Answer to Question 1
C
Holding the eyedropper approximately 1 to 2 cm ( to inch) above the conjunctival sac of the eye prevents accidental contact of the eyedropper with the eye and reduces risk for injury and transfer of microorganisms to the dropper. The cornea is very sensitive. If drops were instilled onto the cornea, this would stimulate the blink reflex. The tissue should be placed just below the lower eyelid so medication that escapes the eye is absorbed. Wiping the eye removes too much of the medication. Squinting or squeezing the eyelids after instillation forces the medication from the conjunctival sac.
Answer to Question 2
C
In the patient with COPD, high levels of oxygen can extinguish the stimulus to breathe. In the individual with healthy lungs, the chemoreceptors are sensitive to small changes in carbon dioxide levels and effectively regulate ventilation. In patients with COPD who retain carbon dioxide, the chemoreceptors are not sensitive to small changes in carbon dioxide and regulate ventilation poorly. In these patients, it is the change in the oxygen level that stimulates changes in ventilation. Patients with COPD are at risk of retaining carbon dioxide and developing carbon dioxide narcosis induced by administration of high levels of oxygen. Uncontrolled oxygen administration may cause acute hypoventilation and carbon dioxide retention with dire consequences. Arterial oxygen saturation levels should be at 88 to 92 and no higher. Some patients with COPD have normal oxygen levels during the day but oxygen desaturation during sleep.
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