Nokea
Which ototoxic medication should the nurse recognize as potentially life altering or threatening to the client?
- A. An oral calcium channel blocker.
- B. An intravenous aminoglycoside antibiotic.
- C. An intravenous glucocorticoid.
- D. An oral loop diuretic.
Correct Answer: B
Rationale: Aminoglycosides (e.g., gentamicin) are ototoxic, causing permanent hearing loss, which is life-altering. Calcium channel blockers, glucocorticoids, and loop diuretics are less ototoxic.
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A 50-year-old client is admitted with the diagnosis of open-angle glaucoma. Which of the following symptoms would the nurse expect the client to have?
- A. Severe eye pain
- B. Constant blurred vision
- C. Severe headaches, nausea, and vomiting
- D. Reports of seeing halos around objects
Correct Answer: D
Rationale: Open-angle glaucoma is characterized by halos around objects due to increased intraocular pressure, not severe pain or headaches.
The nurse is assessing the client’s sensory system. Which assessment data indicate an abnormal stereognosis test?
- A. The client is unable to identify which way the toe is being moved.
- B. The client cannot discriminate between sharp and dull objects.
- C. The toes contract and draw together when the sole of the foot is stroked.
- D. The client is unable to identify a key in the hand with both eyes closed.
Correct Answer: D
Rationale: Abnormal stereognosis is the inability to identify objects (e.g., a key) by touch with eyes closed, indicating parietal lobe dysfunction. Toe movement, sharp/dull, and Babinski reflex test other functions.
The client with severely diminished vision has difficulty with visual discrimination. Which interventions should the nurse recommend to improve the client's sight in the home environment? Select all that apply.
- A. Ensure that all room walls are painted with colors that blend.
- B. Use a white board and a black marker when writing out lists.
- C. Place Velcro tabs on wall light switches to ease locating them.
- D. Ensure that doorknobs on the doors are a bright contrasting color.
- E. Match the color of dishes with the color of table-cloths or placemats.
Correct Answer: B,C,D
Rationale: Using black on white enhances readability. Velcro tabs on light switches aid location in low vision. Contrasting doorknob colors improve safety. Blending wall colors or matching dish and tablecloth colors worsens visual discrimination.
The nurse is assessing the client receiving brimonidine eye drops. Which assessment findings will the nurse recognize as known side effects of brimonidine? Select all that apply.
- A. Blurred vision
- B. Ocular itching
- C. Ocular stinging
- D. Hearing loss
- E. Conjunctivitis
Correct Answer: A,B,C,E
Rationale: Brimonidine (Alphagan) is an alpha-2 adrenergic agonist; the nurse should recognize blurred vision, ocular itching, ocular stinging, and conjunctivitis as side effects of brimonidine. Hearing loss is not a side effect of brimonidine.
The client has had an enucleation of the left eye. Which intervention should the nurse implement?
- A. Discuss the need for special eyeglasses.
- B. Refer the client for an ocular prosthesis.
- C. Help the client obtain a seeing-eye dog.
- D. Teach the client how to instill eyedrops.
Correct Answer: B
Rationale: An ocular prosthesis restores appearance post-enucleation, addressing psychosocial needs. Eyeglasses, guide dogs, and eyedrops are irrelevant post-enucleation.