a client does not understand why vision loss due to glaucoma is irreversible what is the nurses best explanation

ATI RN

Multi Dimensional Care | Exam | Rasmusson

1. A client does not understand why vision loss due to glaucoma is irreversible. What is the nurse's best explanation?

A. Once retinal detachment occurs, it does not return to its normal state
B. Once the tissue has necrosed from high-pressure, it does not regenerate
C. Glaucoma always leads to permanent blindness
D. Once bacterial infection has caused damage, the tissue does not regenerate

Correct answer: B

Rationale: The correct explanation for irreversible vision loss in glaucoma is that once the tissue has necrosed from high pressure, it does not regenerate. This necrosis occurs due to the damage caused by increased intraocular pressure, which leads to irreversible damage to the optic nerve and retinal tissue. Choices A, C, and D are incorrect because they do not directly address the specific mechanism of irreversible vision loss in glaucoma, which is necrosis due to high pressure.

2. To promote independence, which of these is the best intervention to implement?

A. Perform the clientâ€™s activities of daily living for them.
B. Speak directly in front of the client so they can read your lips well.
C. Give the client their washcloth and toothbrush and leave the room.
D. Allow the client to perform the activities of daily living they are able to do.

Correct answer: D

Rationale: The correct answer is to allow the client to perform the activities of daily living they are able to do. This intervention promotes independence by encouraging clients to maintain their functional abilities. Choice A is incorrect as performing the client's activities of daily living for them does not empower independence. Choice B is irrelevant to promoting independence. Choice C is not actively promoting independence as it involves leaving the client alone without any guidance or support.

3. What is a sign of inadequate perfusion?

A. Intact sensation
B. Pallor in toes
C. Bounding pulses
D. Pink fingers

Correct answer: B

Rationale:

4. The client has been asked to perform weight-bearing exercises three times a week. The client admits to not doing the recommended exercises. What is the most appropriate response by the nurse?

A. I walk 3 miles every day. Would you like to join me?
B. Tell me more about your experience with these exercises.
C. My dad never exercised. He fell and broke his hip. Is that your goal?
D. You should be doing these exercises.

Correct answer: B

Rationale: The most appropriate response by the nurse is to ask the client to elaborate on their experience with the exercises. By doing so, the nurse can gain insight into any barriers the client may be facing and work together to find solutions to improve adherence. Choice A is not appropriate as it doesn't address the client's situation. Choice C is not relevant and may induce fear in the client. Choice D is directive and does not promote open communication or understanding of the client's perspective.