A 72-year-old patient comes to the clinic complaining of sudden onset eye pain, nausea, and seeing halos around lights. The nurse notes that the patient’s pupil is mid-dilated and non-reactive to light. What is the most likely cause of these symptoms?
Optic neuritis
Macular degeneration
Narrow angle glaucoma
Cataract
The Correct Answer is C
Choice A: Optic Neuritis
Optic neuritis is an inflammation of the optic nerve that can cause pain and vision loss. The pain typically worsens with eye movement, and vision loss usually occurs in one eye. Symptoms include temporary vision loss, visual field loss, loss of color vision, and flashing lights. However, optic neuritis does not typically cause nausea or seeing halos around lights, and the pupil reaction to light is usually preserved.
Choice B: Macular Degeneration
Macular degeneration primarily affects central vision and is more common in older adults. It can cause blurred or reduced central vision, difficulty recognizing faces, and visual distortions such as straight lines appearing bent. However, it does not cause sudden onset eye pain, nausea, or seeing halos around lights. The pupil reaction to light remains normal in macular degeneration.
Choice C: Narrow Angle Glaucoma
Narrow angle glaucoma, also known as acute angle-closure glaucoma, is a medical emergency characterized by a sudden increase in intraocular pressure. Symptoms include severe eye pain, nausea, vomiting, seeing halos around lights, and a mid-dilated, non-reactive pupil. This condition occurs when the drainage angle between the iris and cornea becomes blocked, leading to a rapid rise in eye pressure. Immediate treatment is necessary to prevent permanent vision loss.
Choice D: Cataract
Cataracts cause clouding of the lens, leading to symptoms such as blurred vision, difficulty seeing at night, sensitivity to light, and seeing halos around lights. However, cataracts develop gradually and do not cause sudden onset eye pain or nausea. The pupil reaction to light is also typically normal in cataract patients.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A Reason:
The client’s tongue is not relevant for diagnosing cataracts. Cataracts are an eye condition characterized by clouding of the lens, which affects vision. The tongue does not provide any information related to the presence of cataracts.
Choice B Reason:
The client’s eyelid is also not relevant for diagnosing cataracts. While the eyelid can be examined for other eye-related conditions, it does not provide information about the lens’s clarity or the presence of cataracts. Cataracts specifically affect the lens inside the eye.
Choice C Reason:
The lens of the client’s eye is the correct area to examine for diagnosing cataracts. Cataracts cause the lens to become cloudy, leading to symptoms such as blurred vision, difficulty seeing at night, and sensitivity to light. An eye examination, including a slit-lamp exam, allows the healthcare provider to see the lens and identify any cloudiness or opacities indicative of cataracts.
Choice D Reason:
The posterior pharynx of the client’s throat is not relevant for diagnosing cataracts. This area is examined for conditions related to the throat and respiratory system, not for eye conditions. Cataracts are diagnosed through an eye examination focusing on the lens.
Correct Answer is A
Explanation
Choice A Reason:
Stopping the transfusion immediately and notifying the healthcare provider is the most appropriate initial action when a transfusion reaction is suspected. This action helps to prevent further complications and allows for prompt evaluation and management of the reaction. The nurse should also keep the IV line open with normal saline to maintain venous access.
Choice B Reason:
Administering antipyretics and continuing the transfusion is not appropriate. Continuing the transfusion could exacerbate the reaction and lead to more severe complications. The priority is to stop the transfusion and assess the patient before considering any further interventions.
Choice C Reason:
Slowing down the rate of the transfusion and reassessing in 30 minutes is not a safe approach. Any signs of a transfusion reaction, such as chills and fever, require immediate cessation of the transfusion. Delaying intervention could result in worsening of the patient’s condition.
Choice D Reason:
Continuing the transfusion and monitoring the patient closely is not appropriate. Immediate cessation of the transfusion is necessary to prevent further exposure to the potentially harmful blood product. Monitoring alone is insufficient without stopping the transfusion.
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