A nurse is assessing a client's internal eye structures with an ophthalmoscope. Which of the following actions should the nurse take?
Position the examination light toward the client's face.
Stand on the right side of the client when examining the left eye.
Dim the lights in the room prior to the examination.
Place the ophthalmoscope directly against the client's forehead.
The Correct Answer is B
A. The examination light of the ophthalmoscope should be directed toward the client's eye, not the client's face.
B. When examining the left eye, the nurse should stand on the right side of the client to facilitate proper alignment of the ophthalmoscope with the client's eye.
C. Dimming the lights in the room may improve visualization of the client's internal eye
structures, but it is not typically necessary for ophthalmoscopic examination and may hinder the nurse's ability to assess the client effectively.
D. Placing the ophthalmoscope directly against the client's forehead would not facilitate proper examination of the internal eye structures and may cause discomfort to the client.
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Related Questions
Correct Answer is D
Explanation
- A) Utility: This principle is about producing the greatest good for the greatest number. In the case of a medication error, the focus is not on the collective good but on the individual patient's rights and well-being.
- B) Paternalism: This principle involves making decisions for others, potentially against their will, for their own good. It does not directly apply to the situation of a medication error where the patient's autonomy and right to be informed are paramount.
- C) Fidelity: This principle refers to loyalty and keeping one's promises. While important, it is secondary to the immediate need for honesty and transparency in the event of a medication error.
- D) Veracity: This principle obligates healthcare providers to tell the truth. When a medication error occurs, it is crucial to inform the patient about the mistake and the steps being taken to remedy it, making veracity the most applicable ethical principle in this scenario.
Correct Answer is D
Explanation
A. Wearing an N95 respirator is not necessary when caring for a client with neutropenia due to HIV unless the client has respiratory symptoms or is undergoing procedures that generate aerosols.
B. Inserting an indwelling urinary catheter should be avoided unless necessary, as it can
introduce the risk of infection, which is particularly concerning in clients with neutropenia.
C. Monitoring vital signs every 8 hours may not provide sufficient frequency for detecting changes in a client with neutropenia who may be at risk for rapid deterioration.
D. Using a dedicated stethoscope helps prevent the spread of infection to other clients by avoiding cross-contamination, which is especially important when caring for a client with neutropenia who is at increased risk of infection.
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