A middle-aged client reports a sudden onset of seeing flashing lights and floating spots. Which is the best nursing action?
Initiate a referral for ophthalmic evaluation as soon as possible.
Advise the client to maintain normal activities, but avoid contact sports until the spots resolve
Instruct the client to rest, and report to the emergency department if eye pain develops.
Tell the client to apply warm, moist compresses and notify the healthcare provider if there is no improvement.
The Correct Answer is A
A. The sudden onset of flashing lights and floaters can be a symptom of a detached retina, a serious eye condition that requires immediate medical attention.
B. This is incorrect. The client should not engage in any activities until the condition is evaluated by a healthcare professional.
C. While rest might seem appropriate, the client should seek immediate medical attention due to the potential seriousness of the symptoms.
D. Warm compresses are not indicated for this condition, and the client should seek immediate medical attention.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. This is the safest and most accurate option. Insulin dosing is critical, and an overdose can lead to hypoglycemia, a serious condition. By discarding the incorrect dose and starting anew, the nurse ensures the client receives the precise amount of insulin prescribed.
B. This option is inefficient and increases the risk of error. It involves using two different methods for insulin administration, which can lead to confusion and potential mistakes. Additionally, it doesn't address the initial error of dialing the incorrect dose.
C. This option is extremely dangerous. Administering more insulin than prescribed can lead to severe hypoglycemia. Wasting the remaining four units does not rectify the primary issue of the overdose.
D. Insulin pens are designed for precision. Altering the dialed dose after an error can compromise the accuracy of the insulin delivery system. This method is not reliable and can lead to inaccurate dosing.
Correct Answer is D
Explanation
A. Anxiety is a common symptom in patients with thyrotoxicosis due to increased metabolic activity and overstimulation of the nervous system. While anxiety can be distressing, it is not typically life- threatening and does not usually require immediate intervention.
B. Hyperglycemia (high blood glucose levels) can occur in patients with thyrotoxicosis due to increased metabolic rate and potential effects on insulin sensitivity. It requires monitoring and management but typically does not demand immediate intervention unless it is severe and causing other complications.
C. Fever can be a sign of thyroid storm, a severe form of thyrotoxicosis that can be life-threatening. Elevated body temperature in the context of thyrotoxicosis requires prompt assessment as it may indicate an underlying severe condition or complications.
D. Dyspnea is a critical symptom that warrants immediate intervention. In the context of thyrotoxicosis, it may indicate a severe complication such as heart failure, thyroid storm, or respiratory distress. Given that dyspnea can lead to compromised oxygenation and potentially life-threatening situations, it is the most urgent symptom to address.
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