For a client who has undergone surgery to repair a retinal detachment in the left eye, which intervention should the nurse implement during the postoperative period?
Obtain vital signs every 2 hours during hospitalization.
Encourage deep breathing and coughing exercises.
Provide an eye shield to be worn while sleeping.
Teach a family member to administer eye drops.
The Correct Answer is C
Choice A reason: Obtaining vital signs every 2 hours is standard postoperative care but does not specifically address the needs of a client recovering from retinal detachment surgery.
Choice B reason: While deep breathing and coughing exercises are important postoperative interventions, they are not specific to the care of a client after retinal detachment surgery.
Choice C reason: Providing an eye shield for sleep helps to protect the eye from accidental rubbing or pressure, which is critical after retinal surgery.
Choice D reason: Teaching a family member to administer eye drops is important for ongoing care but is not as immediately critical as protecting the eye from injury.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","B","D","E","F","G"]
Explanation
Choice A Reason: Allowing for menu deviations can help accommodate the patient’s preferences and encourage eating, which is crucial for recovery from emaciation.
Choice B Reason: Setting precise mealtimes can provide structure and consistency, which may help the patient establish regular eating habits.
Choice C Reason: Encouraging exercise is not appropriate at this stage due to the patient’s bradycardia and low BMI, which indicate a high risk for physical complications.
Choice D Reason: Monitoring trips to the restroom is important to prevent purging behaviors, which can be a concern in patients with eating disorders.
Choice E Reason: Providing family education on the condition is essential to ensure that the family understands the patient’s needs and how to support her recovery.
Choice F Reason: Weighing the patient twice weekly can help monitor her progress and adjust the treatment plan as needed.
Choice G Reason: Acknowledging feelings of anxiety is important for addressing the psychological aspects of the patient’s condition and promoting a supportive environment.
Correct Answer is A
Explanation
Choice A reason: The immediate activation of the lockdown procedure is critical in the event of a suspected infant abduction, as it helps to secure the facility and prevent the unauthorized removal of the infant.
Choice B reason: Matching ID bands is a standard procedure but not the first action to take in a potential abduction scenario.
Choice C reason: Asking the mother about expected visitors is part of the investigation but does not take precedence over securing the facility.
Choice D reason: Determining if the newborn is in the nursery is important but should follow the immediate security measures.
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