Mr. Roberts, a 65-year-old male. presents to the emergency department with sudden onset of severe pain in his right eye. blurred vision, seeing halos around lights, nausea, and vomiting. His right eye is red the cornea appears cloudy, and his intraocular pressure is elevated. What is the most likely diagnosis?

Conjunctivitis

Acute angle-closure glaucoma

Retinal detachment

Migraine with aura

Answer and Explanation

The Correct Answer is B

A. Conjunctivitis. Conjunctivitis generally presents with redness and discharge but does not cause elevated intraocular pressure, severe pain, or visual disturbances like halos.

B. Acute angle-closure glaucoma. Acute angle-closure glaucoma is characterized by sudden severe eye pain, blurred vision, halos around lights, nausea, and vomiting, along with elevated intraocular pressure and a cloudy cornea.

C. Retinal detachment. Retinal detachment may cause sudden vision loss or flashing lights but typically lacks pain, nausea, or vomiting, and does not affect intraocular pressure.

D. Migraine with aura. A migraine with aura may cause visual disturbances but does not present with eye pain, red eye, or elevated intraocular pressure.

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Correct Answer is D

Explanation

A. Warfarin. Warfarin (Coumadin) is an anticoagulant used to prevent blood clots, but it typically requires several days to achieve a therapeutic effect and needs close monitoring of INR (International Normalized Ratio) levels. While it can be used for long-term prevention of DVT, it's not the immediate choice for post-operative prophylaxis.

B. Alteplase (tPA). Alteplase is a thrombolytic agent, used to break down existing clots, not prevent their formation. It is typically used in emergency situations, such as for treating ischemic stroke.

C. Clopidogrel. Clopidogrel is an antiplatelet agent, often used to prevent arterial clots, not DVTs. It is more commonly used in conditions like stroke and heart disease.

D. Enoxaparin. Enoxaparin, a low molecular weight heparin, is commonly used to prevent DVT after surgery by inhibiting specific clotting factors. It’s frequently prescribed for DVT prevention in orthopedic surgery patients.

A. Elevated blood pressure B. warm, flushed skin C. Increased urine output D. Increased heart rate

Correct Answer is D

Explanation

A. Elevated blood pressure. Blood pressure typically drops in hypovolemic shock as blood volume decreases.

B. Warm, flushed skin. As hypovolemic shock progresses, skin becomes cool and clammy due to decreased blood flow and compensatory vasoconstriction.

C. Increased urine output. Hypovolemic shock leads to decreased urine output due to reduced renal perfusion.

D. Increased heart rate. An increased heart rate is an early compensatory response in hypovolemic shock as the body attempts to maintain cardiac output.

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Naxlex Comprehensive Predictor Exams

A nurse is assisting with the care of a postoperative client following a total knee replacement. Which of the following medications should the nurse anticipate the provider to prescribe to prevent the formulation of a deep vein thrombosis (DVT)?

Correct Answer is D

Explanation

A patient with active gastrointestinal bleeding is being monitored for complications. Which of the following signs indicates the patient is developing hypovolemic shock?

Correct Answer is D

Explanation

A nurse is providing discharge teaching to a client with sickle cell disease. Which of the following instructions should the nurse include?

A nurse is caring for a client who sustained burns in an enclosed space and is exhibiting singed nasal hair, black sputum and smoky smelling breath. What is the nurse’s priority intervention?

A nurse is gathering medical history from a client admitted for pyelonephritis. Which of the following should the nurse expect the client to report when asked about their medical history?

A client is diagnosed with osteomyelitis. Which clinical manifestation would the nurse expect to assess?

A 45-year-old male patient present to the emergency department with a severe head injury following a car accident. His Glasgow Coma Scale (GCS) score is 8, and he shows signs of increased intracranial pressure (ICP). Which of the following interventions should be prioritized to manage his ICP?

The nurse is caring for a patient with a T-tube following gallbladder surgery. Which of the following is the most important nursing action?

A nurse is caring for a client in a clinic who has foul, smelling urine, a low-grade fever of 37.7° C (100° F), and pain with urination. Which of the following should the nurse expect the health care provider to order?