The nurse is performing an admission assessment on a client with a diagnosis of detached retina.
Which of the following is associated with this eye disorder?
Sharp, stabbing acute pain in the affected eye.
Total loss of vision.
A curtain-like loss of vision in the affected eye.
Yellow discoloration of the sclera.
The Correct Answer is C
Choice A rationale
Detached retina typically does not present with sharp, stabbing pain. Instead, patients experience painless symptoms like vision abnormalities due to separation of the retina from supporting tissue.
Choice B rationale
Total vision loss is rare with a detached retina unless extensive damage occurs. Partial visual disruption, such as curtain-like vision loss, is a hallmark symptom.
Choice C rationale
A curtain-like loss of vision arises from retinal detachment, disrupting visual fields as the retina separates from its vascular supply and neural connections.
Choice D rationale
Yellow sclera discoloration is associated with jaundice due to bilirubin accumulation, unrelated to retinal detachment pathology, which affects visual symptoms and not scleral appearance.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
Hemiparesis on the right side and ataxia are common manifestations of left-sided stroke, where the motor cortex affecting the contralateral side is impaired, leading to muscle weakness and coordination loss.
Choice B rationale
Spasticity of the left arm suggests motor impairment on the ipsilateral side, which is inconsistent with the nature of left-sided strokes affecting the contralateral side. Apraxia lacks relation to motor loss here.
Choice C rationale
Impulsive behavior and hostility are more indicative of frontal lobe involvement, not motor loss secondary to left-sided strokes. These behaviors do not represent motor manifestations.
Choice D rationale
Visual defects like homonymous hemianopia and diplopia may occur in stroke but are not direct indicators of motor loss. They relate to occipital lobe or optic pathway damage.
Correct Answer is C
Explanation
Choice A rationale
Soft restraints are utilized for agitation but are not prioritized in epilepsy care. Emergency equipment like suction ensures airway safety during seizures.
Choice B rationale
Glasgow Coma Scale evaluates neurological function but is less relevant for epilepsy management compared to essential tools like suction equipment for airway protection.
Choice C rationale
Suction equipment and oxygen are vital in epilepsy management to clear secretions and maintain oxygenation during seizures. Patent IV access allows rapid administration of emergency medications.
Choice D rationale
Dextrose infusion is used to treat hypoglycemia rather than seizures. Epilepsy care prioritizes tools like suction and oxygen for immediate seizure-related complications. .
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