A client does not understand why vision loss due to glaucoma is irreversible. What is the nurse's best explanation?
Once the tissue has necrosed from high pressure, it does not regenerate.
Glaucoma always leads to permanent blindness.
Once retinal detachment occurs, it does not return to its normal state.
Once bacterial infection has caused damage, the tissue does not regenerate.
The Correct Answer is A
Choice A reason: Once the tissue has necrosed from high pressure, it does not regenerate is the best explanation, because it describes the mechanism and outcome of glaucoma. Glaucoma is a condition that causes increased intraocular pressure, which damages the optic nerve and the retina, the tissues that are responsible for transmitting and processing visual information. Once these tissues are necrosed, or dead, they do not regenerate, or grow back, resulting in irreversible vision loss.
Choice B reason: Glaucoma always leads to permanent blindness is not a good explanation, because it is inaccurate and pessimistic. Glaucoma does not always lead to permanent blindness, but rather to progressive vision loss that can be prevented or slowed down with early diagnosis and treatment. Glaucoma can cause peripheral vision loss, tunnel vision, or blind spots, but not necessarily complete blindness.
Choice C reason: Once retinal detachment occurs, it does not return to its normal state is not a good explanation, because it is irrelevant and misleading. Retinal detachment is a condition that occurs when the retina separates from the underlying layer of blood vessels, which can cause vision loss or blindness. However, retinal detachment is not caused by glaucoma, nor is it a common complication of glaucoma. Retinal detachment can sometimes be repaired with surgery, depending on the extent and duration of the detachment.
Choice D reason: Once bacterial infection has caused damage, the tissue does not regenerate is not a good explanation, because it is incorrect and confusing. Bacterial infection is not a cause or a consequence of glaucoma, but rather a separate condition that can affect the eye. Bacterial infection can cause inflammation, pain, discharge, or redness in the eye, but not necessarily vision loss or tissue necrosis. Bacterial infection can usually be treated with antibiotics, which can prevent or reverse the damage.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: Determine whether it is temporary or permanent is not the nurse's priority action for a client with compromised immunity, because it is not the most urgent and relevant. Determining whether the compromised immunity is temporary or permanent is an important assessment, but it should be done after ensuring the safety and infection prevention of the client. Compromised immunity can be temporary or permanent, depending on the cause, such as medication, disease, or genetic disorder.
Choice B reason: Take the client's vital signs every four hours is not the nurse's priority action for a client with compromised immunity, because it is not the most urgent and relevant. Taking the client's vital signs every four hours is an important monitoring, but it should be done after ensuring the safety and infection prevention of the client. Vital signs can indicate the general health status and the presence of infection or inflammation, such as fever, tachycardia, or hypotension.
Choice C reason: Teach the family members to receive the flu shot annually is not the nurse's priority action for a client with compromised immunity, because it is not the most urgent and relevant. Teaching the family members to receive the flu shot annually is an important education, but it should be done after ensuring the safety and infection prevention of the client. The flu shot is a vaccine that can protect the family members and the client from influenza, which can be a serious and potentially fatal infection for people with compromised immunity.
Choice D reason: Wash hands before entering the client's room is the nurse's priority action for a client with compromised immunity, because it is the most urgent and relevant. Washing hands before entering the client's room is a basic and essential infection prevention measure, which can protect the client from exposure to pathogens that can cause infection. People with compromised immunity have a weakened or impaired immune system, which makes them more susceptible and vulnerable to infection.
Correct Answer is D
Explanation
Choice A reason: Properly disposing of contaminated equipment is an important infectioncontrol measure, but it is not the most effective way to prevent the spread of pathogens during client care. Contaminated equipment, such as gloves, gowns, masks, or needles, should be disposed of in designated containers or bags to prevent exposure or injury to others. However, this measure does not eliminate the risk of transmission of pathogens from the hands of the health care worker to the client or the environment.
Choice B reason: Discarding used syringes into appropriate containers is an important infectioncontrol measure, but it is not the most effective way to prevent the spread of pathogens during client care. Used syringes, especially those that contain blood or body fluids, should be discarded into punctureresistant, leakproof, and labeled containers to prevent needlestick injuries or exposure to others. However, this measure does not eliminate the risk of transmission of pathogens from the hands of the health care worker to the client or the environment.
Choice C reason: Changing soiled linens is an important infectioncontrol measure, but it is not the most effective way to prevent the spread of pathogens during client care. Soiled linens, especially those that contain blood or body fluids, should be changed and handled with gloves and minimal agitation to prevent contamination or aerosolization of pathogens. However, this measure does not eliminate the risk of transmission of pathogens from the hands of the health care worker to the client or the environment.
Choice D reason: Performing hand hygiene is the most effective way to prevent the spread of pathogens during client care, because it reduces the number of microorganisms on the hands of the health care worker, which are the most common source and mode of transmission of infection. Hand hygiene should be performed before and after contact with the client, after contact with potentially infectious materials, after removing gloves, and before and after performing invasive procedures. Hand hygiene can be performed by washing with soap and water or using alcoholbased hand rubs.
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