The practical nurse (PN) determines that a client's pupils constrict as they change focus from a far object to a near object. How should the PN document this finding?

Consensual pupillary constriction present.

Nystagmus present with pupillary focus.

Pupils reactive to accommodation.

Peripheral vision intact.

Answer and Explanation

The Correct Answer is C

Accommodation refers to the ability of the eyes to adjust and focus on objects at diﬀerent distances. When a client's pupils constrict as they change focus from a far object to a near object, it indicates that their pupils are reacting appropriately to accommodate the change in focus.

To document this finding accurately, the practical nurse (PN) should document "Pupils reactive to accommodation." This statement captures the observation that the pupils are constricting in response to the client changing their focus from a far object to a near object. It indicates normal pupillary response and accommodation.

Let's brieﬂy evaluate the other options:

a) Consensual pupillary constriction present.

Consensual pupillary constriction refers to the simultaneous constriction of both pupils when light is shone into one eye. This finding is not directly related to accommodation or the client's change in focus.

Therefore, it is not the appropriate documentation for the given scenario.

b) Nystagmus present with pupillary focus.

Nystagmus refers to involuntary eye movements that can aﬀect the alignment and focus of the eyes. The presence of nystagmus is not mentioned in the scenario, and it is not directly related to the client's change in focus. Therefore, it is not the appropriate documentation for the given scenario.

d) Peripheral vision intact.

Peripheral vision refers to the ability to see objects outside the central visual field. While important for assessing visual function, it is not directly relevant to the observed pupillary response during accommodation. Therefore, it is not the appropriate documentation for the given scenario.

In summary, when a client's pupils constrict as they change focus from a far object to a near object, the practical nurse should document "Pupils reactive to accommodation" to accurately describe the observed pupillary response during the accommodation process.

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Correct Answer is ["B","C"]

Explanation

Choice A reason: "I may experience urinary incontinencE." This statement does not indicate the need for additional teaching because it is truE. Urinary incontinence is a common symptom of MS due to nerve damage affecting the bladder control.

Choice B reason: "I should not exercise because this may trigger an exacerbation." This statement indicates the need for additional teaching because it is falsE. Exercise is beneficial for people with MS as it can improve strength, balance, mobility, fatigue, mood, and quality of lifE. Exercise does not cause or worsen MS relapses.

Choice C reason: "I should alternate the eye patch every other day to help with the double vision." This statement indicates the need for additional teaching because it is not recommendeD. Eye patching is not an effective treatment for double vision caused by MS, as it can impair depth perception, increase eye fatigue, and delay recovery. Eye patching should only be used temporarily and under medical supervision.

Choice D reason: "I may experience visual disturbances." This statement does not indicate the need for additional teaching because it is truE. Visual disturbances are common in MS due to inflammation or damage of the optic nerve or other parts of the visual pathway. Visual disturbances can include blurred vision, reduced color vision, pain in the eye, and loss of vision.

Choice E reason: "I need to check the water temperature before I take a batH." This statement does not indicate the need for additional teaching because it is truE. People with MS may have impaired sensation and temperature regulation, which can increase the risk of burns or hypothermia when exposed to hot or cold water. Checking the water temperature before bathing can prevent injury and discomfort.

A. Integumentary system B. Endocrine system C. Central nervous system D. Renal system E. Respiratory system

Correct Answer is ["A","C","E"]

Explanation

Choice A reason: The integumentary system is a portal of entry for anthrax because the bacteria can enter through cuts or abrasions on the skin, causing cutaneous anthrax, which is the most common and least severe form of the diseasE.

Choice B reason: The endocrine system is not a portal of entry for anthrax because the bacteria do not affect the glands or hormones of the body.

Choice C reason: The central nervous system is a portal of entry for anthrax because the bacteria can invade the brain and spinal cord, causing meningitis, which is a rare but fatal complication of anthrax infection.

Choice D reason: The renal system is not a portal of entry for anthrax because the bacteria do not affect the kidneys or urinary tract.

Choice E reason: The respiratory system is a portal of entry for anthrax because the bacteria can be inhaled into the lungs, causing inhalation anthrax, which is the most deadly and difficult to treat form of the diseasE.

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The practical nurse (PN) determines that a client's pupils constrict as they change focus from a far object to a near object. How should the PN document this finding?

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