A nurse is collecting data from an admission history for a client who reports being tackled while playing football and is now seeing bright flashes of light and dark floating spots. Which of the following conditions should the nurse expect the client to be experiencing?

Open-angle glaucoma

Macular degeneration

Meniere’s disease

Retinal detachment

Answer and Explanation

The Correct Answer is D

A. Open-angle glaucoma: Open-angle glaucoma typically presents with increased intraocular pressure and gradual loss of peripheral vision, not with bright flashes of light and dark floating spots.

B. Macular degeneration: Macular degeneration is characterized by central vision loss, not by bright flashes of light and dark floating spots.

C. Meniere’s disease: Meniere’s disease is a disorder of the inner ear characterized by episodes of vertigo, hearing loss, and tinnitus. It does not typically cause bright flashes of light and dark floating spots in the visual field.

D. Retinal detachment: Trauma, such as being tackled while playing football, can lead to retinal detachment, which can manifest with symptoms such as bright flashes of light (photopsia) and dark floating spots (floaters) in the affected eye. This condition is considered a medical emergency and requires prompt evaluation and treatment to prevent permanent vision loss.

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Correct Answer is ["A","B","C","D","E"]

Explanation

A. Administer pain medication as needed. Rationale: Pain management is essential for clients with traumatic brain injury (TBI) to ensure their comfort and to prevent agitation or increased intracranial pressure (ICP) due to pain. Administering pain medication as needed helps alleviate discomfort and promotes rest, which supports the client's recovery.

B. Maintain ventriculostomy at the correct position. Rationale: Ventriculostomy, also known as an external ventricular drain (EVD), is a critical component of managing intracranial pressure (ICP) in clients with traumatic brain injury. Maintaining the ventriculostomy at the correct position ensures accurate monitoring and drainage of cerebrospinal fluid (CSF), which helps control ICP levels and prevents complications such as cerebral edema.

C. Maintain the neck in the midline position. Rationale: Keeping the neck in a midline position is essential for clients with traumatic brain injury to prevent further injury to the cervical spine. Proper alignment of the neck helps maintain spinal stability and reduces the risk of exacerbating any existing spinal cord injury, which may coexist with the traumatic brain injury.

D. Elevate the head of the bed to 30 degrees. Rationale: Elevating the head of the bed to 30 degrees is recommended for clients with traumatic brain injury to promote cerebral venous drainage and reduce intracranial pressure (ICP). This position helps optimize cerebral perfusion and minimizes the risk of cerebral edema, which can occur with increased ICP.

E. Maintain enteral feedings. Rationale: Nutritional support is crucial for clients with traumatic brain injury to support healing and recovery. Enteral feedings, such as tube feedings, may be necessary if the client is unable to consume adequate nutrition orally due to impaired swallowing or altered consciousness. Providing enteral feedings ensures the client receives essential nutrients to support tissue repair and prevent malnutrition-related complications during the recovery process.

A. Diabetes mellitus B. Total cholesterol 170 mg/dL (less than 200 mg /Dl C. HDL cholesterol 65 mg/dL (male greater than 45 mg/dL; female greater than 55 mg/dL) D. Smoking cigarettes E. Family history of aneurysm

Correct Answer is ["D","E"]

Explanation

A. Diabetes mellitus: An inverse association between diabetes mellitus (DM) and abdominal aortic aneurysm (AAA) risk hasbeen reported. Apart from a lower AAA prevalence among patients with vsthose without DM, there isdata showing that DM may exert a protective role on aneurysmal growth in patients with small AAAs, thus decreasing the risk of rupture. As atherosclerosis has almost the same risk factors as aneurysms, the decreased AAA prevalence in patients with DM may indicate that atherosclerosis is an associated feature and not a cause of the aneurysms.

B. Total cholesterol 170 mg/dL (less than 200 mg/dL): While elevated total cholesterol is a risk factor for cardiovascular disease, it is not specifically listed as a risk factor for abdominal aortic aneurysm (AAA). However, dyslipidemia, including elevated total cholesterol levels, can contribute to the development of atherosclerosis, which is a risk factor for AAA.

C. HDL cholesterol 65 mg/dL (male greater than 45 mg/dL; female greater than 55 mg/dL): High-density lipoprotein (HDL) cholesterol levels greater than 65 mg/dL are not listed as a risk factor for abdominal aortic aneurysm (AAA). However, low levels of HDL cholesterol are associated with an increased risk of cardiovascular disease, which may indirectly contribute to the development of AAA through the promotion of atherosclerosis.

D. Smoking cigarettes: Smoking cigarettes is a significant modifiable risk factor for abdominal aortic aneurysm (AAA). Smoking damages the walls of blood vessels, promotes inflammation, and accelerates the development of atherosclerosis, increasing the risk of AAA formation and rupture.

E. Family history of aneurysm: A family history of aneurysm, particularly abdominal aortic aneurysm (AAA), is a risk factor for developing AAA. Genetic factors can predispose individuals to the development of aneurysms, and a positive family history increases the likelihood of AAA occurrence.

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A nurse is collecting data from an admission history for a client who reports being tackled while playing football and is now seeing bright flashes of light and dark floating spots. Which of the following conditions should the nurse expect the client to be experiencing?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is planning care for a client who has a traumatic brain injury (TBI). Which of the following nursing interventions should be added to the plan of care? (Select All that Apply.)

Correct Answer is ["A","B","C","D","E"]

Explanation

Which of the following are risk factors for abdominal aortic aneurysm (AAA)? (Select all that apply.)

Correct Answer is ["D","E"]

Explanation

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