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?
Night blindness
Central vision loss
Peripheral vision loss
Double vision
The Correct Answer is B
Choice A Reason:
Night blindness, or difficulty seeing in low light, is not a primary symptom of macular degeneration. This condition primarily affects the macula, the central part of the retina responsible for sharp, central vision. Night blindness is more commonly associated with conditions like retinitis pigmentosa or vitamin A deficiency.
Choice B Reason:
Central vision loss is the hallmark of macular degeneration. This condition leads to the deterioration of the macula, causing blurred or lost central vision while peripheral vision remains intact. Patients often report difficulty reading, recognizing faces, and performing tasks that require fine visual detail3.
Choice C Reason:
Peripheral vision loss is not typically associated with macular degeneration. This condition affects the central part of the retina, leaving peripheral vision largely unaffected. Peripheral vision loss is more commonly seen in conditions like glaucoma.
Choice D Reason:
Double vision, or diplopia, is not a characteristic symptom of macular degeneration. This condition affects the clarity of central vision but does not typically cause double vision. Double vision can result from issues with the eye muscles or nerves, such as in cases of strabismus or cranial nerve palsies.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A Reason:
Administering intravenous acetazolamide is a critical intervention for acute narrow-angle glaucoma. Acetazolamide is a carbonic anhydrase inhibitor that reduces the production of aqueous humor, thereby lowering intraocular pressure (IOP) quickly. Reducing IOP is essential to prevent optic nerve damage and preserve vision. Normal IOP ranges from 10 to 21 mmHg, and in acute narrow-angle glaucoma, it can exceed 30 mmHg. Rapid reduction of IOP is crucial to alleviate symptoms and prevent further complications.
Choice B Reason:
Applying warm compresses to the affected eye is not an appropriate intervention for acute narrow-angle glaucoma. Warm compresses may provide temporary relief for some eye conditions, but they do not address the underlying issue of elevated intraocular pressure. In fact, warm compresses can potentially increase blood flow to the eye, which might exacerbate the condition.
Choice C Reason:
Encouraging the patient to drink plenty of fluids to stay hydrated is generally good advice for overall health, but it is not a prioritized intervention for acute narrow-angle glaucoma. Hydration does not directly impact intraocular pressure or alleviate the acute symptoms of glaucoma. The primary focus should be on reducing IOP to prevent optic nerve damage.
Choice D Reason:
Administering a mydriatic agent to dilate the pupil is contraindicated in acute narrow-angle glaucoma. Mydriatic agents can worsen the condition by further narrowing the anterior chamber angle, increasing intraocular pressure, and potentially causing more damage to the optic nerve. It is crucial to avoid pupil dilation in this scenario.
Correct Answer is D
Explanation
Choice A Reason:
Febrile non-hemolytic transfusion reactions (FNHTRs) are common and typically present with fever, chills, and sometimes rigors. However, they do not usually cause severe symptoms such as back pain and difficulty breathing. FNHTRs are generally less severe and are caused by the recipient’s immune response to donor white blood cells or cytokines in the transfused blood.
Choice B Reason:
Allergic reactions to blood transfusions can range from mild to severe. Mild reactions may include itching, hives, and rash, while severe reactions (anaphylaxis) can cause difficulty breathing and hypotension. However, allergic reactions do not typically cause back pain, which is more indicative of a hemolytic process.
Choice C Reason:
Fluid overload, also known as transfusion-associated circulatory overload (TACO), can occur when too much blood is transfused too quickly. Symptoms include dyspnea, hypertension, and pulmonary edema. While difficulty breathing is a symptom of fluid overload, chills and back pain are not typical features.
Choice D Reason:
Acute hemolytic transfusion reaction (AHTR) is the most likely cause of the patient’s symptoms. AHTR occurs when the recipient’s immune system attacks the transfused red blood cells, leading to their destruction. This reaction can cause severe symptoms such as chills, fever, back pain, and difficulty breathing. It is a medical emergency that requires immediate intervention to prevent serious complications, including kidney failure and shock.
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