An older client arrives at the outpatient eye surgery clinic for a right cataract extraction and lens implant. During the immediate postoperative period, which intervention should the nurse implement?

Correct Answer: A

Rationale: Post-cataract extraction, the nurse should provide an eyeshield to be worn while sleeping. This protects the surgical eye from accidental rubbing or pressure, which could dislodge the lens implant or cause infection during the vulnerable healing phase. Breathing exercises are for pulmonary issues, frequent vital signs aren't routine for outpatient surgery, and teaching eye drop administration is important but secondary to immediate protection, making the eyeshield the priority intervention.

Correct Answer: B

Rationale: Glomerular filtrate is the fluid filtered from blood plasma into the glomerular capsule. It contains water, electrolytes, glucose, and small molecules but has far fewer proteins due to the filtration membrane's selective barrier (fenestrated endothelium, basement membrane, podocytes), which restricts large proteins like albumin. Plasma retains these proteins, and filtrate includes glucose and sodium in similar concentrations to plasma initially, making B the key difference.

Correct Answer: D

Rationale: The glomerular filtration rate (GFR) is about 125 ml/min, producing 180 L/day of filtrate, but only 1-2 L of urine is excreted daily. Thus, approximately 1% of the GFR is excreted, with 99% reabsorbed by the tubules. Option A reverses this, B underestimates reabsorption, and C is too low, making D the correct statement.

Correct Answer: C

Rationale: Bicarbonate (HCO₃⁻) reabsorption in the proximal tubule involves H⁺ secretion combining with HCO₃⁻ to form H₂CO₃, which breaks into CO₂ and H₂O via luminal carbonic anhydrase (not extracellular). CO₂ diffuses into cells, reforming HCO₃⁻ intracellularly with intracellular carbonic anhydrase. Tubules are impermeable to HCO₃⁻ (D is true), making C false due to the enzyme location error.

Correct Answer: C

Rationale: ADH administration corrects diuresis from ADH deficiency (A) by increasing water reabsorption and may mitigate excess water intake (B) by concentrating urine. However, in nephrogenic diabetes insipidus (C), the kidneys don't respond to ADH due to receptor or aquaporin defects, so diuresis persists despite ADH, making C the exception.