Difficulty: Medium
Average Score: 65%
Simulated
A client is recovering from the surgical removal of glass in the right eye. Which intervention should the nurse implement immediately following the procedure?
Correct answer
B
Rationale
An eye shield protects the surgical site from accidental trauma, especially during sleep when the client might inadvertently rub or press on the eye. This is a critical safety measure following ocular surgery. Teaching eye drop administration is important but not the immediate postoperative priority. Vital sign monitoring is standard but not specific to eye surgery. Deep breathing and coughing exercises are important for preventing pulmonary complications but are not specifically indicated after eye surgery and could increase intraocular pressure if done forcefully.