A 68-year-old woman is in the eye clinic for a checkup. She tells the nurse that she has been having trouble reading the paper, sewing, and even seeing the faces of her grandchildren. On examination, the nurse notes that she has some loss of central vision but her peripheral vision is normal. What do these findings suggest?
Macular degeneration
Increased intraocular pressure or glaucoma
Vision that is normal for someone her age
The beginning stages of cataract formation
The Correct Answer is A
A. Macular degeneration: The loss of central vision while maintaining peripheral vision is characteristic of macular degeneration, a common age-related condition that affects the macula, the central part of the retina responsible for sharp and detailed vision. Patients with this condition often struggle with tasks that require fine visual acuity, such as reading or recognizing faces.
B. Increased intraocular pressure or glaucoma: Glaucoma typically causes peripheral vision loss rather than central vision loss. Patients may not notice changes in their vision until the disease has progressed significantly, making this option less likely given the patient's symptoms.
C. Vision that is normal for someone her age: While age-related changes in vision are common, the specific symptoms described—difficulty reading, sewing, and recognizing faces—indicate a significant problem rather than a normal aging process. Conditions like macular degeneration should be considered when central vision loss is present.
D. The beginning stages of cataract formation: Cataracts generally cause blurred vision, glare, and difficulty with night vision. They typically affect overall vision rather than causing specific central vision loss while preserving peripheral vision. Therefore, while cataracts are common in older adults, they do not align with the symptoms described in this case.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Listening as the patient inhales and then going to the next site during exhalation: This method is not ideal because it does not allow the nurse to assess both inhalation and exhalation at each site. It is important to listen to both phases of respiration to evaluate the quality of breath sounds accurately.
B. Instructing the patient to breathe in and out rapidly while listening to the breath sounds: Rapid breathing can alter breath sounds and may not provide an accurate assessment of normal respiratory patterns. The patient should breathe normally to ensure the nurse can correctly evaluate the breath sounds.
C. If the patient is modest, listening to sounds over his or her clothing or hospital gown: It is important to listen directly to the skin to obtain clear breath sounds. Clothing can muffle sounds and interfere with the accuracy of the assessment, so the nurse should ensure that the area is adequately exposed while maintaining the patient's modesty.
D. Listening to at least one full respiration in each location: This is the correct approach to auscultation. By listening to a full breath cycle at each auscultation site, the nurse can accurately assess the quality and characteristics of the breath sounds, including any abnormal findings.
Correct Answer is A
Explanation
A. The purpose of the tubes is to decrease the pressure and allow for drainage: Tympanostomy tubes are placed in the tympanic membrane to facilitate drainage of middle ear fluid and equalize pressure. They help prevent recurrent otitis media and improve hearing in children prone to persistent effusions. The tubes create a temporary opening that allows air to enter the middle ear, reducing the risk of fluid accumulation and infection.
B. The tubes are permanently inserted during a surgical procedure: Tympanostomy tubes are not permanent; they usually fall out on their own within 6 to 12 months as the tympanic membrane heals. In some cases, if they do not extrude naturally, they may need to be removed by an ear, nose, and throat (ENT) specialist. Permanent tubes are rarely used and only in cases of severe chronic ear problems.
C. The tubes are placed in the inner ear: Tympanostomy tubes are inserted into the tympanic membrane (eardrum), which separates the outer ear from the middle ear. They do not enter the inner ear, which contains the cochlea and vestibular system. Placement in the inner ear would not be anatomically correct and could lead to serious complications.
D. The tubes are used in children with sensorineural loss: Tympanostomy tubes are not a treatment for sensorineural hearing loss, which results from damage to the inner ear or auditory nerve. They are used for conductive hearing issues caused by middle ear effusion, recurrent ear infections, or Eustachian tube dysfunction. Sensorineural hearing loss is typically managed with hearing aids or cochlear implants, not tympanostomy tubes.
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