A patient presents to the emergency department with a complaint of sudden, severe pain to the left eye, nausea, and seeing halos around lights. The nurse suspects primary angle-closure glaucoma. The nurse anticipates that in order to relieve intraocular pressure, the patient should be prepared for which of the following procedures?
Phacoemulsification
Extracapsular cataract extraction
Cochlear implant
Surgical iridectomy
The Correct Answer is D
A. Phacoemulsification is a procedure used to remove cataracts from the eye. It involves using ultrasound waves to break up the cloudy lens (cataract) into small fragments, which are then suctioned out. While this procedure is relevant for cataract treatment, it does not address the acute management of angle-closure glaucoma.
B. Extracapsular cataract extraction is a surgical procedure to remove a cataract from the eye by making an incision and extracting the lens in one piece or in large segments. Like phacoemulsification, this procedure is focused on cataract removal and does not directly treat the underlying issue of acute angle-closure glaucoma.
C. A cochlear implant is a device used to provide a sense of sound to individuals with severe hearing loss or deafness. This procedure is unrelated to the treatment of eye conditions or intraocular pressure and therefore is not appropriate for managing primary angle-closure glaucoma.
D. Surgical iridectomy is a procedure specifically aimed at treating angle-closure glaucoma. It involves creating a small hole (iridectomy) in the peripheral iris to allow aqueous humor to flow from the posterior chamber of the eye to the anterior chamber, bypassing the obstructed drainage angle.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
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.
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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