A nurse is assessing a client in the emergency department when it is noted the left pupil is enlarged and fixed while the right pupil constricts to 2mm when exposed to light. Which of the following is a possible cause of unequal pupil sizing?

Normal variation in pupil size

Age-related changes

Ocular trauma

Excessive light exposure

Answer and Explanation

The Correct Answer is C

A.   There can be slight variations in pupil size but the difference described (one pupil enlarged and fixed, the other constricted and reactive to light) is not considered normal.

B.   Age-related changes in pupil size typically involve a gradual decrease in pupil size, not a sudden and dramatic difference between the two eyes.
C.   Unequal pupil size, especially when one pupil is fixed and dilated, is a classic sign of increased intracranial pressure (ICP), often caused by head trauma.
D.   Exposure to light would cause both pupils to constrict, not one to dilate and fix.

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Correct Answer is A

Explanation

A. Abnormally prominent U wave is a classic sign of hypokalemia. The U wave is normally small and often hidden by the T wave. When it becomes prominent, it's a strong indicator of low potassium levels.
B. Inverted P wave is more indicative of atrial abnormalities, such as atrial fibrillation.
C. Elevated ST segment is often associated with myocardial ischemia or injury.
D. Wide QRS is more characteristic of conduction disturbances like bundle branch blocks.

A. The client who has chronic kidney disease B. The client experiencing an asthma attack C. The client who has Guillain-Barré syndrome D. The client who has a severe burn injury

Correct Answer is C

Explanation

A. This client is at risk for other complications such as electrolyte imbalances or heart failure, but not specifically neurogenic shock.
B. This client is experiencing respiratory distress, which is a different type of shock (anaphylactic or septic shock might be considered, but not neurogenic).

C. Guillain-Barré syndrome is an autoimmune disorder that affects the nervous system, often leading to paralysis. It can cause a rapid loss of muscle function, which can result in neurogenic shock due to loss of sympathetic nervous system tone.
D. This client is at risk for hypovolemic shock due to fluid loss, not neurogenic shock.

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A nurse is assessing a client in the emergency department when it is noted the left pupil is enlarged and fixed while the right pupil constricts to 2mm when exposed to light. Which of the following is a possible cause of unequal pupil sizing?

Nursing Test Bank

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Correct Answer is A

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Correct Answer is C

Explanation

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