A nurse in an ophthalmology clinic is assessing a client who has suspected primary open-angle glaucoma (PAOG). Which assessment finding would support a diagnosis of this type of glaucoma?

Loss of peripheral vision

Opacity of the lens

Decrease in color perception

Pain and purulent discharge

Answer and Explanation

The Correct Answer is A

A.   Loss of peripheral vision is a hallmark sign of primary open-angle glaucoma. In POAG, increased intraocular pressure causes damage to the optic nerve, leading to a gradual loss of peripheral vision. This vision loss is often subtle and progresses slowly, making it difficult for individuals to notice until the condition is advanced.

B.   Opacity of the lens is characteristic of cataracts, not glaucoma. Cataracts involve the clouding of the eye's natural lens, which leads to blurred vision and difficulties with seeing clearly, particularly in bright light. While cataracts and glaucoma can occur simultaneously, opacity of the lens is not indicative of POAG.
C.   Decrease in color perception can be associated with various eye conditions, including age-related macular degeneration (AMD) and certain types of retinal diseases. While it can occur in glaucoma as the disease progresses, it is not the primary or most characteristic sign of POAG.
D.   Pain and purulent discharge are more associated with acute conditions such as conjunctivitis (pink eye) or an eye infection, rather than primary open-angle glaucoma. POAG typically presents without pain or discharge, as it is a chronic condition with a gradual onset of symptoms.

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Correct Answer is A

Explanation

This is the correct expected outcome if the test is positive for myasthenia gravis. Edrophonium works quickly to increase acetylcholine levels, leading to temporary improvement in muscle strength. In a patient with myasthenia gravis, administration of edrophonium typically results in a rapid improvement in symptoms like facial weakness and ptosis within 30 to 60 seconds, with the effects lasting for a few minutes. This brief improvement is indicative of a positive result for myasthenia gravis.
B.A Worsening symptoms after administration of edrophonium are not expected and could indicate an adverse reaction or incorrect diagnosis. In myasthenia gravis, edrophonium typically improves symptoms rather than worsening them.
C. No change in symptoms would be unexpected in the case of myasthenia gravis. If edrophonium is effective, there should be a noticeable improvement in symptoms. If there is no change, it might suggest a diagnosis other than myasthenia gravis or that the test is inconclusive.
D. This outcome is not expected. Edrophonium has a very short duration of action, typically relieving symptoms for only a few minutes. The effects do not last for 24 hours. A longer-lasting improvement might be observed with other treatments for myasthenia gravis, such as anticholinesterase medications like pyridostigmine, but not with edrophonium.

A. Laparoscopic splenectomy B. Transfusion of platelets C. Replacement of ADAMTS-13 D. Administration of protamine sulfate

Correct Answer is A

Explanation

A. Laparoscopic splenectomy involves the surgical removal of the spleen. The spleen is an organ where platelets are often destroyed in ITP. Removing the spleen can reduce the destruction of platelets and potentially improve platelet counts. This procedure is considered when medical therapy fails to adequately control the condition and is often effective in increasing platelet counts for many patients with chronic ITP.
B. Transfusion of platelets is generally not effective in ITP because the underlying problem is that the platelets are being destroyed by the immune system. Platelet transfusions may provide a temporary increase in platelet count but do not address the underlying cause of platelet destruction.
C. ADAMTS-13 is a von Willebrand factor-cleaving protease associated with thrombotic thrombocytopenic purpura (TTP), not ITP. Replacement of ADAMTS-13 is relevant for treating TTP, a different condition that also involves thrombocytopenia but has a different pathophysiology.
D. Protamine sulfate is used to reverse the effects of heparin, an anticoagulant. It is not used to treat ITP and does not affect platelet destruction or platelet count. This procedure is not relevant to the management of ITP.

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A nurse in an ophthalmology clinic is assessing a client who has suspected primary open-angle glaucoma (PAOG). Which assessment finding would support a diagnosis of this type of glaucoma?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is A

Explanation

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Correct Answer is A

Explanation

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