An ophthalmologist tells a client that he has macular degeneration.
The nurse explains to the client that this means there is:
Yellow deposits called drusen under the retina.
Increased intraocular pressure in the eye.
A tendency for the retina to tear.
Blurred vision at any distance.
The Correct Answer is A
Choice A rationale
Age-related macular degeneration is characterized by the accumulation of drusen, which are small yellow or white extracellular deposits located between the retinal pigment epithelium and the Bruch membrane. These deposits interfere with the metabolic support of the photoreceptors in the macula, leading to central vision loss. Drusen are considered the hallmark early clinical sign of the dry form of the disease. Normal visual acuity is 20/20, but the presence of drusen progressively degrades the clarity of the central visual field.
Choice B rationale
Increased intraocular pressure is the primary pathophysiological mechanism associated with glaucoma, not macular degeneration. In glaucoma, the elevated pressure damages the optic nerve, typically resulting in the loss of peripheral vision rather than central vision. Normal intraocular pressure is between 10 and 21 mmHg. Macular degeneration specifically affects the macula, the area responsible for sharp, detailed central vision, and is usually unrelated to the drainage of aqueous humor or the internal pressure levels of the eyeball.
Choice C rationale
A tendency for the retina to tear or pull away from the underlying tissue describes a retinal detachment. This condition often presents with symptoms like sudden flashes of light, floaters, or a curtain-like shadow over the visual field. While both involve the retina, macular degeneration is a chronic, progressive deterioration of the central macular area, whereas a retinal tear is an acute structural failure. The underlying causes of macular degeneration are typically oxidative stress, inflammation, and genetic factors rather than mechanical traction.
Choice D rationale
Blurred vision at any distance is a general symptom that can be associated with refractive errors like astigmatism, myopia, or hyperopia. Macular degeneration specifically targets central vision, leaving peripheral vision relatively intact. Patients with macular degeneration struggle with tasks requiring fine detail, such as reading or recognizing faces, but they can usually navigate their environment using their side vision. Describing the condition as general blurring fails to capture the specific loss of the central visual field caused by macular pigmentary changes.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale
Ensuring all food is soft is an intervention for patients with dysphagia or chewing difficulties, not necessarily for those with visual impairment. While safety is important, restricted textures are only required if a swallowing or dental issue is present. For a visually impaired client, the focus should be on maintaining autonomy and nutritional variety. Unnecessarily altering food consistency can decrease the client's appetite and sense of independence during meals.
Choice B rationale
Serving hot food as quickly as possible is a general standard for food quality but does not address the specific needs of a visually impaired individual. In fact, extremely hot food can be a safety hazard if the client cannot see where the steam or heat is coming from. The priority should be on safe orientation to the tray and providing a clear description of the meal's layout to prevent accidental burns or spills.
Choice C rationale
Describing the location of food items using the numbers on a clock face is a standard and effective rehabilitative technique. This method allows the client to visualize the plate and promotes independence by letting them feed themselves. For example, the nurse might state that the meat is at 6 o'clock and the vegetables are at 2 o'clock. This specific communication strategy enhances the client's spatial awareness and mealtime experience.
Choice D rationale
Leaving the tray on the bedside table without further intervention is negligent for a client with significant visual impairment. Without assistance in identifying the food or its location, the client may be unable to eat, leading to malnutrition or dehydration. Furthermore, it increases the risk of spills and accidents. Proper nursing care involves active engagement to ensure the client is oriented to the environment and can safely consume their meal.
Correct Answer is ["10"]
Explanation
Step 1 is 320 mg ÷ 160 mg × 5 mL.
Step 2 is 2 × 5 mL.
Step 3 is 10.0 mL. The final calculated answer is 10 mL.
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