A 54-year-old man with a history of diabetes mellitus presents to the nurse practitioner with concerns about a new onset of eye symptoms. What is the pathophysiology of diabetic retinopathy?
Light-sensitive cells in the macula slowly break down, causing central vision to diminish over time
Hyperglycemia causes damage to blood vessels in the retina, leading to vision loss
Many degenerative processes denature and coagulate lens proteins in lens fibers, resulting in loss of transparency
Increased intraocular pressure is caused by anatomical changes in the lens or by inhibited or obstructed outflow
The Correct Answer is B
Choice A reason: This describes the pathophysiology of macular degeneration, not diabetic retinopathy. Macular degeneration involves the breakdown of photoreceptor cells in the macula, leading to central vision loss, but is not directly caused by diabetes.
Choice B reason: Diabetic retinopathy is caused by chronic hyperglycemia leading to microvascular damage in the retina. This includes capillary leakage, microaneurysms, and neovascularization, which can result in retinal edema, hemorrhage, and ultimately vision loss. It is a leading cause of blindness in adults with diabetes.
Choice C reason: This describes the pathophysiology of cataracts, where lens proteins become denatured and coagulated, leading to opacity. While cataracts are more common in diabetics, this is not the mechanism of diabetic retinopathy.
Choice D reason: This describes the pathophysiology of glaucoma, which involves increased intraocular pressure due to impaired aqueous humor drainage. Although glaucoma can co-occur with diabetes, it is not the primary mechanism of diabetic retinopathy.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: While colonoscopy every 10 years is standard for average-risk individuals, continued screening in older adults should be individualized. Automatically scheduling another colonoscopy may not be necessary without considering life expectancy and prior results.
Choice B reason: Guidelines suggest that adults aged 76–85 may choose to continue or discontinue colorectal cancer screening based on overall health, prior screening history, and personal preferences. Since this patient had a normal colonoscopy at age 70 and is otherwise healthy, shared decision-making is appropriate.
Choice C reason: Scheduling a colonoscopy at age 80 is arbitrary and not guideline-based. Screening intervals should be based on prior findings and individualized risk assessment.
Choice D reason: Blanket cessation of screening at age 77 is not recommended. Decisions should be personalized, especially in healthy individuals with a long life expectancy.
Correct Answer is B
Explanation
Choice A reason: This response is inappropriate and irrelevant to the question. Pap smear guidelines are based on age and sexual activity, not contraceptive use. It also risks making assumptions about the patient’s intentions.
Choice B reason: Current guidelines recommend initiating Pap smear screening at age 21, regardless of sexual activity. This response provides accurate, evidence-based information and respects the patient’s autonomy and inquiry.
Choice C reason: This response is dismissive and assumes the patient’s sexual activity status. It fails to provide the necessary health education and may discourage future engagement in preventive care.
Choice D reason: This response is intrusive and judgmental. It does not answer the patient’s question and may create discomfort or mistrust in the clinical relationship.
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