The nurse is teaching a client with newly diagnosed glaucoma about the condition. Which statement by the client indicates a need for further teaching?

“I should avoid activities that increase eye pressure, like heavy lifting.”

“Glaucoma can lead to vision loss if not managed properly.”

“Eye drops will cure my glaucoma and restore my vision.”

“Regular eye exams are important to monitor my condition.”

Answer and Explanation

The Correct Answer is C

Choice A reason: Avoiding heavy lifting is correct, as it increases intraocular pressure (IOP) in glaucoma, damaging the optic nerve. This statement shows understanding, as limiting activities that elevate IOP protects retinal ganglion cells, reducing progression risk, aligning with proper glaucoma management strategies.

Choice B reason: Glaucoma can cause vision loss if untreated, as elevated IOP damages optic nerve fibers, leading to irreversible blindness. This statement reflects accurate understanding of the disease’s progressive nature, emphasizing the need for management to preserve vision, requiring no further teaching.

Choice C reason: Eye drops (e.g., timolol) reduce IOP but do not cure glaucoma or restore vision, as optic nerve damage is irreversible. This statement indicates misunderstanding, as glaucoma is chronic, requiring lifelong management to slow progression, necessitating further teaching to correct this misconception.

Choice D reason: Regular eye exams monitor IOP and optic nerve health in glaucoma, preventing progression. This statement shows understanding, as consistent follow-up detects changes in retinal nerve fiber layer thickness, ensuring timely adjustments in therapy, aligning with effective disease management.

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Correct Answer is D

Explanation

Choice A reason: Keeping pressure on the abdomen and coughing is incorrect for diaphragmatic breathing, which enhances lung expansion, not airway clearance. Coughing is for post-drainage. The client’s incorrect technique (abdominal expansion on exhalation) requires correction, as this reverses mechanics, reducing ventilation efficiency in conditions like COPD.

Choice B reason: The client’s technique is incorrect, expanding the abdomen on exhalation, not inhalation, reducing diaphragmatic efficacy. Confirming it as correct is wrong, as it impairs lung expansion. Demonstrating proper technique corrects the error, ensuring effective breathing to improve oxygenation, addressing the physiological need for ventilation.

Choice C reason: Documenting success is inaccurate, as the client’s technique is reversed, expanding the abdomen on exhalation. Diaphragmatic breathing requires inhalation expansion to lower the diaphragm, increasing lung capacity. Correcting the technique via demonstration ensures proper mechanics, not documenting an ineffective method that hinders ventilation.

Choice D reason: Demonstrating proper diaphragmatic breathing corrects the client’s error of exhalation expansion. Inhaling expands the abdomen via diaphragmatic descent, increasing tidal volume; exhaling relaxes it. This optimizes ventilation, addressing the need for effective breathing in conditions requiring enhanced lung function, ensuring the client learns the correct technique.

A. Discourage straining on stool. B. Medicate with PRN IV narcotic. C. Initiate infusion for an IV fluid bolus. D. Administer an IV antiemetic.

Correct Answer is B

Explanation

Choice A reason: Discouraging straining on stool prevents pain exacerbation or constipation in cancer but is not the priority with a pain score of 9. Severe pain from bone metastases, stimulating nociceptors, requires urgent IV narcotics to improve comfort, addressing the primary palliative goal over secondary issues like straining.

Choice B reason: A pain score of 9 in metastatic bone cancer indicates severe nociceptive pain from tumor invasion. IV narcotics (e.g., morphine) rapidly bind opioid receptors, reducing pain perception. This prioritizes comfort in palliative care, especially with stable vitals (SpO₂ 95%), addressing pain before nausea in this critical scenario.

Choice C reason: An IV fluid bolus treats dehydration from vomiting but does not address severe pain (9/10), a palliative priority. Bone metastases cause intense pain, requiring narcotics. Fluids are secondary, as vitals (BP 110/80) suggest stability, making pain relief more urgent to enhance quality of life in palliative care.

Choice D reason: An IV antiemetic controls nausea, likely from tumor or treatment effects, but severe pain (9/10) is the priority in palliative care. Narcotics provide rapid relief for bone metastasis pain, improving comfort. Antiemetics are secondary, as pain significantly impacts quality of life more immediately than nausea.

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The nurse is teaching a client with newly diagnosed glaucoma about the condition. Which statement by the client indicates a need for further teaching?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse observes an adult client perform a return demonstration of diaphragmatic breathing. The client inhales while holding the abdomen, then removes the hand to allow expansion of the abdomen during exhalation. Which action should the nurse take after observing the client’s demonstration?

Correct Answer is D

Explanation

Correct Answer is B

Explanation

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