A nurse is collecting data from a client related to changes in vision. Which of the following statements indicates that the client might be developing a cataract?

"I can't see anything from the sides of my eyes."

"My vision is almost gone from the center part of my eye."

"My contact lenses just don't fit like they used to."

"l keep seeing flashes of lights moving around in my eye."

Answer and Explanation

The Correct Answer is B

A. "I can't see anything from the sides of my eyes." This statement suggests a visual field deficit, which may be indicative of conditions affecting peripheral vision, such as glaucoma, retinal detachment, or optic nerve disorders. It is not a typical symptom of cataracts.

B. "My vision is almost gone from the center part of my eye." This statement indicates a central visual impairment, which is a common symptom of cataracts. Cataracts cause clouding of the lens, leading to blurred or dimmed vision, especially in the center of the visual field. This symptom often progresses gradually over time.

C. "My contact lenses just don't fit like they used to." This statement suggests discomfort or fit issues with contact lenses and is not specifically indicative of cataracts. It may be related to changes in the shape or health of the cornea, conjunctiva, or tear film.

D. "I keep seeing flashes of lights moving around in my eye." Flashes of light in the visual field are not typical symptoms of cataracts. They may indicate other ocular conditions such as vitreous detachment, migraines with aura, or retinal disorders.

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Correct Answer is A

Explanation

Answer: A. Ensuring that the client and their family are kept informed about the client's care

Rationale:

A. Ensuring that the client and their family are kept informed about the client's care:
This action is the priority because communication is vital in managing a client with multiple organ dysfunction syndrome (MODS). Keeping the client and their family informed can help them understand the seriousness of the condition, the plan of care, and potential outcomes. It also fosters trust and ensures that the family can make informed decisions regarding the client's care.

B. Being aware of the client's wishes regarding care:
While being aware of the client’s wishes is important, especially in critical conditions like MODS, the priority lies in ensuring ongoing communication about the client's current status and treatment. Understanding the client's wishes can guide care but should follow the immediate need for clear communication about the evolving situation.

C. Scheduling periods of rest for the client:
Rest is essential for recovery, particularly in clients with MODS, but scheduling rest periods is a part of implementing care rather than a primary action. It can be planned based on the client’s needs and condition but does not take precedence over ensuring that the family is informed.

D. Discussing the client's resting times with the family:
While involving the family in discussions about the client's care is beneficial, the immediate priority is to ensure they are fully informed about the overall condition and care plan. This discussion can occur after establishing a solid communication foundation regarding the client's status and care approach.

A. The heart's electrical transmission through the atrioventricular (AV) node is unusually slow. B. The heart's electrical signals are rapid, chaotic, and irregular. C. An early electrical signal occurs before the expected sinoatrial (SA) node signal. D. The SA node sends an electrical signal greater than 100/min.

Correct Answer is B

Explanation

A. The heart's electrical transmission through the atrioventricular (AV) node is unusually slow: This statement does not align with the manifestations of dizziness and palpitations in atrial fibrillation. A slow conduction through the AV node would typically manifest as bradycardia or heart block rather than rapid and irregular palpitations.

B. The heart's electrical signals are rapid, chaotic, and irregular: This is the correct answer. Atrial fibrillation is characterized by rapid, chaotic, and irregular electrical signals in the atria, leading to ineffective atrial contractions and an irregular ventricular response. The irregularity and rapidity of the heart rate can lead to symptoms such as palpitations and dizziness.

C. An early electrical signal occurs before the expected sinoatrial (SA) node signal: This statement does not accurately describe the mechanism of atrial fibrillation. Atrial fibrillation involves disorganized electrical activity in the atria, rather than a single early electrical signal.

D. The SA node sends an electrical signal greater than 100/min: While a heart rate greater than 100/min (tachycardia) is commonly associated with atrial fibrillation, this statement does not fully explain the manifestations of dizziness and palpitations. These symptoms are more directly related to the irregularity and chaotic nature of the heart's electrical signals in atrial fibrillation.

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A nurse is collecting data from a client related to changes in vision. Which of the following statements indicates that the client might be developing a cataract?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is providing care for a client who has multiple organ dysfunction syndrome (MODS). Which of the following actions is the priority when planning care for this client?

Correct Answer is A

Explanation

Rationale:

A nurse is providing teaching to a client who has atrial fibrillation and reports dizziness and palpitations. Which of the following should the nurse understand is the cause of these manifestations?

Correct Answer is B

Explanation

A nurse is assessing a client who is experiencing an episode of tinnitus. Which of the following statements from the client indicates that the tinnitus might be affecting their well-being?

A nurse is collecting data from a client related to changes in vision. Which of the following statements indicates that the client might be developing a cataract?

A nurse is reviewing home medications with a client scheduled for a cataract extraction procedure. Which of the following medications should the nurse question administering?

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A nurse is providing care for a client experiencing obstructive shock. Which of the following diagnoses should the nurse expect?

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