthy aging 9th edition by touhy

138 TOP: Integrated Process: Teaching/Learning MSC: Client Needs: Health Promotion and Maintenance 2.. 131 TOP: Integrated Process: Teaching/Learning MSC: Client Needs: Health Promotion

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Test Bank for New Ebersole and Hess Toward Healthy Aging 9th

Edition by Touhy

Sample Chapter 11: Vision MULTIPLE CHOICE

1 You have four rooms to choose from for your older client to be admitted this afternoon Which room would you choose?

a A brightly lit, blue room with cozy throw rugs

b An orange-carpeted room with soft lighting and yellow

walls

c A brightly lit, blue room with an EZ-Glide wax floor

d A fluorescent-lighted room with green walls and a glossy,

tiled floor

ANS: B

Light colors such as red, orange, and yellow are more easily seen by aging eyes Softer lighting will help reduce some of the glare and is also easier seen by aging eyes Fidelity

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of color is less accurate with the blues, greens, and violets of the spectrum, and the

slowed ability of the pupils to adjust to light makes glare a problem Glare can come from sunlight, but a brightly waxed floor and glossy tile can also cause glare

DIF: Cognitive Level: Applying REF: p 138

TOP: Integrated Process: Teaching/Learning

MSC: Client Needs: Health Promotion and Maintenance

2 An older adult client shares with the nurse that, “I don’t know what it is but it seems that I need more light for reading or even watching television as I get

older.” The nurse explains that aging may cause this change due to the:

a slower ability of the pupil to adjust to changes in lighting

b impact arcus senilis has on visual acuity

c flattening and thinning of the cornea

d retinal changes that begin to occur with aging

ANS: A

A slowed ability of the pupil to accommodate to changes in light accounts for the need of this patient to have more light in order to read Arcus senilis does not affect vision It is true that the cornea becomes flatter and thinner with aging, which results in astigmatism Astigmatism does not account for the need for increased light that this patient is

reporting The changes in the retina do not account for the need for increased light that this patient is reporting

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3 A 77-year-old client being treated for glaucoma asks the nurse what causes

glaucoma The nurse’s response is:

a the exact etiology of glaucoma is variable and often

unknown

b spasms of the orbicular muscle

c changes to the suspensory ligaments, ciliary muscles, and

parasympathetic nerves

d bits of broken coalesced vitreous from the peripheral or

central part of the retina

ANS: A

The etiology of glaucoma is variable and often unknown However, when the natural fluids of the eye are blocked by ciliary muscle rigidity and the buildup of pressure,

damage to the optic nerve occurs Spasms of the orbicular muscle can cause the lower lid

to turn inward If it stays this way, it is called entropion The changes described

contribute to decreased accommodation Bits of coalesced vitreous that have broken off from the peripheral or central part of the retina is the definition of floaters

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DIF: Cognitive Level: Remembering REF: p 134

4 An older man tells a nurse, “The doctor says I have something wrong with my eyes, something called presbyopia Can you explain why I have this? I was always fortunate to have good eyesight.” The nurse formulates a response based on the knowledge that:

a the lens of the eye loses elasticity causing a loss of focus

for near objects

b the cornea of the eye becomes thicker and less curved

causing an increase in astigmatism

c the lens of the eye increases in opacity causing a decrease

in light refraction

d the cornea of the eye forms a gray ring at the edges

ANS: A

Presbyopia is the loss of focus for near objects, caused by a loss of elasticity and hence a loss of accommodation of the lens of the eye All of the other options are normal age-related changes; however, they are not age-related to presbyopia

DIF: Cognitive Level: Applying REF: p 132, Table 11-1

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5 An older resident in a long-term care facility reports to the nurse that she has been noticing changes in her vision, including the appearance of halos around objects and a yellow tint to most objects The nurse knows that these complaints are most often associated with:

a cataracts

b glaucoma

c diabetic retinopathy

d age-related macular degeneration

ANS: A

Signs of cataracts include the appearance of halos around objects as light is diffused, blurring, decreased perception of light and color giving a yellow tint to most objects, and

a sensitivity to glare

6 An older patient reports the following symptoms to a nurse during a routine visit

to the geriatric clinic: blurry vision, the need for more light when reading, and

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blind spots in the middle of his visual field He also states, “Strangely enough my peripheral vision continues to be pretty good.” The nurse suspects that the patient has which of the following?

b Age related macular degeneration

c Diabetic retinopathy

d Cataracts

ANS: B

Blurry vision, needing more light, and blind spots in the middle of the visual field

(scotomas) are all characteristics of age related macular degeneration The other three eye diseases do not present with these symptoms

DIF: Cognitive Level: Applying REF: pp 135–136

MULTIPLE RESPONSE

1 A nurse is providing glaucoma education for a group of older adults in a senior center The nurse knows that the following groups are most likely to develop

glaucoma (Select all that apply.)

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a African Americans

b Mexican Americans

c Individuals with a family history of glaucoma

d Individuals with diabetes

e Asian Americans

ANS: A, B, C, D

African Americans are at risk of developing glaucoma at an earlier age than other racial and ethnic groups Mexican Americans, individuals with a family history of glaucoma, and individuals with diabetes are among the other high-risk groups Asian Americans are more likely to lose eyesight from age-related macular degeneration than other groups

2 A nurse is performing preoperative teaching for an older adult who is scheduled to have a cataract extraction and lens implant The nurse includes which of the

following in the teaching plan? (Select all that apply.)

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a Avoid lifting heavy objects after the surgery

b Avoid bending from the waist after the surgery

c Take stool softeners as needed

d Maintain strict control of your blood sugar and blood

pressure

e Maintain a dry sterile dressing over the eye for 10 days

ANS: A, B, C

Postcataract surgery the individual needs to avoid heavy lifting, straining, and bending from the waist Fall prevention is also very important as is complying with eye drop administration Maintaining strict blood sugar and blood pressure control is most

important for diabetic retinopathy, not cataract extraction There usually is not a dressing over the operative site, and not for 10 days

DIF: Cognitive Level: Applying REF: pp 134–135

3 An older patient is diagnosed with diabetic retinopathy The patient asks a nurse:

“Is there anything that I can do to prevent progression of this disease and

blindness?” The nurse includes which of the following into the response? (Select

all that apply.)

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a Strict control of blood glucose levels is important in

slowing disease progression

b Laser photocoagulation treatments can stop progression

of the disease

c Control of blood pressure and cholesterol levels are

important steps slowing disease progression

d Wearing sunglasses to protect the eyes from ultraviolet

light can stop disease progression

e Eating a diet high in beta-carotene can stop disease

progression

ANS: A, B, C

Constant strict control of blood pressure, blood glucose, and cholesterol and laser

photocoagulation treatments can halt progression of the disease Laser treatment can reduce vision loss in 50% of patients Neither protecting the eyes from ultraviolet light nor eating a diet high in beta-carotene has been proven to be effective in stopping disease progression

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4 A nurse is conducting an assessment of an older patient’s eyes The nurse expects

to see which of the following normal age-related changes of the external

eye? (Select all that apply.)

a The eyelids are less elastic and droopy

b The eyes are very dry

c The eyelids may not close completely

d There is a loss of eyelashes

e The lower lid may be turned outward

ANS: A, B, C, E

Normal age-related changes in the external eye include a loss of elasticity causing

drooping Eyes become drier, and the eyelids may not close completely Decreases in orbital muscle strength may result in entropion, the outward turning of the lower lid Loss

of eyelashes is not a normal age-related change

DIF: Cognitive Level: Remembering REF: p 132, Table 11-1

New Ebersole and Hess Toward Healthy Aging: 9th Edition Test Bank – Touhy

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