Practice Question
A client with a history of hypertension presents to the clinic with eye pain. Which assessment findings indicate that the client may be experiencing primary angle-closure glaucoma? Select all that apply.
Answer Choices:
Correct Answer:
Sudden, severe eye pain.
Rationale:
Sudden, severe eye pain.
✴️ Primary angle-closure glaucoma is an acute eye emergency characterized by sudden, severe eye pain due to rapidly increased intraocular pressure (IOP).
✴️ The drainage angle between the iris and cornea becomes blocked, leading to impaired aqueous humor outflow and pressure buildup.
✴️ Clients may describe the pain as intense, throbbing, or deep, sometimes accompanied by redness and a hard, firm globe.
✴️ This acute pain is a key distinguishing feature from chronic forms of glaucoma, which are typically painless.
✴️ Recognizing sudden severe eye pain with other ocular symptoms is critical for urgent ophthalmologic referral to prevent permanent vision loss.
Client states, "I could see pretty good this morning then all of a sudden everything is cloudy."
✴️ The description of sudden onset of cloudy vision fits the acute nature of angle-closure glaucoma, where IOP rises quickly.
✴️ Rapid pressure changes affect the cornea and optic nerve, producing blurred or cloudy vision within hours.
✴️ This contrasts with chronic open-angle glaucoma, where vision declines gradually and painlessly over time.
✴️ A history of “vision was fine earlier and then suddenly became cloudy” strongly suggests an acute ocular process, not a slow degenerative change.
✴️ This symptom, in combination with eye pain and headache, points toward primary angle-closure glaucoma and requires emergency treatment.
Headache.
✴️ Elevated intraocular pressure can cause referred pain that manifests as a headache, often on the same side as the affected eye.
✴️ Clients may also experience nausea and vomiting due to the intensity of pain and autonomic response.
✴️ When headache coexists with eye pain and sudden visual changes, it suggests a systemic reaction to high IOP.
✴️ This cluster of symptoms—eye pain, cloudy vision, halos, headache, and nausea—is typical of acute angle-closure glaucoma.
✴️ Because headache is part of this acute symptom complex, it is considered a supporting sign of primary angle-closure glaucoma.
Client states, "I see flashes of light."
✴️ Flashes of light (photopsia) are more characteristic of retinal detachment or retinal tears, not primary angle-closure glaucoma.
✴️ In retinal detachment, clients often describe flashes, floaters, or a curtain over their vision, reflecting retinal traction or separation.
✴️ Angle-closure glaucoma symptoms more commonly include severe eye pain, halos around lights, blurred vision, headache, and nausea, rather than isolated flashes.
✴️ While both conditions are urgent ocular problems, recognizing the different symptom patterns guides appropriate triage and management.
✴️ Because flashes of light more strongly indicate retinal pathology, this is not a classic sign of primary angle-closure glaucoma.
Client states, "My vision has been getting worse over time."
✴️ The statement “getting worse over time” suggests a chronic, progressive condition, such as primary open-angle glaucoma, diabetic retinopathy, or macular degeneration.
✴️ Primary open-angle glaucoma typically involves slow, painless loss of peripheral vision rather than sudden, severe symptoms.
✴️ Angle-closure glaucoma, in contrast, presents with abrupt onset of pain and marked visual changes within a short time frame.
✴️ Distinguishing between sudden vs. gradual vision loss is essential for differentiating acute emergencies from chronic diseases.
✴️ Because this description reflects a gradual decline, it is not typical of primary angle-closure glaucoma.
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This question is from NR302 QUIZ 5B RODGERS 15428 ATL SEPT25 -CHAMBERLAIN UNIVERSITY (EXAMPLIFY) which contains 11 questions.
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From Exam
NR302 QUIZ 5B RODGERS 15428 ATL SEPT25 -CHAMBERLAIN UNIVERSITY (EXAMPLIFY)
11 Questions
View Full Exam Start PracticingQuestion Details
- Category: RN Nursing Exam(s)
- Subcategory: Examplify Exam(s)
- Domain: Health Assessment
- Answer Choices: 5