A nurse in an ophthalmology clinic is interviewing a client who was referred by his primary care provider for suspicion of cataracts. Which of the following findings is consistent with manifestations of cataracts?
Loss of peripheral vision
A decreased ability to perceive colors
Loss of central vision
Seeing bright flashes of light and floaters
The Correct Answer is B
Choice A reason: This is incorrect because loss of peripheral vision is not a manifestation of cataracts, but of glaucoma. Glaucoma is a condition that causes increased pressure inside the eye and damage to the optic nerve, which can lead to loss of vision in the outer edges of the visual field. The nurse should assess the client's intraocular pressure and visual field test results to rule out glaucoma.
Choice B reason: This is correct because a decreased ability to perceive colors is a manifestation of cataracts. Cataracts are a condition that causes clouding or opacity of the lens, which is the transparent structure behind the pupil that focuses light onto the retina. Cataracts can reduce the clarity and contrast of vision and make colors appear faded or yellowish. The nurse should ask the client about any changes in color perception or brightness of objects.
Choice C reason: This is incorrect because loss of central vision is not a manifestation of cataracts but of macular degeneration. Macular degeneration is a condition that affects the macula, which is the central part of the retina that is responsible for sharp and detailed vision. Macular degeneration can cause blurred or distorted central vision, difficulty reading or recognizing faces, or dark spots in the visual field. The nurse should assess the client's visual acuity and fundoscopic examination results to rule out macular degeneration.
Choice D reason: This is incorrect because seeing bright flashes of light and floaters is not a manifestation of cataracts but of retinal detachment. Retinal detachment is a condition that occurs when the retina, which is the layer of tissue at the back of the eye that converts light into nerve impulses, separates from its underlying support tissue. Retinal detachment can cause sudden flashes of light, floaters, or shadows in the visual field. The nurse should refer the client to an ophthalmologist immediately if retinal detachment is suspected.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["B","D","E"]
Explanation
The correct answers are b, d, and e.
Choice A: Slurred speech.
Slurred speech can be associated with increased ICP due to the pressure effects on the brain areas responsible for speech production. However, it is not typically considered a late sign of increased ICP. It may occur earlier in the progression as the brain's ability to coordinate muscle movements is affected.
Choice B: Bradycardia with a bounding pulse.
Bradycardia with a bounding pulse is a classic sign of Cushing's triad, which is a late and ominous sign of significantly increased ICP. It indicates that the body is attempting to increase arterial blood pressure to overcome the increased ICP and maintain cerebral perfusion. The normal range for adult heart rate is 60-100 beats per minute.
Choice C: Confusion.
Confusion can be an early sign of increased ICP as it can indicate changes in cerebral function. However, it is not specifically a late sign of increased ICP. Early signs of increased ICP can include headache, nausea, and confusion, as the brain is initially responding to the pressure changes.
Choice D: Hypertension with an increasing pulse pressure.
Hypertension with an increasing pulse pressure is another component of Cushing's triad. It reflects the body's compensatory mechanism to preserve cerebral blood flow in the face of rising ICP. An increasing pulse pressure (the difference between systolic and diastolic blood pressure) is a late sign of increased ICP. Normal pulse pressure is typically 30-40 mm Hg.
Choice E: Nonreactive dilated pupils.
Nonreactive dilated pupils are a late sign of increased ICP and indicate pressure on the cranial nerves that control pupil size and reaction to light. This is a grave sign and often indicates impending brain herniation.
Choice F: Hypotension with a decreasing pulse pressure.
Hypotension with a decreasing pulse pressure is not typically associated with increased ICP. In fact, hypertension with a widening pulse pressure would be more indicative of increased ICP as part of Cushing's triad.
Correct Answer is A
Explanation
Choice A reason: This is the correct answer because both ulcerative colitis and Crohn's disease are inflammatory bowel diseases (IBD) that cause chronic inflammation of the digestive tract. The inflammation can cause symptoms such as abdominal pain, diarrhea, bleeding, weight loss, or fever. The nurse should educate the client on how to manage inflammation and prevent complications.
Choice B reason: This is incorrect because both ulcerative colitis and Crohn's disease do not affect the entire alimentary canal, but different parts of it. Ulcerative colitis affects only the colon (large intestine) and rectum, while Crohn's disease can affect any part of the digestive tract from mouth to anus, most commonly the ileum (the last part of the small intestine). The nurse should explain the differences in location and extent of
the diseases.
Choice C reason: This is incorrect because both ulcerative colitis and Crohn's disease do not always require a bowel diversion, but only in some cases. A bowel diversion is a surgical procedure that creates an opening (stoma) in the abdomen to divert fecal matter into an external bag or pouch. It may be done to treat severe complications such as perforation, obstruction, fistula, or cancer. The nurse should inform the client about the indications, types, and care of bowel diversions.
Choice D reason: This is incorrect because both ulcerative colitis and Crohn's disease are not caused by low-fat, high-fiber diets, but by unknown factors. The exact causes of IBD are not clear, but they may involve genetic, immune, environmental, or microbial factors. Low-fat, high-fiber diets may help prevent or reduce symptoms of IBD, but they do not cause them. The nurse should advise the client on how to follow a balanced and nutritious diet that suits their individual needs and preferences.
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