Nokea
The nurse is preparing a client for cataract surgery. The nurse is aware that the procedure will use:
- A. Mydriatics to facilitate removal
- B. Miotic medications such as Timoptic
- C. A laser to smooth and reshape the lens
- D. Silicone oil injections into the eyeball
Correct Answer: A
Rationale: Mydriatics are used to dilate the pupil, facilitating lens removal during cataract surgery.
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In caring for a critically ill client with a nasogastric tube (NGT) for enteral feeding, which action by the nurse demonstrates competency in NGT care? Select all that apply.
- A. The nurse checks gastric residual every 4 hours for continuous feedings.
- B. The nurse maintains the client in a low Fowler's position during feeding.
- C. The nurse checks gastric residual before each bolus or intermittent feeding.
- D. The tubing is changed every 48 hours or when the bag appears visibly soiled.
- E. The nurse returns the residual to the stomach unless the volume is greater than 250 mL.
Correct Answer: A, C, E
Rationale: Checking residuals for continuous and bolus feedings and returning residuals (unless >250 mL) are standard. Low Fowler’s increases aspiration risk, and tubing change frequency varies by policy.
When preparing a client for admission to the surgical suite, the nurse recognizes that which one of the following items is most important to remove before sending the client to surgery?
- A. Hearing aid
- B. Contact lenses
- C. Wedding ring
- D. Dentures
Correct Answer: B
Rationale: Contact lenses must be removed before surgery to prevent corneal damage or injury under anesthesia, especially if electrocautery is used, which could cause burns if foreign objects are present in the eyes.
The client's intravenous (IV) line has a gauze pad wrapped around the IV catheter at the insertion site and a transparent dressing over the gauze dressing. How long after application should the nurse change the dressing?
- A. At the normal rotation time for the IV.
- B. When the transparent dressing loosens.
- C. In 48 hours.
- D. In 24 hours.
Correct Answer: B
Rationale: Transparent dressings should be changed when they loosen (B) or per facility policy (typically every 5-7 days unless soiled or loose). Fixed intervals (C, D) or IV rotation (A) do not apply directly.
A client with a tracheostomy is exhibiting difficulty breathing, and respirations are increasingly noisy. Secretions are very thick. Which of the following initial interventions is most indicated?
- A. Increase humidification, and suction the tracheostomy tube.
- B. Notify the physician.
- C. Sit the client upright, and encourage the client to breathe deeply and cough.
- D. Gently irrigate and suction the tracheostomy tube.
Correct Answer: A
Rationale: Thick secretions causing noisy respirations and breathing difficulty indicate the need for increased humidification to thin secretions and suctioning to clear the tracheostomy tube (A). Notifying the physician (B) or encouraging coughing (C) is secondary, and irrigation (D) is not typically the initial step.
A client with Crohn's disease requires TPN to provide adequate nutrition. The nurse finds the TPN bag empty. What fluid would the nurse select to hang until another bag is prepared in the pharmacy?
- A. Lactated Ringers
- B. Normal saline
- C. D10W
- D. Normosol R
Correct Answer: C
Rationale: D10W provides dextrose to prevent hypoglycemia, a risk when TPN (high in glucose) is abruptly stopped. Saline or other fluids don't provide necessary glucose.