A nurse is providing teaching to a group of clients about changes that occur when clients experience open-angle glaucoma. Which of the following statements should the nurse include in the teaching?

"Vision changes occur when blood vessels leak fluid or blood under a portion of the retina."

"Vision changes occur when the cloudy lens alters the passage of light through the eye."

"Vision changes occur when retinal tissue pulls away from the blood vessels in the eye."

"Vision changes occur when pressure in the eye is increased due to a decrease of aqueous humor."

Answer and Explanation

The Correct Answer is D

A. "Vision changes occur when blood vessels leak fluid or blood under a portion of the retina": This statement describes a symptom of diabetic retinopathy, not open-angle glaucoma. In open-angle glaucoma, vision changes primarily result from increased intraocular pressure (IOP) due to impaired drainage of aqueous humor, not leakage of fluid or blood under the retina.

B. "Vision changes occur when the cloudy lens alters the passage of light through the eye": This statement describes a symptom of cataracts, not open-angle glaucoma. Cataracts involve clouding of the lens inside the eye, which affects the passage of light and leads to visual disturbances. Open-angle glaucoma, however, primarily affects the optic nerve and visual field due to increased intraocular pressure.

C. "Vision changes occur when retinal tissue pulls away from the blood vessels in the eye": This statement describes a symptom of retinal detachment, not open-angle glaucoma. Retinal detachment occurs when the retina detaches from the underlying layers of the eye, leading to vision changes and potentially vision loss. Open-angle glaucoma, on the other hand, primarily involves increased intraocular pressure and optic nerve damage.

D. "Vision changes occur when pressure in the eye is increased due to a decrease of aqueous humor": This statement is accurate. In open-angle glaucoma, vision changes occur due to increased intraocular pressure resulting from inadequate drainage of aqueous humor from the eye. This increased pressure can lead to damage of the optic nerve, resulting in peripheral vision loss and potentially blindness if left untreated.

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Correct Answer is A

Explanation

A. Loss of sensation and cognition difficulties: Secondary conditions commonly associated with traumatic brain injury (TBI) include sensory impairments such as loss of sensation, as well as cognitive difficulties such as memory loss, attention deficits, and impaired executive functioning. These issues arise due to the damage to brain tissue caused by the initial injury and can have significant impacts on the client's overall function and quality of life.

B. Development of emotional disorders and acute pain : While emotional disorders such as depression, anxiety, and post-traumatic stress disorder (PTSD) are common following TBI, acute pain is not typically considered a primary secondary condition associated with TBI. Chronic pain may develop as a secondary condition, but acute pain is more often associated with the immediate aftermath of the injury.

C. Body dysmorphia and neurofibrillary tangles : Body dysmorphia, a condition characterized by obsessive preoccupation with perceived flaws in physical appearance, and neurofibrillary tangles, abnormal protein aggregates found in the brains of individuals with neurodegenerative disorders such as Alzheimer's disease, are not typically associated with TBI.

D. Decreased appetite and a lack of sleep : While changes in appetite and sleep disturbances may occur as secondary symptoms of TBI, they are not as commonly anticipated as loss of sensation and cognition difficulties. These issues may arise due to disruptions in brain function or changes in lifestyle following the injury.

A. Respiratory rate of 12/min B. Blood pressure of 108/74 mm Hg C. Changes to pupil size and shape D. Swelling of the optic nerve E. Decreasing Glasgow Coma scores

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

Explanation

A. Respiratory rate of 12/min: A respiratory rate of 12/min is within the normal adult range (12-20 breaths per minute). In the context of increased intracranial pressure (ICP), respiratory rate changes might be noted as part of the Cushing's reflex (which is characterized by bradycardia, hypertension, and abnormal respiratory patterns like Cheyne-Stokes or ataxic breathing), but a rate of 12/min on its own is not indicative of a worsening condition. However, if the patient begins to show signs of irregular or abnormal breathing patterns, this would raise concern.

B. Blood pressure of 108/74 mm Hg: This blood pressure is also within the normal range and does not suggest a worsening of intracranial pressure. In fact, ICP can lead to a rise in blood pressure (due to the body's compensatory mechanisms, known as Cushing's triad), along with bradycardia and abnormal respirations. Thus, a stable blood pressure like 108/74 mm Hg is not concerning in this context.

C. Changes to pupil size and shape: Changes in pupil size, shape, or reactivity are significant indicators of worsening intracranial pressure. Unequal pupils (anisocoria), sluggish or absent response to light, and fixed dilated pupils are signs of brainstem compression or damage, which often occur as ICP increases. This could indicate herniation or severe brain injury, which are worsening conditions.

D. Swelling of the optic nerve: Swelling of the optic nerve, or papilledema, is another important sign of increased intracranial pressure. It occurs due to increased pressure within the skull, which causes congestion and swelling of the optic disc. This finding can be seen on fundoscopy and indicates a worsening condition, as it suggests elevated pressure affecting the brain.

E. Decreasing Glasgow Coma scores: A decreasing Glasgow Coma Scale (GCS) score is a critical indicator of worsening neurologic function in a patient with increased ICP. The GCS is used to assess a patient's level of consciousness, and a decreasing score suggests that the brain's function is deteriorating. This can be caused by worsening edema, brain herniation, or other severe neurological impairments associated with elevated ICP.

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A nurse is providing teaching to a group of clients about changes that occur when clients experience open-angle glaucoma. Which of the following statements should the nurse include in the teaching?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has a traumatic brain injury (TBI). Which of the following secondary conditions should the nurse anticipate the client might develop?

Correct Answer is A

Explanation

A nurse is caring for a client who has increased intracranial pressure and has a worsening neurologic condition. Which of the following cues should the nurse recognize as a worsening condition? (Select All that Apply.)

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

Explanation

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