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The nurse is administering eye drops to a client. Which action is correct?
- A. Ask the client to report any blurring of vision and difficulty focusing that occurs after the administration of eye drops.
- B. Apply gentle pressure to the nasolacrimal canal for one to two minutes after instillation to prevent systemic absorption.
- C. Have the client lie down with eyes closed for 45 minutes after giving drops.
- D. Gently pull the lower lid down and place medicine in the center of the eye.
Correct Answer: B
Rationale: Applying pressure to the nasolacrimal canal prevents systemic absorption of eye drops, enhancing safety and efficacy.
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The client with severe otitis media and mastoiditis is prescribed levofloxacin IV, 250 mg every 12 hours. The medication is diluted in 100 mL of NS. To deliver the antibiotic in 30 minutes, the nurse must infuse the solution at a rate of how many mL per hour?
- A. 200
Correct Answer: A
Rationale: The rate of IV infusion is calculated as follows: 100 mL over 30 minutes equals X mL over 60 minutes. Thus, 100/30 = X/60, so X = (100 × 60) / 30 = 200 mL/hr.
Which intervention should the nurse include when conducting an in-service to the ancillary nursing staff on caring for elderly clients addressing normal developmental sensory changes?
- A. Ensure curtains are open when having the client read written material.
- B. Provide a variety of written material when discussing a procedure.
- C. Assist the client when getting out of the bed and sitting in the chair.
- D. Request a telephone for the hearing impaired for all elderly clients.
Correct Answer: A
Rationale: Open curtains maximize light, compensating for age-related vision decline. Varied materials, mobility assistance, and hearing-impaired phones are less universally applicable.
The nurse is questioning the client about vision changes. Which symptom indicates that the client may be developing a cataract?
- A. Blurred vision, worsening at night
- B. Shooting pain in the back of one eye
- C. Increased frequency of headaches
- D. Seeing spots in the vision field of one eye
Correct Answer: A
Rationale: The lens opacity from a developing cataract diminishes vision. Blurriness and decreased night vision are early symptoms. Shooting eye pain is often associated with a subarachnoid hemorrhage, not a cataract. Headaches are not associated with cataract formation. Floating dark spots in the vision field are associated with bleeding within the eye that occurs with detached retina.
The client diagnosed with glaucoma is prescribed a miotic cholinergic medication. Which data indicate 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.
Correct Answer: B
Rationale: Miotic cholinergics (e.g., pilocarpine) reduce intraocular pressure in glaucoma by increasing aqueous outflow. Redness, pupil reaction, and floaters are not primary indicators.
When planning care for a woman with myasthenia gravis, the nurse asks her what time of day she feels strongest. The nurse would expect which of the following replies?
- A. I can wash up and comb my hair before breakfast because I feel best in the morning.'
- B. I only feel good for about an hour after I take my medication.'
- C. I feel strongest in the evening, so I would prefer to take a shower before bedtime.'
- D. I feel best after lunch after I've been moving around a little.'
Correct Answer: A
Rationale: Muscle strength in myasthenia gravis is typically best in the morning, with weakness worsening throughout the day.