A client is receiving miotics for the treatment of open-angle glaucoma. The nurse determines that a priority nursing problem is a “Risk for injury and this is based on which etiology?

Increased frequency of lacrimation.

Decreased night vision.

Increased sensitivity to light.

Diminished color perception.

Answer and Explanation

The Correct Answer is B

A) Increased frequency of lacrimation is not typically associated with miotic therapy. Miotics work by constricting the pupil and increasing outflow of aqueous humor to reduce intraocular pressure, but they do not directly affect lacrimation (tear production). Therefore, this option is not the etiology for the “Risk for injury” nursing problem.

B) Decreased night vision is a common side effect of miotic therapy. Miotics constrict the pupil, which can reduce the amount of light entering the eye, leading to impaired night vision or difficulty seeing in low-light conditions. This impaired vision increases the risk of injury, particularly in situations with reduced lighting.

C) Increased sensitivity to light (photophobia) is not typically associated with miotic therapy. Miotics constrict the pupil, which may actually reduce sensitivity to light by decreasing the amount of light entering the eye. Therefore, increased sensitivity to light is not the etiology for the “Risk for injury” nursing problem in this case.

D) Diminished color perception is not a common side effect of miotic therapy. Miotics primarily affect pupil constriction and intraocular pressure but do not typically alter color perception. Therefore, diminished color perception is not the etiology for the “Risk for injury” nursing problem.

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Correct Answer is A

Explanation

A) Sleeps soundly through the night: Zolpidem is a sedative-hypnotic medication commonly prescribed for the short-term treatment of insomnia in older adults. The desired outcome of administering zolpidem is improved sleep quality, including the ability to sleep soundly through the night. Documenting that the client sleeps soundly through the night indicates that the medication has achieved its intended effect of promoting sleep.

B) Exhibits fewer emotional outbursts: While zolpidem may indirectly contribute to emotional stability by improving sleep quality, it is not primarily indicated for reducing emotional outbursts. Therefore, this documentation does not specifically reflect the desired outcome of zolpidem administration.

C) Improved ability to concentrate: Zolpidem’s primary effect is on sleep induction rather than concentration. While improved sleep may indirectly enhance concentration in some cases, this documentation does not directly relate to the intended outcome of zolpidem therapy.

D) Decreased episodes of incontinence: Zolpidem is not indicated for the treatment of urinary incontinence, so documenting a decrease in episodes of incontinence would not reflect the desired outcome of zolpidem administration.

Therefore, the most appropriate documentation indicating that the desired outcome has been achieved when administering zolpidem to an older client is that the client “sleeps soundly through the night.” This reflects the medication’s primary purpose of improving sleep quality and duration.

A. Measure the client’s vital signs. B. Obtain a fingerstick blood glucose. C. Perform a neurological exam. D. Administer glucagon intramuscularly (IM).

Correct Answer is B

Explanation

A) While measuring the client’s vital signs is a routine nursing intervention, the reported symptoms of confusion and blurred vision after receiving glipizide suggest the possibility of hypoglycemia. Vital signs may not provide immediate information about the client’s glucose levels or help confirm hypoglycemia. However, if the client’s symptoms persist or worsen, assessing vital signs becomes important to monitor for signs of shock or other complications.

B) Obtaining a fingerstick blood glucose is the priority action in this situation. Glipizide is an oral antidiabetic medication that stimulates insulin release from the pancreas, leading to lower blood glucose levels. Symptoms such as confusion and blurred vision are indicative of hypoglycemia, a potential adverse effect of glipizide. Checking the client’s blood glucose level will confirm hypoglycemia and guide further interventions.

C) While performing a neurological exam may be warranted if the client’s symptoms persist or if there are concerns about other neurological issues, confirming hypoglycemia with a fingerstick blood glucose test should be the immediate priority.

D) Administering glucagon intramuscularly (IM) is indicated for severe hypoglycemia when the client is unconscious or unable to swallow. However, in this scenario, the client is conscious and able to report symptoms. Before administering glucagon, it is essential to confirm hypoglycemia with a blood glucose measurement to avoid unnecessary interventions.

Therefore, the nurse should promptly obtain a fingerstick blood glucose to confirm hypoglycemia and initiate appropriate treatment for the client’s symptoms.

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A client is receiving miotics for the treatment of open-angle glaucoma. The nurse determines that a priority nursing problem is a “Risk for injury and this is based on which etiology?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

When administering zolpidem to an older client, which computer documentation indicates that the desired outcome has been achieved?

Correct Answer is A

Explanation

A client reports confusion and blurred vision after receiving a dose of glipizide. Which action should the nurse implement?

Correct Answer is B

Explanation

Which instruction should the nurse include when teaching a client about self-administration of a bulk-forming laxative?

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The nurse is providing discharge instructions for a client with metastatic cancer who is proscribed morphine for bone pain. Which information from the client indicates to the nurse an understanding of the medication?

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A young adult female client who is planning to become pregnant asks the nurse if she can continue taking isotretinoin for cystic acne. Which information is most important for the nurse to provide this client?