NU 160 Exam 4 Spring 2025

Correct Answer D: The gas bubble will be reabsorbed after several weeks.

Explanation:

D. The gas bubble will be reabsorbed after several weeks.

In a pars plana vitrectomy for retinal detachment, a gas bubble is often used to help reattach the retina by applying pressure against the detached area. The gas is gradually reabsorbed by the body over several weeks. This reabsorption process helps to maintain the pressure needed for retinal healing while the retina is reattached.

Why the Other Options Are Incorrect:

A. The gas bubble will be inserted into the anterior chamber.

The gas bubble is inserted into the vitreous cavity, not the anterior chamber. The anterior chamber is the space between the cornea and the iris, while the vitreous cavity is the large space filled with gel-like material behind the lens.

B. The gas bubble will apply pressure to the cornea.

The gas bubble applies pressure to the retina, not the cornea. It helps to keep the retina in place as it heals and reattaches to the back of the eye.

C. The gas bubble will be removed once the procedure is completed.

The gas bubble is not removed after the procedure. It naturally resorbs over time. No surgical removal of the gas is required unless there is a complication.

Correct Answer C: It will take 2 months for my intraocular pressure to decrease.

Explanation:

C. It will take 2 months for my intraocular pressure to decrease.

This statement is correct. After laser trabeculoplasty, the reduction in intraocular pressure (IOP) may not be immediate and can take up to several weeks or even months to achieve the full effect. The statement reflects the expected time frame for the pressure to decrease after the procedure.

Why the Other Options Are Incorrect:

A. My contact is making my eye feel itchy.

This statement could indicate a potential complication, such as irritation, infection, or an allergic reaction, which is not typical after laser trabeculoplasty. The use of contact lenses immediately following eye surgery is generally not recommended without provider approval, and itchy eyes should be reported to the healthcare provider.

B. I can remove the eye patch when I go to sleep.

This statement is incorrect. The eye patch or shield is typically worn for protection after the procedure and should generally remain in place as per the healthcare provider's instructions. The client should follow the specific discharge instructions provided by the surgeon or doctor regarding when to remove the eye patch or shield.

D. I'm looking forward to holding my grandbaby this weekend.

This statement is not related to understanding the discharge instructions for post-operative care after laser trabeculoplasty. The client should avoid any activities that might put pressure on the eyes or involve physical contact that could potentially cause harm to the eye in the early post-operative period. The nurse should clarify activity restrictions with the client to ensure proper healing.

Correct Answer D: Vision changes occur when the cloudy lens alters the passage of light through the eye.

Explanation:

Cataracts are a condition where the lens of the eye becomes cloudy, which interferes with the passage of light through the lens. This clouding of the lens causes blurry, cloudy, or dim vision. The correct statement reflects this process, where the cloudy lens alters the passage of light to the retina, resulting in vision changes.

Why "D" is correct:

D. Vision changes occur when the cloudy lens alters the passage of light through the eye.

This is the most accurate description of cataracts. The clouding of the lens in the eye causes light to scatter, preventing it from properly reaching the retina, which leads to vision changes such as blurriness, glare, and difficulty seeing at night.

Why the Other Options Are Incorrect:

A. Vision changes occur when blood vessels leak fluid or blood under a portion of the retina.

This statement describes the process of macular degeneration, not cataracts. In macular degeneration, blood vessels under the retina leak, causing vision changes. Cataracts, on the other hand, involve clouding of the lens, not issues with blood vessels under the retina.

B. Vision changes occur when retinal tissue pulls away from the blood vessels in the eye.

This description refers to retinal detachment, a different eye condition. Retinal detachment occurs when the retina separates from the underlying tissue, which can lead to vision loss if untreated. It is not related to cataracts.

C. Vision changes occur when pressure in the eye is increased due to a decrease of aqueous humor.

This statement describes glaucoma, a condition where increased pressure in the eye can lead to damage to the optic nerve. Cataracts are caused by changes to the lens, not by pressure changes in the eye.

Correct Answer B: Oral herpes simplex virus type 1

Explanation:

B. Oral herpes simplex virus type 1

The description of the lesion, particularly its yellow-grey base and painful nature, suggests a herpes simplex virus (HSV) type 1 infection. HSV-1 is a common cause of cold sores or fever blisters, which can present as painful, erythematous lesions with a yellow-grey center on the buccal mucosa or lips. These lesions are typically associated with a primary or recurrent infection of the virus, and the pain and appearance are characteristic of this condition.

Why the Other Options Are Incorrect:

A. Oral cancer

Oral cancer typically presents as persistent, non-healing ulcers or lumps in the mouth that may not have a yellow-grey base. These lesions usually do not resolve on their own and may be painless initially. The lesion described in the question is painful, which is more consistent with an infectious cause like HSV-1. Oral cancer also tends to present in other areas of the mouth, such as the tongue or floor of the mouth, and is generally not localized to the buccal mucosa with the specific characteristics described here.

C. Oral aphthous ulcer

An oral aphthous ulcer (canker sore) is also a common cause of painful lesions in the mouth. However, these ulcers typically have a white or yellow center with a red border rather than a yellow-grey base. Additionally, aphthous ulcers are usually not as erythematous as the lesion described and are not typically associated with viral infections. They often occur in individuals without other systemic infections or conditions.

D. Crohn's disease

While Crohn’s disease can cause oral lesions (such as cobblestone mucosa or deep ulcers in the mouth), these lesions are often part of a more systemic inflammatory condition. Crohn's-related mouth ulcers are generally larger, deeper, and more chronic than the acute, painful, and erythematous lesion described here. The lesion described in the question is more characteristic of a viral infection, such as HSV-1, rather than an inflammatory disease like Crohn’s.

Correct Answers B: Drowsiness

C. Urinary retention

D. Dry mouth

Explanation:

B. Drowsiness

Meclizine is an antihistamine with sedating properties. Drowsiness is a common side effect, and clients should be cautioned to avoid driving or operating machinery until they know how the medication affects them.

C. Urinary retention

This is an anticholinergic effect of meclizine. It can slow bladder emptying, particularly in older adults or those with prostate conditions. Clients should report any new difficulty urinating.

D. Dry mouth

Dry mouth is another anticholinergic side effect of meclizine. Clients may be advised to chew sugar-free gum or drink water frequently to manage this discomfort.

Why the Other Options Are Incorrect:

A. Insomnia

Meclizine is sedating and typically causes drowsiness, not insomnia. It may even be used to help clients rest while experiencing vertigo.

E. Increased salivation

This is not a typical side effect. Meclizine tends to cause dry mouth due to its anticholinergic effects, not increased salivation.

Correct Answer B: Chronic blood loss

Explanation:

B. Chronic blood loss

Chronic blood loss is a common and significant cause of anemia in patients with ulcerative colitis. In ulcerative colitis, the inflamed colon can lead to bleeding in the gastrointestinal tract, especially during active disease flares. This persistent or recurrent blood loss can lead to iron deficiency anemia, as the body loses red blood cells faster than it can produce them. This is the primary contributor to the client's anemia in the context of ulcerative colitis.

Why the Other Options Are Incorrect:

A. Intestinal malabsorption syndrome

While intestinal malabsorption can occur in various gastrointestinal disorders and contribute to anemia by impairing the absorption of essential nutrients like iron, vitamin B12, or folic acid, it is less commonly a primary cause of anemia in ulcerative colitis compared to chronic blood loss. In severe cases, malabsorption might occur if the disease affects a significant portion of the small intestine, but it is typically the chronic blood loss that most directly leads to anemia in this condition.

C. Intestinal parasites

Intestinal parasites are not typically associated with ulcerative colitis unless there is an additional infection. While they can cause gastrointestinal symptoms and contribute to anemia, this is not a common cause of anemia in ulcerative colitis, which is more related to inflammation and blood loss rather than parasitic infections.

D. Dietary iron restrictions

Although iron deficiency is a common cause of anemia in patients with ulcerative colitis, it is usually due to blood loss rather than dietary restrictions. Most patients with ulcerative colitis do not intentionally restrict iron; in fact, they may often need more iron due to blood loss from their gastrointestinal tract. Therefore, dietary iron restrictions are not typically a contributing factor to anemia in these clients.

Correct Answers:

B. Amoxicillin

C. Vonoprazan

E. Esomeprazole

Explanation:

Peptic ulcer disease (PUD) is a condition where open sores develop on the inner lining of the stomach or the upper part of the small intestine. The treatment of PUD typically involves a combination of medications to reduce stomach acid, eradicate Helicobacter pylori (the bacteria that causes many ulcers), and promote healing of the ulcer. Here's why the selected options are commonly used for treating PUD:

B. Amoxicillin:

Amoxicillin is an antibiotic that is commonly used as part of the combination therapy for eradicating H. pylori infection, which is a major cause of peptic ulcers. A common treatment regimen involves a combination of antibiotics (e.g., amoxicillin) and proton pump inhibitors (PPIs) to eliminate the bacteria and reduce acid production.

C. Vonoprazan:

Vonoprazan is a newer medication that belongs to the class of potassium-competitive acid blockers (P-CABs). It works by blocking acid secretion in the stomach and is used in the treatment of PUD, particularly in countries where it is approved for use. It is effective in managing acid-related diseases, including PUD.

E. Esomeprazole:

Esomeprazole is a proton pump inhibitor (PPI) that reduces stomach acid production. PPIs like esomeprazole are commonly used to treat PUD as they help in reducing acid secretion, allowing the ulcer to heal and preventing further damage to the stomach lining.

Why the Other Options Are Incorrect:

A. Aspirin:

Aspirin is a nonsteroidal anti-inflammatory drug (NSAID), which can actually exacerbate or cause peptic ulcers. It is not used to treat PUD; in fact, NSAIDs like aspirin are contraindicated for people with active ulcers because they can irritate the stomach lining and increase the risk of bleeding.

D. Lisinopril:

Lisinopril is an angiotensin-converting enzyme (ACE) inhibitor used primarily to treat high blood pressure and heart failure. It does not play a role in the treatment of PUD and is not involved in acid reduction or H. pylori eradication.

F. Gabapentin:

Gabapentin is a medication used to treat nerve pain and seizures, but it is not used for the treatment of peptic ulcers. It has no impact on reducing stomach acid or promoting ulcer healing.

Correct Answers:

A. Grape juice

B. Lemon gelatin

D. Broth

Explanation:

Clear liquid diets are typically prescribed after surgery to provide hydration and maintain electrolyte balance while minimizing the workload on the digestive system. Clear liquids are transparent and can be easily absorbed by the stomach. The items listed below are appropriate for a clear liquid diet:

A. Grape juice

Grape juice is a clear liquid that does not contain any solids, making it suitable for a clear liquid diet. However, it should be strained to ensure that there are no pulp particles, which would make it unsuitable.

B. Lemon gelatin

Lemon gelatin is considered a clear liquid since it dissolves into a liquid form, making it appropriate for a clear liquid diet. The key here is that gelatin should not contain any solid particles or dairy components, which lemon gelatin does not.

D. Broth

Broth is a common item on a clear liquid diet. It is clear, contains no solid food particles, and provides hydration and electrolytes, which are essential after surgery.

Why the Other Options Are Incorrect:

C. Custard

Custard is not suitable for a clear liquid diet because it contains dairy and has a thicker consistency. A clear liquid diet is intended to consist of liquids that do not contain solid food particles or dairy products, so custard would not meet the criteria.

E. Nonfat milk

Nonfat milk is not considered a clear liquid because it is a dairy product with a thicker consistency that is not easily absorbed by the digestive system following surgery. It should be avoided during the clear liquid phase of the diet.

Correct Answers:

B. Methotrexate

G. Sulfasalazine

Explanation:

B. Methotrexate

Methotrexate is a disease-modifying antirheumatic drug (DMARD) that is sometimes used to treat inflammatory bowel disease (IBD), especially Crohn's disease, in cases where other treatments are ineffective. It works by suppressing the immune system and reducing inflammation.

G. Sulfasalazine

Sulfasalazine is a 5-aminosalicylic acid (5-ASA) compound used to treat ulcerative colitis and sometimes Crohn's disease. It works by reducing inflammation in the intestines.

Why the Other Options Are Incorrect:

A. Metformin

Metformin is primarily used to treat type 2 diabetes and has no role in treating inflammatory bowel disease.

C. Lisinopril

Lisinopril is an ACE inhibitor used to treat high blood pressure and heart failure, not IBD.

D. Hydrochlorothiazide

Hydrochlorothiazide is a diuretic used to treat high blood pressure and edema, not IBD.

E. Aspirin

Aspirin is a nonsteroidal anti-inflammatory drug (NSAID). While it has anti-inflammatory properties, it is typically avoided in IBD, as it can irritate the gastrointestinal tract and worsen symptoms of IBD.

F. Ibuprofen

Ibuprofen is also an NSAID and should be avoided in patients with IBD because it can increase inflammation and cause damage to the gastrointestinal lining.