A nurse is reinforcing teaching about smoking cessation with a client who has chronic bronchitis and has smoked two packs of cigarettes per day for 30 years. Which of the following client statements indicates an understanding of the teaching?

A. Apply light pressure to the inner canthus just after instilling the eye drops: Applying gentle pressure to the nasolacrimal duct (punctal occlusion) prevents the medication from draining into the nasopharynx, reducing systemic absorption. This technique limits the drug’s entry into the bloodstream while maximizing local therapeutic effect in the eye.

B. Wipe the eye from the inner to the outer canthus with a sterile saline-moistened cotton ball: Wiping the eye from inner to outer canthus helps remove discharge and prevent contamination of the conjunctival sac, but it does not reduce systemic absorption of ophthalmic medications.

C. Administer the medication drops directly into the lower conjunctival sac of each eye: Placing drops in the lower conjunctival sac is standard technique for ocular administration, ensuring proper drug delivery. However, this alone does not prevent systemic absorption through the nasolacrimal duct.

D. Wait 5 min after instillation before instilling the drops in the other eye: Allowing time between eye drops prevents dilution or washout between medications in different eyes, but it does not affect systemic absorption from the nasolacrimal duct.

A. "I will have general anesthesia during the procedure.": Thoracentesis is performed using local anesthesia to numb the puncture site, not general anesthesia. Local anesthesia allows the client to remain awake, follow breathing instructions, and reduce procedural risk associated with systemic sedation. General anesthesia is unnecessary and increases potential complications.

B. "I will lie flat for 6 hours following the procedure.": After a thoracentesis, clients are generally encouraged to resume normal positioning as tolerated, often sitting upright or semi-Fowler’s position. Prolonged flat positioning is not required and does not prevent complications. Monitoring focuses on respiratory status and observing for pneumothorax.

C. "I will have a chest x-ray following the procedure.": A post-procedure chest x-ray is standard to confirm lung re-expansion and to check for complications such as pneumothorax or hemothorax. This imaging ensures that the lung has not been punctured or collapsed during fluid removal, and it guides further management if abnormalities are detected.

D. "I will breathe deeply through my nose during the procedure.": Clients are usually instructed to sit upright and remain still, with occasional breath-holding at end-inspiration during needle insertion. Breathing deeply through the nose is not a standard instruction and may increase movement, risking needle trauma to lung tissue.