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?

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.

Choice A reason: Scheduling energy-intensive activities at the time of day when the client has higher energy levels is an activity plan that would best conserve the client's energy without compromising physical or mental health because it allows the client to perform tasks when they feel most capable and comfortable, as well as balance rest and activity throughout the day.

Choice B reason: Scheduling all activities within a small block of time to allow the client a longer, uninterrupted rest period is not an activity plan that would best conserve the client's energy without compromising physical or mental health because it can cause fatigue, stress, and frustration for the client, as well as reduce their mobility and function.

Choice C reason: Scheduling toilet breaks before and after any other planned activity is not an activity plan that would best conserve the client's energy without compromising physical or mental health because it can limit the client's fluid intake and output, as well as increase the risk of urinary tract infections or constipation.

Choice D reason: Scheduling the client's hygiene activities and limiting visitors is not an activity plan that would best conserve the client's energy without compromising physical or mental health because it can neglect the client's social and emotional needs, as well as isolate the client from their support system.