Question

A nurse is caring for a client who has a new diagnosis of primary open-angle glaucoma and a prescription for timolol ophthalmic drops. For which of the following adverse effects should the nurse monitor the client?

Answer 1

Correct Answers:

Bradycardia

Rationale :

🟠 Timolol is a beta-adrenergic blocker that, when absorbed systemically, may cause decreased heart rate or bradycardia.

🟠 Although it is administered as an ophthalmic drop, it can still be systemically absorbed through the nasolacrimal duct.

🟠 Nurses should advise clients to occlude the nasolacrimal duct after administration to minimize systemic absorption.

🟠 Clients should be monitored for signs of bradycardia, especially if they have pre-existing cardiac conditions.

🟠 This adverse effect is critical because it may compromise cardiac output in vulnerable individuals.

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Answer 2

Correct Answers:

Diarrhea

Rationale :

🟡 Pilocarpine is a cholinergic agent that stimulates the parasympathetic nervous system.

🟡 Its parasympathetic activity increases gastrointestinal motility, leading to potential diarrhea as a systemic effect.

🟡 Systemic absorption of ophthalmic cholinergics can result in muscarinic side effects, including sweating, salivation, and diarrhea.

🟡 Clients should be educated about these possible systemic symptoms when using pilocarpine drops.

🟡 Monitoring for GI symptoms is essential to detect systemic absorption early.

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Answer 3

Correct Answers:

streptococcal infection

Rationale :

🟢 Acute glomerulonephritis is commonly triggered by a recent streptococcal infection, especially pharyngitis or impetigo.

🟢 The immune response to the infection can lead to glomerular inflammation and damage.

🟢 Asking about a recent sore throat or skin infection is vital for establishing a causal relationship.

🟢 Early identification of streptococcal infection helps guide appropriate treatment and prevent complications.

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Answer 4

Correct Answers:

Conductive hearing loss in the left ear

Rationale :

🔵 In a Weber test, sound lateralizes to the affected ear in cases of conductive hearing loss.

🔵 The leftward localization suggests the left ear has a conductive issue, like cerumen impaction or fluid buildup.

🔵 This finding helps differentiate from sensorineural hearing loss, which would lateralize to the unaffected ear.

🔵 Conductive hearing loss impacts sound transmission, not nerve conduction, thus altering sound localization.

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Answer 5

Correct Answers:

Report signs of corneal rejection to the physician.

Rationale :

🟣 Cloudiness of the cornea after keratoplasty is a warning sign of graft rejection.

🟣 Rejection must be addressed promptly to preserve graft viability and prevent vision loss.

🟣 Other signs include redness, photophobia, and decreased vision.

🟣 Nurses should report such symptoms immediately to the provider for urgent management.

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Answer 6

Correct Answers:

Continuous swallowing

Rationale :

🟤 After a tonsillectomy, continuous swallowing may indicate active bleeding, as the child swallows blood.

🟤 This is a classic, often subtle, early sign of postoperative hemorrhage.

🟤 It requires immediate attention to prevent aspiration or shock.

🟤 Nurses should continuously observe for other signs like increased heart rate or vomiting blood.

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Answer 7

Correct Answers:

"Apply the ointment in a thin line into the conjunctival sac."

Rationale :

⚫ The conjunctival sac is the correct site for ophthalmic ointment application to ensure proper medication absorption.

⚫ A thin line prevents excess accumulation, which could cause blurred vision or discomfort.

⚫ The patient should close their eyes gently, not squeeze, to help spread the medication.

⚫ Proper technique ensures effectiveness and minimizes cross-contamination.

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Answer 8

Correct Answers:

Atropine sulfate (Isopto Atropine)

Rationale :

⚪ Atropine, an anticholinergic, causes mydriasis and cycloplegia, increasing intraocular pressure.

⚪ It is contraindicated in glaucoma, especially open-angle, as it worsens pressure build-up.

⚪ Safe glaucoma medications include miotics (e.g., pilocarpine) and beta-blockers (e.g., betaxolol).

⚪ Nurses should question atropine orders in glaucoma patients and notify the provider.

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Answer 9

Correct Answers:

Blood pressure 162/90 mm Hg

Rationale :

🟥 A blood pressure of 162/90 mm Hg is elevated and concerning in clients with glomerulonephritis, indicating worsening renal function.

🟥 Persistent hypertension in these patients can further damage glomeruli and reduce renal perfusion.

🟥 It increases the risk of acute kidney injury and long-term complications.

🟥 Immediate reporting allows prompt intervention, such as antihypertensives or fluid restriction.

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Answer 10

Correct Answers:

"I should call the clinic before taking any over-the-counter medications."

Rationale :

🟧 Clients with glaucoma must avoid medications that elevate intraocular pressure, including certain decongestants and antihistamines.

🟧 Over-the-counter drugs may contain anticholinergic or sympathomimetic agents, which can worsen the condition.

🟧 Nurses should reinforce the importance of consulting healthcare providers before taking any new medication.

🟧 This ensures medication safety and glaucoma control.

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ATI LPN Medsurg~2023

No.

1 :
A nurse is caring for a client who has a new diagnosis of primary open-angle glaucoma and a prescription for timolol ophthalmic drops. For which of the following adverse effects should the nurse monitor the client?

2 :
A nurse is collecting data from a client who self-administers pilocarpine ophthalmic drops. Which of the following findings by the nurse indicates a systemic adverse effect of this medication?

3 :
A client has been admitted to the hospital with acute glomerulonephritis. The nurse plans to collect data and initially asks the client about a recent history of:

4 :
A patient undergoing a Weber test says that the sound is louder in her left ear. What should this result indicate?

5 :
After keratoplasty, you observe that the patient's cornea is cloudy. What should you do?

6 :
A nurse is collecting data from a child who is postoperative following a tonsillectomy. Which of the following is a clinical manifestation of a hemorrhage?

7 :
A nurse is reinforcing teaching with a client with bacterial conjunctivitis of the right eye, and a prescription for an antibiotic ophthalmic ointment. Which of the following statements should the nurse make?

8 :
Which medication, if prescribed for the client with glaucoma, should the nurse question?

9 :
A nurse is caring for a client who has a diagnosis of acute glomerulonephritis. Which of the following should be reported immediately to the provider?

10 :
A nurse is reinforcing teaching with a client who has been newly diagnosed with chronic open angle glaucoma. Which of the following statements by the client indicates an understanding of the teaching?

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ATI LPN Medsurg~2023

No.

1 : A nurse is caring for a client who has a new diagnosis of primary open-angle glaucoma and a prescription for timolol ophthalmic drops. For which of the following adverse effects should the nurse monitor the client?

2 : A nurse is collecting data from a client who self-administers pilocarpine ophthalmic drops. Which of the following findings by the nurse indicates a systemic adverse effect of this medication?

3 : A client has been admitted to the hospital with acute glomerulonephritis. The nurse plans to collect data and initially asks the client about a recent history of:

4 : A patient undergoing a Weber test says that the sound is louder in her left ear. What should this result indicate?

5 : After keratoplasty, you observe that the patient's cornea is cloudy. What should you do?

6 : A nurse is collecting data from a child who is postoperative following a tonsillectomy. Which of the following is a clinical manifestation of a hemorrhage?

7 : A nurse is reinforcing teaching with a client with bacterial conjunctivitis of the right eye, and a prescription for an antibiotic ophthalmic ointment. Which of the following statements should the nurse make?

8 : Which medication, if prescribed for the client with glaucoma, should the nurse question?

9 : A nurse is caring for a client who has a diagnosis of acute glomerulonephritis. Which of the following should be reported immediately to the provider?

10 : A nurse is reinforcing teaching with a client who has been newly diagnosed with chronic open angle glaucoma. Which of the following statements by the client indicates an understanding of the teaching?

1 :
A nurse is caring for a client who has a new diagnosis of primary open-angle glaucoma and a prescription for timolol ophthalmic drops. For which of the following adverse effects should the nurse monitor the client?

2 :
A nurse is collecting data from a client who self-administers pilocarpine ophthalmic drops. Which of the following findings by the nurse indicates a systemic adverse effect of this medication?

3 :
A client has been admitted to the hospital with acute glomerulonephritis. The nurse plans to collect data and initially asks the client about a recent history of:

4 :
A patient undergoing a Weber test says that the sound is louder in her left ear. What should this result indicate?

5 :
After keratoplasty, you observe that the patient's cornea is cloudy. What should you do?

6 :
A nurse is collecting data from a child who is postoperative following a tonsillectomy. Which of the following is a clinical manifestation of a hemorrhage?

7 :
A nurse is reinforcing teaching with a client with bacterial conjunctivitis of the right eye, and a prescription for an antibiotic ophthalmic ointment. Which of the following statements should the nurse make?

8 :
Which medication, if prescribed for the client with glaucoma, should the nurse question?

9 :
A nurse is caring for a client who has a diagnosis of acute glomerulonephritis. Which of the following should be reported immediately to the provider?

10 :
A nurse is reinforcing teaching with a client who has been newly diagnosed with chronic open angle glaucoma. Which of the following statements by the client indicates an understanding of the teaching?