A client does not understand why vision loss due to glaucoma is irreversible. What is the nurse's best explanation?
Once the tissue has necrosed from high pressure, it does not regenerate.
Glaucoma always leads to permanent blindness.
Once retinal detachment occurs, it does not return to its normal state.
Once bacterial infection has caused damage, the tissue does not regenerate.
The Correct Answer is A
Choice A reason: Once the tissue has necrosed from high pressure, it does not regenerate is the best explanation, because it describes the mechanism and outcome of glaucoma. Glaucoma is a condition that causes increased intraocular pressure, which damages the optic nerve and the retina, the tissues that are responsible for transmitting and processing visual information. Once these tissues are necrosed, or dead, they do not regenerate, or grow back, resulting in irreversible vision loss.
Choice B reason: Glaucoma always leads to permanent blindness is not a good explanation, because it is inaccurate and pessimistic. Glaucoma does not always lead to permanent blindness, but rather to progressive vision loss that can be prevented or slowed down with early diagnosis and treatment. Glaucoma can cause peripheral vision loss, tunnel vision, or blind spots, but not necessarily complete blindness.
Choice C reason: Once retinal detachment occurs, it does not return to its normal state is not a good explanation, because it is irrelevant and misleading. Retinal detachment is a condition that occurs when the retina separates from the underlying layer of blood vessels, which can cause vision loss or blindness. However, retinal detachment is not caused by glaucoma, nor is it a common complication of glaucoma. Retinal detachment can sometimes be repaired with surgery, depending on the extent and duration of the detachment.
Choice D reason: Once bacterial infection has caused damage, the tissue does not regenerate is not a good explanation, because it is incorrect and confusing. Bacterial infection is not a cause or a consequence of glaucoma, but rather a separate condition that can affect the eye. Bacterial infection can cause inflammation, pain, discharge, or redness in the eye, but not necessarily vision loss or tissue necrosis. Bacterial infection can usually be treated with antibiotics, which can prevent or reverse the damage.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: This is an incorrect statement because it is not based on any assessment or diagnosis. Osteoporosis is a condition that affects the bones, not the joints. It also does not cause fatigue. The nurse should not make assumptions or give advice without proper evaluation.
Choice B reason: This is an incorrect statement because it is dismissive and insensitive. Arthritis is a general term that covers many types of joint inflammation and pain. It is not a simple condition that can be treated with just ibuprofen. The nurse should not minimize the patient's concerns or prescribe medication without a doctor's order.
Choice C reason: This is the correct statement because it shows empathy and interest in the patient's situation. It also helps the nurse gather more information about the onset, duration, frequency, and severity of the pain. This can help the nurse identify possible causes and plan appropriate interventions.
Choice D reason: This is an incorrect statement because it is rude and judgmental. Weight loss may or may not help with joint pain, depending on the underlying cause. The nurse should not blame the patient or make them feel guilty. The nurse should focus on the patient's current symptoms and needs, not their appearance or lifestyle.
Correct Answer is D
Explanation
Choice A reason: Use gentle brushing and flossing techniques for clients with fragile mucosa is an important nursing intervention, but it is not the priority. Gentle brushing and flossing can help prevent plaque, gingivitis, and infection in the oral cavity, especially for clients with fragile mucosa due to dehydration, medication, or radiation. However, this intervention is not as urgent as having a suction apparatus ready at the bedside.
Choice B reason: Handle dentures with care is an important nursing intervention, but it is not the priority. Handling dentures with care can prevent damage, loss, or misplacement of the dentures, which can affect the client's comfort, appearance, and nutrition. However, this intervention is not as urgent as having a suction apparatus ready at the bedside.
Choice C reason: Position the client on one side with the head turned towards you is an important nursing intervention, but it is not the priority. Positioning the client on one side with the head turned towards you can facilitate the access and visibility of the oral cavity, as well as prevent the aspiration of saliva, blood, or debris. However, this intervention is not as effective as having a suction apparatus ready at the bedside.
Choice D reason: Have a suction apparatus ready at the bedside is the priority nursing intervention, because it can prevent the aspiration of saliva, blood, or debris, which can cause choking, pneumonia, or respiratory distress. Having a suction apparatus ready at the bedside can allow the nurse to quickly and safely remove any secretions or foreign materials from the oral cavity or the airway of the unconscious client.
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