The nurse is testing a client's visual accommodation. Which of the following should the nurse recognize as an assessment finding from visual accommodation?

The pupils constrict when the examiner's index finger slowly moves toward the client's nose.

The client involuntary blinks in the presence of bright light directed over the pupils during the eye exam.

The client's peripheral vision becomes sharper when the examiner shines a light over the pupils.

The pupils dilate when the examiner's index finger slowly moves toward the client's nose.

Answer and Explanation

The Correct Answer is A

A. The pupils constrict when the examiner's index finger slowly moves toward the client's nose.

This statement is correct. Visual accommodation is the process by which the eye's lens changes shape to focus on objects at varying distances. When an object moves closer to the eyes, the pupils constrict to adjust and focus on the near object, preventing double vision.

B. The client involuntarily blinks in the presence of bright light directed over the pupils during the eye exam.

This statement describes the pupillary light reflex, not visual accommodation. The pupillary light reflex is the response of the pupils to light exposure.

C. The client's peripheral vision becomes sharper when the examiner shines a light over the pupils.

This statement is not accurate. Peripheral vision sharpness is not related to visual accommodation. Visual accommodation mainly involves adjusting focus for objects at varying distances.

D. The pupils dilate when the examiner's index finger slowly moves toward the client's nose.

This statement is incorrect. Pupils should constrict, not dilate, when focusing on a near object (as in visual accommodation). Dilation occurs in low-light conditions or in response to sympathetic stimulation.

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Correct Answer is A

Explanation

A. Fifth left intercostal space at the midclavicular line:

Explanation: The apical pulse, or the point of maximal impulse (PMI), is typically located at the fifth intercostal space at the midclavicular line on the chest. This is the area where the heartbeat is best heard using a stethoscope in most adults.

B. Third left intercostal space at the midclavicular line:

Explanation: This location is too high for the apical pulse. The heart's apex is generally not found at the third intercostal space; it's lower, closer to the fifth intercostal space.

C. Fourth left intercostal space at the sternal border:

Explanation: This location is not the typical site for auscultating the apical pulse. The PMI is usually heard at the midclavicular line, not at the sternal border.

D. Under the left breast at the midclavicular line:

Explanation: This position is not precise enough for auscultating the apical pulse. The specific intercostal space (fifth) and midclavicular line are crucial for accurate assessment.

A. The best time to perform a BSE is 4 to 7 days after the first day of the menstrual period. B. If she suspects that she is pregnant, then the woman should not perform a BSE until her baby is born. C. The best time to perform BSE is in the middle of the menstrual cycle. D. The woman needs to perform BSE only bimonthly unless she has fibrocystic breast tissue.

Correct Answer is A

Explanation

A. The best time to perform a BSE is 4 to 7 days after the first day of the menstrual period:

This statement is correct. Performing BSE a few days after the menstrual period ensures that the breasts are less likely to be swollen or tender, which can make it easier to detect any unusual changes.

B. If she suspects that she is pregnant, then the woman should not perform a BSE until her baby is born:

This statement is incorrect. Pregnant women can still perform breast self-examinations. In fact, it's important for pregnant women to be aware of any changes in their breasts.

C. The best time to perform BSE is in the middle of the menstrual cycle:

This statement is not as accurate as the first choice. While it's true that performing BSE a few days after the menstrual period can be easier due to reduced breast tenderness, it doesn't necessarily mean the middle of the menstrual cycle for every woman. The timing can vary based on an individual's menstrual cycle.

D. The woman needs to perform BSE only bimonthly unless she has fibrocystic breast tissue:

This statement is incorrect. Regular monthly breast self-examinations are recommended for all women, regardless of whether they have fibrocystic breast tissue or not. Detecting changes early is crucial for breast health.

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The nurse is testing a client's visual accommodation. Which of the following should the nurse recognize as an assessment finding from visual accommodation?

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