A patient presents to the emergency room with symptoms of severe eye pain, blurred vision, and nausea. The ophthalmologist diagnoses the patient with acute narrow-angle glaucoma. Which of the following interventions should be prioritized to alleviate the patient’s symptoms and prevent further complications?

Administer intravenous acetazolamide to reduce intraocular pressure.

Apply warm compresses to the affected eye to relieve pain.

Encourage the patient to drink plenty of fluids to stay hydrated.

Administer a mydriatic agent to dilate the pupil.

Advising the patient to limit fluid intake to prevent kidney damage is not appropriate. In fact, adequate hydration is crucial for patients with multiple myeloma to help flush out toxins and prevent kidney damage. Limiting fluid intake can lead to dehydration and worsen kidney function, which is already at risk due to the disease.

Answer and Explanation

The Correct Answer is A

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.

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Free Nursing Study Resources

Correct Answer is D

Explanation

Choice A Reason:

Weight loss is not typically associated with acromegaly. Acromegaly is characterized by excessive growth hormone production, leading to the enlargement of bones and tissues. Patients often experience weight gain rather than loss due to increased bone and soft tissue mass.

Choice B Reason:

Exophthalmos, or bulging eyes, is not a common manifestation of acromegaly. This symptom is more commonly associated with Graves’ disease, a thyroid disorder. Acromegaly primarily affects the bones and soft tissues, leading to changes in facial features and extremities.

Choice C Reason:

Thin and fragile hair is not a typical symptom of acromegaly. While hormonal imbalances can affect hair quality, acromegaly is more commonly associated with changes in bone and soft tissue structure. Symptoms like coarse, oily skin and excessive sweating are more characteristic of this condition.

Choice D Reason:

Enlarged hands and feet are hallmark signs of acromegaly. The excessive production of growth hormone leads to the enlargement of bones in the hands, feet, and face. Patients may notice that their rings no longer fit and that their shoe size has increased. This symptom is a key indicator of acromegaly and is often used in the diagnosis of the condition.

A. Adrenal hyperplasia B. Pituitary adenoma C. Thyroid carcinoma D. Hypothalamic dysfunction

Correct Answer is B

Explanation

Choice A Reason:

Adrenal hyperplasia involves the enlargement of the adrenal glands, which can lead to an overproduction of adrenal hormones. However, it does not directly cause hyperpituitarism. Hyperpituitarism is related to the overactivity of the pituitary gland, not the adrenal glands.

Choice B Reason:

Pituitary adenoma is the most common cause of hyperpituitarism. These benign tumors in the pituitary gland lead to the overproduction of one or more pituitary hormones, causing symptoms such as severe headaches, visual disturbances, and joint pain. The pituitary gland’s overactivity due to the adenoma results in the excessive release of hormones, which can affect various bodily functions.

Choice C Reason:

Thyroid carcinoma is a type of cancer that affects the thyroid gland While it can cause hormonal imbalances, it does not typically lead to hyperpituitarism. The symptoms described are more consistent with a pituitary-related issue rather than a thyroid condition.

Choice D Reason:

Hypothalamic dysfunction can affect the pituitary gland’s function since the hypothalamus regulates pituitary hormone release. However, it is less likely to be the primary cause of hyperpituitarism compared to a pituitary adenoma. The direct overproduction of hormones by the pituitary gland is more commonly due to an adenoma.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A patient with acromegaly is being evaluated. Which clinical manifestation is most likely to be observed in this patient?

Correct Answer is D

Explanation

A 45-year-old male patient presents with complaints of severe headaches, visual disturbances, and joint pain. Upon further investigation, he is diagnosed with hyperpituitarism. Which of the following is the most likely underlying cause of his symptoms?

Correct Answer is B

Explanation

A 65-year-old patient has just received a blood transfusion. Shortly after the transfusion begins, the patient complains of chills, back pain, and difficulty breathing. What is the most likely cause of these symptoms?

A nurse is reinforcing teaching with a client who has type 1 diabetes mellitus about self-care during illness. Which of the following instructions should the nurse include in the teaching?

A 65-year-old patient with a history of chronic anemia is receiving a blood transfusion. Fifteen minutes into the transfusion, the patient reports feeling chills and has a temperature of 101°F (38.3°C). What is the most appropriate initial nursing action?

A 45-year-old male patient is diagnosed with hypopituitarism. Which of the following interventions is the most appropriate initial action for managing this condition?

A 70-year-old patient is diagnosed with cataracts and is discussing treatment options with their healthcare provider. Which of the following is the most appropriate treatment for cataracts?

A 65-year-old patient presents to the emergency department with sudden onset of flashes of light, a shadow over the visual field, and floaters in their right eye. What is the most likely diagnosis?

A 55-year-old male patient is admitted to the hospital with a diagnosis of thrombocytopenia. Upon assessment, you note petechiae on his lower extremities, and he reports fatigue and occasional nosebleeds. Which of the following interventions should be prioritized for this patient?

A 20-year-old male patient with a known history of hemophilia A is brought to the emergency department with swelling and pain in his right knee after a minor fall. Which of the following is the most appropriate initial nursing intervention?