Nokea
The elderly client has undergone a right-eye cataract removal with an intraocular implant. Which discharge instructions should the nurse teach the client?
- A. Have the client demonstrate placing the otic drops in the ear.
- B. Teach the client to instill the eyedrops as prescribed.
- C. Remind the client to keep the lights in the home low at all times.
- D. Encourage the client to sleep on two pillows at night.
Correct Answer: B
Rationale: Instilling prescribed eyedrops (e.g., antibiotics, steroids) prevents infection and inflammation post-cataract surgery. Otic drops are irrelevant, low lights are unnecessary, and elevation is not standard.
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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.
The client with diminished sight has problems with the glare from light. Which recommendation should the nurse make?
- A. Install fluorescent lighting throughout the home.
- B. Wear sunglasses and hats with brims when outdoors.
- C. Avoid going outdoors on days that are sunny.
- D. Use direct sunlight from windows rather than lights.
Correct Answer: B
Rationale: Wearing sunglasses and hats with brims while outdoors blocks direct light, reducing glare. Fluorescent lighting and direct sunlight increase glare, and avoiding sunny days is unnecessary.
Which statement best describes the scientific rationale for the nurse holding the otoscope with the hand in a pencil-hold position when examining the client's ear?
- A. It is usually the most comfortable position to hold the otoscope.
- B. This allows the best visualization of the tympanic membrane.
- C. This prevents inserting the otoscope too far into the external ear.
- D. It ensures the nurse will not cause pain when examining the ear.
Correct Answer: C
Rationale: The pencil-hold prevents deep insertion, protecting the ear canal and tympanic membrane. Comfort, visualization, and pain avoidance are secondary.
A 68-year-old woman is brought to the emergency room by ambulance. She was found by her husband slumped in her chair and unresponsive. Tentative diagnosis is cerebrovascular accident (CVA). The physician orders a 15% solution of mannitol IV. The nurse knows that this drug is given for what purpose?
- A. To increase urine output
- B. To dissolve clots
- C. To reduce blood pressure
- D. To decrease muscle spasms
Correct Answer: C
Rationale: Mannitol reduces intracranial pressure and blood pressure by promoting diuresis in CVA patients with cerebral edema.
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.