A nurse assesses an elderly patient diagnosed with age-related macular degeneration (AMD). Which of the following assessment findings would be most consistent with AMD?
Loss of peripheral vision.
Blurred or distorted central vision.
Halos around lights at night.
Sudden onset of total vision loss.
The Correct Answer is B
Macular degeneration involves the progressive deterioration of the macula, the retinal region responsible for high-acuity vision. Accumulation of drusen or choroidal neovascularization disrupts photoreceptor function, leading to metamorphopsia and a permanent central scotoma that impairs reading and facial recognition.
Rationale:
A. The loss of peripheral vision, often described as tunnel vision, is the hallmark of glaucoma. Macular degeneration spares the peripheral retina and specifically targets the central field. Increased intraocular pressure typically damages the optic nerve fibers responsible for side vision instead.
B. The destruction of the macula directly causes blurring and distortion of images located in the center of the visual field. This is the most characteristic finding as the patient loses the ability to see fine detail. Amsler grid testing is frequently used to monitor these distortions.
C. Seeing halos around lights, especially at night, is a classic symptom associated with cataracts or angle-closure glaucoma. These visual phenomena result from light scattering or corneal edema rather than retinal macular atrophy. It is not a primary clinical manifestation of age-related degeneration.
D. Sudden, painless, total vision loss is a medical emergency usually indicating a central retinal artery occlusion. Age-related macular degeneration is typically a gradual process occurring over several years. Acute changes in AMD usually involve hemorrhagic leakage rather than immediate total blindness.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["E","F"]
Explanation
A concussion is a mild traumatic brain injury resulting from rapid acceleration-deceleration forces causing neuronal dysfunction, impaired cerebral glucose metabolism, and transient disruption of cortical and brainstem regulation. Deterioration after head injury may indicate evolving intracranial hemorrhage or increased intracranial pressure (ICP) requiring urgent escalation.
Rationale:
A. Vision 20/25 is within normal functional visual acuity limits for a 12-year-old. It does not indicate neurological deterioration or increased ICP. This finding is stable and does not require urgent reporting in post-concussion monitoring.
B. Slight bruising on the forehead reflects superficial soft tissue trauma from the initial impact. It does not indicate intracranial injury progression. External bruising alone without neurological decline is not an emergency warning sign.
C. Occasional yawning may reflect fatigue or post-concussive tiredness due to transient cerebral dysfunction. It is nonspecific and not independently associated with increased ICP or neurological deterioration requiring urgent intervention.
D. Short-term memory loss is a common expected post-concussion symptom due to temporary disruption of hippocampal function. While it should be monitored, it is not an acute red flag unless it is worsening or accompanied by other neurologic signs.
E. Nausea and vomiting are critical warning signs of rising intracranial pressure or possible intracranial bleeding. They suggest worsening cerebral edema or brain irritation and require immediate medical evaluation and escalation of care.
F. Blurred vision indicates possible increased intracranial pressure or cranial nerve involvement affecting visual pathways. This is a neurological red flag suggesting potential deterioration of brain function and requires urgent assessment and prompt intervention.
Correct Answer is B
Explanation
Acute angle-closure glaucoma is ophthalmic emergency due to sudden trabecular meshwork obstruction causing elevated intraocular pressure, optic nerve ischemia, presenting with severe ocular pain, nausea, vomiting, glaucoma, intraocular pressure, optic nerve, halos.
Rationale:
A. Cranial nerve III assessment evaluates ocular motor function involvement assessment. Cranial nerve III controls most extraocular eye movements functionally. Oculomotor dysfunction presents with ptosis diplopia not acute pain state. Symptoms here indicate intraocular pressure emergency not nerve palsy process.
B. Acute angle-closure glaucoma is ophthalmic emergency from sudden trabecular blockage causing high intraocular pressure. acute angle-closure presents with severe eye pain, halos, nausea. emergency referral is required to prevent vision loss. Delay results in optic nerve ischemia and blindness state.
C. Corneal light reflex assesses ocular alignment via cranial nerve II and III pathways. corneal reflex tests blink response to corneal stimulation touch. alignment abnormalities indicate strabismus not acute ocular pressure emergency. Symptoms require urgent referral not reflex testing process state.
D. Presbyopia is age-related loss of lens accommodation due to decreased elasticity causing near vision difficulty. presbyopia develops gradually after age 40 years. age-related changes do not cause eye pain or halos. Symptoms here indicate acute pathology not refractive aging state.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.