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 A
Explanation
Choice A reason: Iron deficiency anemia is classically microcytic and hypochromic, meaning the red blood cells are smaller than normal (decreased MCV) and have reduced hemoglobin content. Additionally, RDW is increased due to anisocytosis, which reflects a wide variation in red blood cell sizes as the bone marrow releases immature cells in response to iron deficiency. This pattern is one of the earliest and most consistent hematologic findings in iron deficiency anemia.
Choice B reason: A decreased RDW is not typical in iron deficiency anemia. RDW tends to rise as the body attempts to compensate for anemia by producing red blood cells of varying sizes. A low RDW would suggest a more uniform population of red cells, which is not characteristic of iron deficiency.
Choice C reason: Increased MCV is seen in macrocytic anemias such as those caused by vitamin B12 or folate deficiency. Iron deficiency anemia is microcytic, not macrocytic, and therefore MCV would be decreased, not increased.
Choice D reason: MCHC is typically decreased in iron deficiency anemia due to the reduced hemoglobin concentration in red blood cells. An increased MCHC would suggest hyperchromic anemia, which is not consistent with iron deficiency.
Correct Answer is D
Explanation
Choice A reason: Divalproex is an anticonvulsant approved for migraine prophylaxis. It modulates neurotransmitter activity and reduces neuronal excitability, making it effective for chronic migraine prevention.
Choice B reason: Topiramate is another anticonvulsant with proven efficacy in migraine prophylaxis. It reduces frequency and severity by stabilizing neuronal firing and inhibiting cortical spreading depression.
Choice C reason: Metoprolol is a beta-blocker commonly used for migraine prevention. It reduces sympathetic nervous system activity and stabilizes vascular tone, helping to prevent migraine attacks.
Choice D reason: Sumatriptan is a triptan used for acute migraine treatment, not prophylaxis. It acts as a serotonin receptor agonist to abort migraine episodes but does not prevent their occurrence. Therefore, it is not considered first-line for prophylaxis.
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