An environmental service attendant is brought to an urgent care clinic after having bleach splash to their eyes and face.
The client spent 10 minutes at the eye wash station rinsing their face and eyes prior to arrival.
The client reports 9 (0-10 scale) of burning to their eyes and periorbital area.
The sclera of both eyes are deep red.
The urgent care nurse will first:

Review the safety data sheet online for products with bleach.

Continue irrigating eyes with saline until pain-free, then check pH of both eyes.

Contact the physician for miotic ophthalmic drops for pain control.

Assess visual acuity of both eyes and check vital signs.

Answer and Explanation

The Correct Answer is B

Choice A rationale

Reviewing the safety data sheet does not directly alleviate the immediate chemical injury or prevent further damage. Immediate irrigation of the eyes is the priority after chemical exposure to minimize damage to the ocular surface.

Choice B rationale

Continuous irrigation removes chemical agents from the eyes and prevents further damage. Ensuring a pain-free state and checking pH confirm the removal of irritants, essential for preventing deeper eye tissue damage.

Choice C rationale

Miotic drops reduce intraocular pressure but do not address acute chemical injury. Pain relief is secondary to irrigating and neutralizing pH, which directly prevents ongoing tissue damage and irritation.

Choice D rationale

Assessing visual acuity and vital signs is important but secondary to preventing further chemical penetration. Immediate irrigation prevents damage progression and is prioritized over assessments during the acute phase of exposure.

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Correct Answer is C

Explanation

Choice A rationale

Soft stools and flatus indicate proper gastrointestinal function, suggesting tolerance to feeding. With no adverse symptoms, it is not scientifically valid to hold enteral feeding based on these findings alone.

Choice B rationale

Diluting medications with D5W and flushing ensures patency but does not address potential complications like abdominal distention or bowel sounds. RLQ tenderness must first be evaluated for safety.

Choice C rationale

Abdomen distention with hypoactive bowel sounds and RLQ tenderness suggests possible ileus or bowel obstruction. Discussing this condition with the prescriber ensures safe feeding practices and prevents worsening complications.

Choice D rationale

Residual formula checks are relevant for gastric, not jejunostomy, feeding. Scientific practice discourages assessing residual in jejunostomy feeding as the tube bypasses the stomach.

A. Patient's heart rate is 62 and regular. B. Patient is able to lie flat without reporting difficulty breathing. C. Patient does not report dyspnea after climbing one flight of stairs. D. Patient has weight loss of 3 lbs (1.4 kg) over 2 weeks.

Correct Answer is A

Explanation

Choice A rationale

Metoprolol decreases cardiac workload by reducing heart rate and myocardial oxygen demand. A heart rate of 62 is within normal limits, demonstrating effective beta-blocker action and improved cardiac efficiency.

Choice B rationale

Lying flat without difficulty breathing reflects improved respiratory status, which is more related to pulmonary management, not directly indicative of reduced cardiac workload or beta-blocker efficacy.

Choice C rationale

Absence of dyspnea after climbing stairs suggests improved physical fitness but does not directly measure the cardiac effects of metoprolol, which targets heart rate reduction and myocardial oxygen use.

Choice D rationale

Weight loss is related to overall health improvement or dietary changes rather than specific effects of metoprolol, which primarily impacts heart rate and cardiac oxygen consumption.

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Naxlex Comprehensive Predictor Exams

A client with a severe stroke has been prescribed enteral feedings via a jejunostomy tube.For safe administration, the nurse should:

Correct Answer is C

Explanation

A patient is prescribed metoprolol in the treatment of stable angina.What is the best outcome measure of decreased cardiac workload due to metoprolol for the nurse to evaluate?

Correct Answer is A

Explanation

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