A client with Bell palsy cannot completely close the affected eye. Which instruction is most important for the nurse to include in the care plan?
1Patch both eyes throughout the day to keep facial movements symmetrical
2Rinse the affected eye with tap water whenever dryness becomes noticeable again
3Use prescribed lubricating drops and protect the affected eye during sleep✓ Correct answer
4Exercise the eyelid against resistance until complete closure returns
Explanation
Incomplete eyelid closure exposes the cornea to drying and injury. Lubricating drops or ointment and nighttime eyelid protection maintain moisture while facial nerve function recovers; forceful exercise and tap-water rinsing do not protect the cornea.
Quick answer Lubricate and protect the eye that cannot close, especially during sleep, to prevent corneal injury.
Why this is correct Facial nerve weakness reduces blinking and full eyelid closure. Without a normal protective tear film, the cornea can dry, abrade, or ulcerate, so moisture and physical protection are priorities.
Easy analogy or mental picture The eyelid is a windshield wiper and cover for the cornea; Bell palsy leaves the surface exposed. Lubrication supplies moisture, but the analogy does not replace assessment for redness, pain, or vision change.
Memory hook Bell palsy plus incomplete eye closure means protect moisture and protect the cornea.
NCLEX decision rule When facial weakness prevents eyelid closure, prioritize corneal protection with prescribed lubrication and secure nighttime coverage. Teach the client to report pain, redness, or visual change promptly.
Why the other choices are wrong Patching the unaffected eye impairs safety without benefit. Tap water is not a lubricant, and resisted eyelid exercise can add irritation without reliably restoring nerve function.
References
[1]
NCSBN: 2026 NCLEX-RN Test PlanNational Council of State Boards of Nursing
[2]
NCBI Bookshelf: Bell PalsyU.S. National Library of Medicine