A patient presents to the emergency department with sudden, severe eye pain, blurred vision, and seeing halos around lights. Which of the following conditions is most likely causing these symptoms?
Conjunctivitis
Acute angle-closure glaucoma
Dry eye syndrome
Cataract
The Correct Answer is B
A. Conjunctivitis: Conjunctivitis typically presents with redness, itching, tearing, and discharge. It does not cause sudden severe eye pain, halos around lights, or rapid vision loss, making it unlikely in this emergency scenario.
B. Acute angle-closure glaucoma: This is a medical emergency characterized by sudden severe eye pain, blurred vision, halos around lights, headache, nausea, and vomiting. It results from a rapid increase in intraocular pressure due to blocked aqueous humor drainage.
C. Dry eye syndrome: Dry eye causes burning, irritation, and a gritty sensation but does not lead to acute, severe pain or halos around lights. It is a chronic, uncomfortable condition rather than an acute emergency.
D. Cataract: Cataracts cause gradual, painless clouding of the lens that leads to blurry vision and glare. They do not present with sudden eye pain or acute onset of symptoms as seen in this case.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Uric acid of 6.5 mg/dL: Although hyperuricemia is a common risk factor for gout, a level of 6.5 mg/dL falls within the reference range and may not always indicate an acute attack. Some patients experience gout flares even with uric acid in the normal range.
B. Erythrocyte sedimentation rate (ESR) of 5 mm/hr: An ESR of 5 mm/hr is within the normal range and does not suggest active inflammation. During an acute gout flare, inflammatory markers like ESR are often elevated due to the intense joint inflammation.
C. Decreased C-Reactive Protein (CRP): A decreased CRP is not expected in acute gout. CRP usually rises as part of the systemic inflammatory response, reflecting the acute inflammatory process occurring in the affected joint.
D. Urate crystals in the synovial fluid: The presence of monosodium urate crystals in joint aspirate is the hallmark diagnostic finding in gout. This confirms the diagnosis during an acute attack, as the crystals precipitate in the joint space, causing pain and inflammation.
Correct Answer is ["A","B","D"]
Explanation
A. Ibuprofen: NSAIDs such as ibuprofen are on the Beers List due to the risk of gastrointestinal bleeding, renal impairment, and hypertension in older adults. Safer alternatives are recommended when possible.
B. Diazepam: Long-acting benzodiazepines like diazepam are included because they increase the risk of sedation, confusion, and falls in older adults. Shorter-acting agents or nonpharmacologic approaches are preferred.
C. Warfarin: Warfarin is not broadly listed as inappropriate but requires careful monitoring of INR and diet. It is often necessary for anticoagulation and is not automatically contraindicated for older adults.
D. Digoxin: Digoxin is on the Beers List at doses greater than 0.125 mg/day due to the risk of toxicity, particularly with reduced renal clearance in older adults. Lower doses or alternatives are often considered safer.
E. Metformin: Metformin is not on the Beers List and is commonly used safely in older adults, except in cases of severe renal impairment where lactic acidosis risk is increased. It is generally a preferred first-line therapy for type 2 diabetes.
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