A patient presents to the emergency room with symptoms of severe eye pain, blurred vision, and nausea. The ophthalmologist diagnoses the patient with acute narrow-angle glaucoma. Which of the following interventions should be prioritized to alleviate the patient’s symptoms and prevent further complications?

Administer intravenous acetazolamide to reduce intraocular pressure.

Apply warm compresses to the affected eye to relieve pain.

Encourage the patient to drink plenty of fluids to stay hydrated.

Administer a mydriatic agent to dilate the pupil.

Advising the patient to limit fluid intake to prevent kidney damage is not appropriate. In fact, adequate hydration is crucial for patients with multiple myeloma to help flush out toxins and prevent kidney damage. Limiting fluid intake can lead to dehydration and worsen kidney function, which is already at risk due to the disease.

Answer and Explanation

The Correct Answer is A

Choice A Reason:

Administering intravenous acetazolamide is a critical intervention for acute narrow-angle glaucoma. Acetazolamide is a carbonic anhydrase inhibitor that reduces the production of aqueous humor, thereby lowering intraocular pressure (IOP) quickly. Reducing IOP is essential to prevent optic nerve damage and preserve vision. Normal IOP ranges from 10 to 21 mmHg, and in acute narrow-angle glaucoma, it can exceed 30 mmHg. Rapid reduction of IOP is crucial to alleviate symptoms and prevent further complications.

Choice B Reason:

Applying warm compresses to the affected eye is not an appropriate intervention for acute narrow-angle glaucoma. Warm compresses may provide temporary relief for some eye conditions, but they do not address the underlying issue of elevated intraocular pressure. In fact, warm compresses can potentially increase blood flow to the eye, which might exacerbate the condition.

Choice C Reason:

Encouraging the patient to drink plenty of fluids to stay hydrated is generally good advice for overall health, but it is not a prioritized intervention for acute narrow-angle glaucoma. Hydration does not directly impact intraocular pressure or alleviate the acute symptoms of glaucoma. The primary focus should be on reducing IOP to prevent optic nerve damage.

Choice D Reason:

Administering a mydriatic agent to dilate the pupil is contraindicated in acute narrow-angle glaucoma. Mydriatic agents can worsen the condition by further narrowing the anterior chamber angle, increasing intraocular pressure, and potentially causing more damage to the optic nerve. It is crucial to avoid pupil dilation in this scenario.

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Correct Answer is A

Explanation

Choice A Reason:

Storing hearing aids in a dry, cool place when not in use is crucial for maintaining their functionality and longevity. Moisture and heat can damage the delicate electronic components of hearing aids. Using a dehumidifier specifically designed for hearing aids can help prevent moisture buildup and extend the life of the devices.

Choice B Reason:

Using cotton swabs to clean the interior components of the hearing aid is not recommended. Cotton swabs can push debris further into the hearing aid and potentially damage the internal components. Instead, specialized cleaning tools such as wax loops, brushes, and earmold tubing blowers should be used to clean hearing aids properly.

Choice C Reason:

It is not okay to wear hearing aids while showering or swimming. Most hearing aids are water-resistant but not waterproof. Exposure to water can damage the hearing aids and affect their performance. It is important to remove hearing aids before any activities involving water.

Choice D Reason:

Replacing the batteries of hearing aids once a month regardless of usage is not necessary. Battery life depends on the type of hearing aid, the battery size, and the amount of usage. It is more practical to replace the batteries when they are low or depleted, as indicated by the hearing aid’s low battery warning.

A. Monitor platelet counts and assess for signs of bleeding. B. Administer aspirin to manage pain and prevent clot formation. C. Administer a diuretic to reduce fluid retention and swelling. D. Encourage the patient to increase physical activity to improve circulation.

Correct Answer is A

Explanation

Choice A Reason:

Monitoring platelet counts and assessing for signs of bleeding is crucial for managing thrombocytopenia. Thrombocytopenia is characterized by a low platelet count, which increases the risk of bleeding. Regular monitoring helps in detecting any significant drops in platelet levels, allowing for timely interventions to prevent severe bleeding. Assessing for signs of bleeding, such as petechiae, bruising, or nosebleeds, is essential to manage the condition effectively and prevent complications.

Choice B Reason:

Administering aspirin to manage pain and prevent clot formation is not appropriate for patients with thrombocytopenia. Aspirin is an antiplatelet agent that inhibits platelet function, which can exacerbate bleeding tendencies in patients with low platelet counts. Using aspirin in this context could increase the risk of bleeding and is therefore contraindicated.

Choice C Reason:

Administering a diuretic to reduce fluid retention and swelling is not relevant for managing thrombocytopenia. Diuretics are used to manage conditions like hypertension and edema but do not address the underlying issue of low platelet counts. In fact, diuretics can lead to electrolyte imbalances, which may complicate the patient’s condition further.

Choice D Reason:

Encouraging the patient to increase physical activity to improve circulation is not a priority intervention for thrombocytopenia. While physical activity is generally beneficial for overall health, it can increase the risk of trauma and bleeding in patients with low platelet counts. It is important to avoid activities that could lead to injury and bleeding in these patients.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is educating a patient on proper hearing aid care and maintenance. Which of the following statements should the nurse include in the teaching?

Correct Answer is A

Explanation

A 55-year-old male patient is admitted to the hospital with a diagnosis of thrombocytopenia. Upon assessment, you note petechiae on his lower extremities, and he reports fatigue and occasional nosebleeds. Which of the following interventions should be prioritized for this patient?

Correct Answer is A

Explanation

A 65-year-old patient has just received a blood transfusion. Shortly after the transfusion begins, the patient complains of chills, back pain, and difficulty breathing. What is the most likely cause of these symptoms?

A 72-year-old patient comes to the clinic complaining of sudden onset eye pain, nausea, and seeing halos around lights. The nurse notes that the patient’s pupil is mid-dilated and non-reactive to light. What is the most likely cause of these symptoms?

Which of the following is an appropriate treatment for Meniere’s disease?

A 65-year-old patient presents to the emergency department with sudden onset of flashes of light, a shadow over the visual field, and floaters in their right eye. What is the most likely diagnosis?

A 65-year-old patient with newly diagnosed multiple myeloma presents with bone pain and fatigue. Which of the following is the most appropriate initial nursing intervention?

A nurse is reinforcing teaching with a client who has type 1 diabetes mellitus about self-care during illness. Which of the following instructions should the nurse include in the teaching?