The practical nurse (PN) is reviewing instructions for the use of pilocarpine eye drops with a client who has glaucoma. The client states, "I should use these drops to anesthetize my eye if I experience eye pain.”. Which action should the PN implement?

Ask the client to describe the intensity of the eye pain using the numerical pain scale.

Remind the client that the action of the eye drops is to decrease internal eye pressure.

Document in the chart that the client understands the action and use of the eye drops.

Clarify with the client that eye pain in glaucoma is uncommon, so drops are rarely needed.

Answer and Explanation

The Correct Answer is B

Choice A rationale:

Asking the client to describe the intensity of the eye pain using the numerical pain scale is not the most relevant action in this situation. The client's statement indicates a misconception about the purpose of pilocarpine eye drops, so addressing this misunderstanding should be the focus.

Choice B rationale:

Reminding the client that the action of the eye drops is to decrease internal eye pressure is the appropriate action. Pilocarpine eye drops are used to treat glaucoma by reducing intraocular pressure, not to anesthetize the eye.

Choice C rationale:

Documenting in the chart that the client understands the action and use of the eye drops might be necessary but should not be the first action taken. The priority is to correct the client's misunderstanding about the eye drops.

Choice D rationale:

Clarifying with the client that eye pain in glaucoma is uncommon, so drops are rarely needed, is not accurate. While eye pain might not be a common symptom of glaucoma, pilocarpine eye drops are specifically used to manage intraocular pressure and are not intended to address eye pain.

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Correct Answer is B

Explanation

The correct answer is choice B: Monitor the client's hearing. Choice A rationale:

Observing the skin for a rash is not relevant to assessing for signs of ototoxicity. Aminoglycosides can cause skin reactions, but this is not a specific sign of ototoxicity.

Choice B rationale:

Monitoring the client's hearing is essential when administering aminoglycosides because these medications can cause ototoxicity, which is damage to the inner ear and auditory nerve leading to hearing loss or tinnitus. Regular hearing assessments can help detect any changes in hearing and prompt appropriate interventions.

Choice C rationale:

Measuring the urinary output is not directly related to assessing for ototoxicity.

Aminoglycosides can cause kidney toxicity, but this is a separate concern from ototoxicity. Choice D rationale:

Checking for changes in vision is not specifically associated with aminoglycoside administration. Vision changes are not a common side effect of these medications, so it would not be a primary assessment in this situation.

A. Place the client in an orthopneic position B. Keep the client NPO and encourage to void. C. Gather the procedure tray and equipment. D. Cleanse the site and cover with a sterile towel.

Correct Answer is C

Explanation

The correct answer is Choice C:

Gather the procedure tray and equipment. Choice A rationale:

Placing the client in an orthopneic position (sitting upright and leaning forward) is not necessary for a thoracentesis procedure. The position may be uncomfortable for the client and does not facilitate the procedure.

Choice B rationale:

Keeping the client NPO (nothing by mouth) and encouraging them to void before the procedure is not directly relevant to a thoracentesis. NPO status might be indicated for other procedures requiring anesthesia but not for a bedside thoracentesis.

Choice C rationale:

This is the correct choice. The PN should prepare by gathering the procedure tray and equipment before the healthcare provider arrives to perform the thoracentesis. This ensures that all necessary items are readily available for the procedure.

Choice D rationale:

Cleansing the site and covering it with a sterile towel is a task usually performed by the healthcare provider who will be performing the thoracentesis. The PN's role is to prepare the necessary equipment and assist the provider during the procedure.

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The practical nurse (PN) is reviewing instructions for the use of pilocarpine eye drops with a client who has glaucoma. The client states, "I should use these drops to anesthetize my eye if I experience eye pain.”. Which action should the PN implement?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The practical nurse (PN) is providing care for a client who is receiving an aminoglycoside to treat a bacterial infection. To assess for signs of ototoxicity, which action should the PN take?

Correct Answer is B

Explanation

A client is scheduled for a thoracentesis that will be done at the bedside. What should the practical nurse (PN) prepare before the healthcare provider arrives on the unit to perform the procedure?

Correct Answer is C

Explanation

Which finding should the practical nurse (PN) instruct the postpartum client to report to the charge nurse?

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The unlicensed assistive personnel (UAP) tells the practical nurse (PN) that a male client is angry because the night shift took over 2 hours to bring him the pain medication he had to request three times. Which action should the PN implement first?

The practical nurse (PN) is preparing for shift change. Which task has the highest priority and should be completed first?

The practical nurse (PN) finds a postoperative client lying in bed with an unsecured surgical dressing as seen in the picture. After reinforcing the dressing, which follow-up assessment is most important for the PN to implement?

The practical nurse (PN) observes an unlicensed assistive personnel (UAP) performing oral hygiene on an unconscious client who is lying in a flat side-lying position with an emesis basin on a towel under the chin. Which action should the PN take?