The nurse is preparing an older adult client for discharge following cataract extraction. Which instruction should be included in the discharge teaching?

Avoid straining at stool, bending, or lifting heavy objects.

Irrigate conjunctiva with ophthalmic saline prior to instilling antibiotic ointment.

Do not read without direct lighting for 6 weeks.

Limit exposure to sunlight during the first 2 weeks when the cornea is healing.

Answer and Explanation

The Correct Answer is A

A. Avoid straining at stool, bending, or lifting heavy objects: These activities can increase intraocular pressure and disrupt healing of the surgical site after cataract extraction. The client should be taught to avoid anything that could strain the eye and risk complications like hemorrhage or wound dehiscence.

B. Irrigate conjunctiva with ophthalmic saline prior to instilling antibiotic ointment:
Routine irrigation is not required and may introduce additional risk. Clients are instructed on proper hand hygiene and drop instillation rather than conjunctival irrigation.

C. Do not read without direct lighting for 6 weeks: While good lighting helps reduce eye strain, reading in lower light does not delay healing after cataract surgery. This instruction is unnecessary and could limit the client’s ability to resume normal activities.

D. Limit exposure to sunlight during the first 2 weeks when the cornea is healing: Although bright light can be uncomfortable post-surgery, wearing sunglasses typically offers sufficient protection. There is no requirement to restrict sunlight exposure completely.

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Correct Answer is ["B","C"]

Explanation

A. Contagious until symptoms subside: Streptococcal pharyngitis is contagious until 24 hours after starting antibiotics, not until all symptoms are gone. This is important for limiting transmission to others in the household or school setting.

B. Sandpaper-like rash: A sandpaper-textured rash is a hallmark sign of scarlet fever, which is a complication of strep throat. It usually begins on the neck or chest and spreads, often feeling coarse to the touch.

C. Peeling and flaking skin in a week: Desquamation, or skin peeling, is common several days after a strep rash subsides, particularly on the hands and feet. This symptom signals the healing phase of scarlet fever.

D. Darkening of skin under arms: Darkened underarm skin is typically linked to acanthosis nigricans, associated with insulin resistance or obesity. It is not seen with streptococcal infections or fever-related conditions.

E. Fever lasting for 7 to 10 days: Fever from strep throat usually resolves quickly within 24–48 hours of initiating antibiotic therapy. Prolonged fever would be atypical and requires further evaluation for complications.

A. Encourage the client's family to visit more often. B. Encourage the client to participate in group activities. C. Engage the client in non-threatening conversations. D. Schedule a daily conference with the social worker.

Correct Answer is C

Explanation

A. Encourage the client's family to visit more often: The client is withdrawn, increased visits may feel overwhelming. This approach assumes the client is ready for interaction, which may not be the case, and does not directly address communication barriers.

B. Encourage the client to participate in group activities: This may be premature for a client who is severely withdrawn. Pushing participation too soon may increase distress or resistance, making rapport-building through simpler interactions more effective initially.

C. Engage the client in non-threatening conversations: Starting with gentle, non-intrusive conversations helps build trust and re-establish communication. It meets the client where they are emotionally and lays a foundation for further therapeutic engagement without increasing anxiety or pressure.

D. Schedule a daily conference with the social worker: Daily meetings may not be feasible or welcomed by a withdrawn client. Interventions should first aim to re-establish connection through nurse-client interaction.

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The nurse is preparing an older adult client for discharge following cataract extraction. Which instruction should be included in the discharge teaching?

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Naxlex Comprehensive Predictor Exams

Correct Answer is ["B","C"]

Explanation

The nurse notes that a client with depression has been more withdrawn and noncommunicative during the past two weeks. Which intervention is most important to include in the updated plan of care for this client?

Correct Answer is C

Explanation

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