A nurse who works at a primary care clinic is precepting a nursing student in their senior year of nursing school. The student has evaluated the medical records for the clients that day and will perform assessments and education as appropriate. The preceptor will be able to validate her student is able to prioritize those that are at high risk for developing cataracts if she is able to verbalize which client?

A 55-year-old client with hyperthyroidism

A 30-year-old client who drinks a beer twice a week

A 75-year-old client who has smoked for 50 years

A 40-year-old with arteriosclerosis

Answer and Explanation

The Correct Answer is C

Choice A reason: Hyperthyroidism may cause eye issues like exophthalmos, not cataracts. Lens opacity from aging or smoking outweighs thyroid risk, making this 55-year-old less prioritized for cataract screening than older, smoking-exposed clients in this context fully.
Choice B reason: Minimal alcohol (two beers weekly) at 30 poses no cataract risk. Age and smoking are stronger factors; this young client lacks the cumulative exposure or oxidative stress tied to lens clouding, excluding them entirely here.
Choice C reason: At 75, with 50 years of smoking, this client faces high cataract risk. Aging degrades lens proteins, and smoking’s oxidative damage accelerates opacity, making this the priority for assessment and education on cataract prevention accurately here.
Choice D reason: Arteriosclerosis at 40 affects vessels, not lenses directly. While vascular health matters, age and smoking outweigh this risk for cataracts, rendering this client lower priority than the older, heavily smoking individual in this scenario fully.

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Correct Answer is B

Explanation

Choice A reason: Brachial pulse, in the upper arm, is strong and palpable in healthy adults, used for blood pressure cuffs. Its deep location ensures consistent detection, unlike weaker pulses, making it reliably felt across most individuals without vascular issues here.

Choice B reason: Ulnar pulse, near the wrist’s pinky side, is often faint or not palpable in many healthy people due to its depth and smaller artery size. This variability distinguishes it as less detectable compared to other major pulses consistently.

Choice C reason: Femoral pulse, in the groin, is robust and palpable in healthy adults, reflecting large artery flow to the legs. Its prominence ensures detection, unlike the ulnar, making it a standard check not commonly absent in normal assessments fully.

Choice D reason: Radial pulse, at the wrist’s thumb side, is easily palpable in healthy clients, a key vital sign check. Its superficial location ensures consistent detection, contrasting with the ulnar’s frequent elusiveness in normal peripheral exams entirely here.

A. Sit by the client's side and speak very slowly. B. Speak directly to the client, a little more slowly, in a normal, clear voice. C. Prepare to remove the blockage in the ear. D. Raise your voice and speak loudly and into the client's good ear.

Correct Answer is B

Explanation

Choice A reason: Speaking very slowly distorts speech, worsening comprehension in presbycusis, an age-related high-frequency hearing loss. Facing the client aids lip-reading, but excessive slowness disrupts natural cadence, reducing clarity for those with sensorineural deficits typically seen here.

Choice B reason: Speaking directly, slightly slower, in a clear voice enhances understanding in presbycusis. Facing the client supports visual cues, while normal volume avoids distortion, addressing high-frequency loss effectively without assuming blockage or overcompensating unnecessarily for this condition.

Choice C reason: Presbycusis is sensorineural, not conductive from blockages like cerumen. Preparing to remove nonexistent wax misdiagnoses this age-related cochlear degeneration, wasting time and missing the communication adjustments needed for effective care in this scenario entirely.

Choice D reason: Raising the voice distorts sound, worsening presbycusis comprehension, as shouting amplifies lower frequencies, not the lost high ones. Assuming a “good ear” ignores bilateral degeneration, making this less effective than clear, direct speech for communication here.

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Naxlex Comprehensive Predictor Exams

The nurse is performing a peripheral vascular assessment of an adult client. The nurse is palpating the client's peripheral pulses but knows that some are not palpable, even in healthy clients. What pulse is not palpable in a large proportion of healthy clients?

Correct Answer is B

Explanation

A nurse is caring for a client who has presbycusis. Which of the following actions should the nurse take?

Correct Answer is B

Explanation

A client presents with a cluster of upper airway complaints that include rhinorrhea. Which area of assessment would yield the most pertinent information to the etiology of rhinorrhea?

A decrease in tongue strength is noted on examination of a client. The nurse interprets this as indicating a problem with which cranial nerve?

While examining a client's mouth the nurse notes the presence of fasciculations, fine tremors of the client's tongue. How should the nurse best respond to the assessment finding?

The nurse has begun the objective assessment of a client's heart and neck vessels and is assessing the client's jugular veins. What finding would the nurse consider to be expected in a healthy client?

A nurse is integrating health promotion education into the assessment of a client's mouth, nose and throat. What interview question is most likely to identify a risk factor for oral cancer?