The nurse asks the client to perform the action pictured. What is the nurse assessing?

Color discrimination
Near vision
Distance vision
Intraocular pressure
The Correct Answer is B
A) Color discrimination:
Color discrimination involves assessing the client's ability to differentiate between various colors, typically using color plates like the Ishihara test. This test is often used to detect color blindness or deficiencies in color vision. The action depicted in the image, which involves reading text up close, is not relevant to assessing color vision capabilities.
B) Near vision:
Near vision is assessed by having the client read small text or print held at a close distance, often using a near vision chart or card. The image shows the client covering one eye with an occluder while reading text, which is a common method to test the clarity and focus of near vision. This helps determine if the client has issues such as presbyopia, which affects near vision acuity.
C) Distance vision:
Distance vision is typically evaluated using a Snellen chart, where the client reads letters or symbols from a distance of 20 feet. The test aims to assess the clarity of vision at a distance. The action in the image does not align with this type of assessment, as it focuses on close-up reading rather than distance.
D) Intraocular pressure:
Intraocular pressure is measured using tools like a tonometer to assess the fluid pressure inside the eye, which is crucial for diagnosing conditions like glaucoma. This test involves specific instruments and procedures, unlike the reading task depicted in the image, which is unrelated to measuring eye pressure.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A) Facial edema: Myxedema is a severe form of hypothyroidism that is often characterized by the accumulation of mucopolysaccharides in the skin and other tissues, leading to facial and peripheral edema. This is a classic symptom of myxedema and is expected in clients with this condition.
B) Diarrhea: Diarrhea is more commonly associated with hyperthyroidism rather than hypothyroidism. Clients with myxedema typically experience constipation due to slowed gastrointestinal motility.
C) Tachycardia: Tachycardia is associated with hyperthyroidism. In contrast, myxedema is associated with bradycardia or a slow heart rate because of the overall slowing of the body's metabolic processes.
D) Heat intolerance: Heat intolerance is a symptom of hyperthyroidism. Clients with myxedema usually experience cold intolerance due to decreased metabolic activity and impaired thermoregulation.
Correct Answer is A
Explanation
A) Dehydration:
When the skin remains tented and returns to its normal position slowly after being pinched, it indicates decreased skin turgor, which is a clinical sign of dehydration. Dehydration can occur due to fluid loss from sweating during vigorous physical activity like a beach tournament.
B) Hypervolemia:
Hypervolemia refers to excess fluid volume in the body, which would typically manifest with signs such as peripheral edema or jugular vein distention rather than decreased skin turgor.
C) Properly Hydrated:
Properly hydrated individuals would have normal skin turgor, where the skin returns promptly to its normal position after being pinched.
D) Infection:
Skin tenting is not a specific sign of infection. Infection would typically present with localized signs such as redness, warmth, swelling, and possibly systemic signs like fever.
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