Nokea
A client uses timolol maleate (Timoptic) eyedrops. The expected outcome of this beta-adrenergic blocker is to control glaucoma by:
- A. Constricting the pupils.
- B. Dilating the canals of Schlemm.
- C. Reducing aqueous humor formation.
- D. Improving the ability of the ciliary muscle to contract.
Correct Answer: C
Rationale: Timolol maleate, a beta-adrenergic blocker, reduces intraocular pressure by decreasing the production of aqueous humor in the eye.
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A client with a hemorrhagic stroke is slightly agitated, heart rate is 118, respirations are 22, bilateral rhonchi are auscultated, SpO2 is 94%, blood pressure is 144/88, and oral secretions are noted. What order of interventions should the nurse follow when suctioning the client to prevent increased intracranial pressure (ICP) and maintain adequate cerebral perfusion?
- A. Suction the airway.
- B. Hyperoxygenate.
- C. Suction the mouth.
- D. Provide sedation.
Correct Answer: B,D,A,C
Rationale: The correct order is: 1) Hyperoxygenate to prevent hypoxia (B); 2) Provide sedation to reduce agitation and ICP spikes (D); 3) Suction the airway to clear secretions (A); 4) Suction the mouth to remove residual secretions (C). This sequence minimizes ICP increases and ensures oxygenation.
When assessing a client for early septic shock, the nurse observes for which of the following?
- A. Cool, clammy skin.
- B. Warm, flushed skin.
- C. Decreased systolic blood pressure.
- D. Hemorrhage.
Correct Answer: B
Rationale: Early septic shock is characterized by vasodilation and increased cardiac output, leading to warm, flushed skin. Cool, clammy skin and decreased blood pressure occur in later stages, and hemorrhage is not a feature of septic shock.
A client with Parkinson's disease asks the nurse to explain to his nephew "what the doctor said the pallidotomy would do." The nurse's best response includes stating that the main goal for the client after pallidotomy is improved:
- A. Functional ability.
- B. Emotional stress.
- C. Alertness.
- D. Appetite.
Correct Answer: A
Rationale: Pallidotomy aims to improve functional ability by reducing symptoms like tremors and rigidity. Emotional stress, alertness, and appetite are not primary targets of this procedure.
Which clinical manifestations should the nurse expect to assess in a client diagnosed with an overdose of a cholinergic agent?
- A. Dry mucous membranes.
- B. Urinary incontinence.
- C. Central nervous system (CNS) depression.
- D. Seizures.
- E. Skin rash.
Correct Answer: B,C,D
Rationale: Cholinergic overdose (e.g., organophosphates) causes urinary incontinence (B), CNS depression (C), and seizures (D) due to excessive acetylcholine. Dry mucous membranes and skin rash are not typical.
A nurse is palpating a female client's breast while assessing for breast disease. In the illustration below, indicate the area of the breast in which tumors are most commonly found.
Correct Answer:
Rationale: Most breast tumors are found in the upper outer quadrant of the breast, as this area contains the most glandular tissue.