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. Bradypnea: Characterized by a regular but abnormally slow respiratory rate, typically fewer than 12 breaths per minute in adults. While the patient’s respiratory rate is 12, the irregular pattern and shallow depth suggest a different pattern rather than simple bradypnea.
B. Agonal respirations: Marked by gasping, labored breaths often seen in severe hypoxia or nearing death. This pattern is typically irregular and associated with brainstem dysfunction, which is not described in this case.
C. Chronic obstructive breathing: Seen in patients with COPD, involving prolonged expiration due to airway obstruction. The patient’s case does not mention an obstructive pattern but rather shallow and irregular respirations.
D. Hypoventilation: Defined by shallow, irregular breathing that leads to inadequate alveolar ventilation, commonly caused by drug overdose, particularly opioids or sedatives. The patient’s presentation of shallow and irregular respirations fits this pattern.
Correct Answer is D
Explanation
A. Perform the confrontation test: The confrontation test is used to assess peripheral vision rather than overall visual acuity. It is not the standard method for measuring visual acuity in routine physical examinations.
B. Determine the patient's ability to read newsprint at a distance of 12 to 14 inches: While this can be useful for assessing near vision, it does not provide a complete assessment of visual acuity, which includes both near and distance vision.
C. Ask the patient to read the print on a handheld Jaeger card: The Jaeger card is specifically used for assessing near vision. While it is useful for determining how well the patient can see up close, it does not assess distance visual acuity, which is typically required in routine examinations for teenagers.
D. Use the Snellen chart positioned 20 feet away from the patient: The Snellen chart is the standard tool for measuring distance visual acuity. It is positioned 20 feet away from the patient to evaluate how well they can see letters of various sizes. This method provides a clear assessment of the patient’s visual acuity for routine physical examinations.
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