Page 1999 - Saunders Comprehensive Review For NCLEX-RN

Rationale: Aspirin (acetylsalicylic acid) is contraindicated for GI bleeding and is
potentially ototoxic. The client should be advised to notify the prescribing primary
health care provider so the medication can be discontinued and/or a substitute that
is less toxic to the ear can be taken instead. Options 1, 2, and 4 do not have effects
that are potentially associated with hearing difficulties.
Test-Taking Strategy: Focus on the subject, the medication that may be causing
the client’s complaint. Review the classifications and/or therapeutic effects as well as
the side and adverse effects of each medication in the options. Of the medications
identified, only aspirin can cause ototoxicity. In addition, it is contraindicated for GI
bleed.
Level of Cognitive Ability: Analyzing
Client Needs: Physiological Integrity
Integrated Process: Nursing Process—Analysis
Content Area: Pharmacology: Pain: Nonopioid Analgesics
Health Problem: Adult Health: Ear: Vertigo/tinnitus
Priority Concepts: Safety; Sensory Perception
Reference: Hodgson, Kizior (2018), pp. 87-89.

703. Answer: 3

Rationale: Cyclopentolate is a rapidly acting mydriatic and cycloplegic
medication. Cyclopentolate is effective in 25 to 75 minutes, and accommodation
returns in 6 to 24 hours. Cyclopentolate is used for preoperative mydriasis, not pupil
constriction. The nurse should consult with the surgeon about the time of
administration of the eye drops, because 15 minutes is not adequate time for dilation
to occur.
Test-Taking Strategy: Note the strategic word, initial. Options 2 and 4 are
comparable or alike and are eliminated first (miosis refers to a constricted pupil).
Note that the question identifies a client being prepared for eye surgery. The pupil
would need to be dilated for the surgical procedure.
Level of Cognitive Ability: Analyzing
Client Needs: Physiological Integrity
Integrated Process: Nursing Process—Implementation
Content Area: Pharmacology: Eye and Ear Medications: Mydriatic, Cycloplegic,
Anticholinergics
Health Problem: Adult Health: Eye: Cataracts
Priority Concepts: Clinical Judgment; Safety
Reference: Lilley et al. (2017), p. 916.

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