A 68-year-old patient presents to the clinic with complaints of gradually worsening vision. Upon examination, the nurse notes that the patient has difficulty seeing at night, increased sensitivity to glare, and a noticeable cloudiness in the lens of the eyes. Which clinical manifestation is most indicative of cataracts?

Cloudiness in the lens of the eyes

Double vision in one eye

Eye pain and redness

Sudden loss of vision

Answer and Explanation

The Correct Answer is A

Choice A Reason:

Cloudiness in the lens of the eyes is the hallmark symptom of cataracts. Cataracts cause the lens to become opaque, leading to blurred vision and difficulty seeing clearly. This cloudiness can make it challenging to perform everyday tasks and is the most indicative sign of cataracts.

Choice B Reason:

Double vision in one eye can occur with cataracts, but it is not the most indicative symptom. While cataracts can cause visual disturbances, the primary symptom is the cloudiness of the lens, which directly impacts vision clarity.

Choice C Reason:

Eye pain and redness are not typical symptoms of cataracts. These symptoms are more commonly associated with other eye conditions such as infections or glaucoma. Cataracts primarily cause visual disturbances without significant pain or redness.

Choice D Reason:

Sudden loss of vision is not characteristic of cataracts. Cataracts develop gradually over time, leading to a slow progression of vision impairment. Sudden vision loss is more likely to be associated with acute conditions such as retinal detachment or vascular occlusions.

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Correct Answer is D

Explanation

Choice A Reason:

Warm and moist skin is not a typical manifestation of hypoglycemia. Instead, hypoglycemia often causes symptoms such as cold, clammy skin due to the body’s response to low blood sugar levels. Warm and moist skin can be associated with other conditions, such as hyperthyroidism or fever, but not hypoglycemia.

Choice B Reason:

A decreased appetite is not a common symptom of hypoglycemia. In fact, hypoglycemia can sometimes cause increased hunger as the body signals the need for more glucose. Symptoms of hypoglycemia are more related to the body’s immediate response to low blood sugar, such as shakiness, sweating, and confusion.

Choice C Reason:

Increased thirst is a symptom more commonly associated with hyperglycemia (high blood sugar) rather than hypoglycemia. When blood sugar levels are high, the body tries to eliminate excess glucose through urine, leading to dehydration and increased thirst. Hypoglycemia, on the other hand, does not typically cause increased thirst.

Choice D Reason:

Feeling shaky is a classic symptom of hypoglycemia. When blood sugar levels drop, the body releases adrenaline, which can cause shakiness, sweating, and a rapid heartbeat. Recognizing this symptom is crucial for individuals with diabetes to take immediate action to raise their blood sugar levels and prevent severe hypoglycemia.

A. Administer IV levothyroxine. B. Start broad-spectrum antibiotics. C. Administer corticosteroids immediately. D. Initiate fluid restriction.

Correct Answer is A

Explanation

Choice A Reason:

Administering IV levothyroxine is the priority intervention for a patient with myxedema coma. Myxedema coma is a severe form of hypothyroidism that requires immediate thyroid hormone replacement to correct the deficiency and stabilize the patient’s condition. Intravenous levothyroxine is preferred because it provides a rapid increase in thyroid hormone levels, which is crucial for reversing the life-threatening symptoms of myxedema coma, such as hypothermia, bradycardia, and altered mental status.

Choice B Reason:

Starting broad-spectrum antibiotics is not the primary intervention for myxedema coma. While infections can precipitate myxedema coma and should be treated if present, the immediate priority is to address the severe hypothyroidism with thyroid hormone replacement. Antibiotics may be administered if an infection is suspected or confirmed, but they do not directly address the underlying thyroid hormone deficiency.

Choice C Reason:

Administering corticosteroids immediately is important but not the highest priority. Corticosteroids are often given to patients with myxedema coma to treat potential adrenal insufficiency, which can coexist with severe hypothyroidism. However, the primary intervention remains the administration of thyroid hormone replacement to correct the hypothyroid state.

Choice D Reason:

Initiating fluid restriction is not appropriate for managing myxedema coma. Patients with myxedema coma often require careful fluid management to address potential hyponatremia and maintain hemodynamic stability. Fluid restriction is not a standard intervention for this condition and does not address the critical need for thyroid hormone replacement.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is reinforcing teaching with a client who has diabetes mellitus about the manifestations of hypoglycemia. Which of the following statements by the client indicates an understanding of the teaching?

Correct Answer is D

Explanation

A 65-year-old patient is admitted to the ICU with myxedema coma. Which of the following interventions is the priority for this patient?

Correct Answer is A

Explanation

A nurse is providing care for an older adult client who has hyperglycemia, polydipsia, and polyuria. Which of the following manifestations supports the clinical presentation of hyperosmolar hyperglycemic syndrome (HHS)? (Select All that Apply.)

A 78-year-old patient comes to the clinic with complaints of difficulty seeing faces and reading small print. The patient is diagnosed with macular degeneration. Which of the following interventions should the nurse prioritize to help manage the patient’s condition?

A 70-year-old patient presents with complaints of visual disturbances. Upon assessment, the patient reports experiencing difficulty reading, seeing faces clearly, and needing more light when performing tasks. What is the most likely clinical manifestation of macular degeneration?

A nurse is preparing a young adult client who has a hearing impairment for surgery. Which of the following actions should the nurse take?

A nurse is preparing a plan of care for a client who is postoperative following a cochlear implant insertion. Which of the following instructions should the nurse include in the plan of care?

A 20-year-old male patient with a known history of hemophilia A is brought to the emergency department with swelling and pain in his right knee after a minor fall. Which of the following is the most appropriate initial nursing intervention?

A 65-year-old patient has just received a blood transfusion. Shortly after the transfusion begins, the patient complains of chills, back pain, and difficulty breathing. What is the most likely cause of these symptoms?