A nurse in the emergency department is preparing to irrigate the eyes of a client who received a chemical splash on their face. Which of the following actions should the nurse take?

Completely irrigate one eye before irrigating the second eye.

Inform the client they will need to blink their eyes rapidly during the irrigation process.

Delay the irrigation process until the type of chemical in the eyes is identified.

Ask the client to count the number of fingers held up by the nurse prior to irrigating their eyes.

Answer and Explanation

The Correct Answer is A

Choice A rationale:

Completely irrigating one eye before irrigating the second eye is the correct action to take when a client receives a chemical splash on their face. This approach helps prevent the potential spread of the chemical from one eye to the other. Irrigation should be done immediately to flush out the chemical and minimize its harmful effects.

Choice B rationale:

Informing the client to blink their eyes rapidly during the irrigation process is not recommended. Blinking may exacerbate the dispersion of the chemical and could lead to further damage to the eyes. Instead, the client should keep their eyes open during irrigation.

Choice C rationale:

Delaying the irrigation process until the type of chemical in the eyes is identified is not appropriate. Time is critical in minimizing the impact of the chemical on the eyes. Immediate irrigation is essential, regardless of the type of chemical, to remove the substance from the eyes.

Choice D rationale:

Asking the client to count the number of fingers held up by the nurse before irrigating their eyes is not relevant in this situation. The priority is to initiate immediate irrigation to remove the chemical from the eyes. Assessing the client's visual acuity can be done later in the evaluation process after the eyes have been irrigated.

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Correct Answer is D

Explanation

Choice A rationale:
(Potassium level) Lovastatin is a medication used to treat high cholesterol levels. While potassium levels are important to monitor for certain conditions, they are not directly related to the initiation of lovastatin therapy. Therefore, this is not the correct choice for diagnostic testing before starting the medication.
Choice B rationale:
(Hemoglobin level) Hemoglobin levels are important to assess for anemia or other blood disorders. However, they are not specifically required before starting lovastatin therapy. Therefore, this is not the correct choice for diagnostic testing before starting the medication.
Choice C rationale:
(Kidney function tests) While kidney function tests are essential for many medications to ensure proper excretion and avoid toxicity, they are not directly related to the initiation of lovastatin therapy. Therefore, this is not the correct choice for diagnostic testing before starting the medication.
Choice D rationale:
(Liver function tests) Liver function tests are crucial before starting lovastatin therapy. Lovastatin is metabolized in the liver, and it can potentially cause liver damage or abnormalities in liver enzymes. Monitoring liver function helps detect any pre-existing liver conditions and ensures the safe use of the medication. Therefore, this is the correct choice for diagnostic testing before starting the medication.

A. Administer the medication no faster than 100 mg/min. B. Monitor plasma phenytoin levels to establish the therapeutic range. C. Add the medication to the existing IV solution. D. Monitor the client for hypertension.

Correct Answer is A

Explanation

Choice A rationale:

Administering phenytoin IV no faster than 100 mg/min is crucial to prevent adverse effects such as cardiovascular collapse or severe hypotension. Rapid administration of phenytoin can cause cardiac arrhythmias and should be avoided.

Choice B rationale:

Monitoring plasma phenytoin levels to establish the therapeutic range is a necessary action in managing the client's seizure disorder, but it does not pertain to the specific administration of phenytoin via intermittent bolus.

Choice C rationale:

Adding the medication to the existing IV solution is not appropriate for phenytoin administration. Phenytoin should be administered separately and not mixed with other IV solutions to maintain its stability and prevent interactions.

Choice D rationale:

Monitoring the client for hypertension is not directly related to the administration of phenytoin via intermittent bolus. Hypertension is not a common adverse effect of this medication. However, blood pressure should be monitored as part of routine care for any client on antiepileptic therapy.

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A nurse in the emergency department is preparing to irrigate the eyes of a client who received a chemical splash on their face. Which of the following actions should the nurse take?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is teaching a client who has a new prescription for lovastatin. Which of the following diagnostic tests should the nurse instruct the client to complete before starting the medication?

Correct Answer is D

Explanation

A nurse is planning to administer phenytoin IV via intermittent bolus to a client who has a seizure disorder and is receiving a continuous IV infusion of dextrose 5% in water (D5W). Which of the following actions should the nurse plan to take?

Correct Answer is A

Explanation

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