A 65-year-old man with emphysema and bronchitis has come to the clinic for a follow-up appointment.
On assessment the nurse might expect to see which finding?

Choice A rationale

The abducens cranial nerve (CN VI) controls the lateral rectus muscle of the eye, which is responsible for outward movement. It is not assessed using the Snellen visual acuity chart. The function of this nerve is tested through the evaluation of lateral eye movements.

Choice B rationale

The optic cranial nerve (CN II) is responsible for vision, including visual acuity and visual fields. It is assessed using the Snellen visual acuity chart to determine how well a person can see at various distances. This test evaluates the clarity and sharpness of vision, making CN II the correct answer.

Choice C rationale

The trochlear cranial nerve (CN IV) controls the superior oblique muscle, which helps with downward and inward eye movements. It is not assessed using the Snellen visual acuity chart but rather through the evaluation of eye movements and alignment.

Choice D rationale

The oculomotor cranial nerve (CN III) controls most of the eye's movements, including those of the superior, inferior, and medial rectus muscles, as well as the inferior oblique muscle. It is also responsible for controlling the pupil's response to light. The Snellen visual acuity chart does not assess the function of CN III, as it focuses on visual clarity and acuity.

Choice A rationale

Vitiligo is a condition caused by the destruction or malfunction of melanocytes, the cells responsible for producing melanin pigment. This leads to the development of white patches on the skin, as melanin is absent in these areas. Vitiligo is an autoimmune condition and can affect any part of the body, including the skin, hair, and mucous membranes.

Choice B rationale

Excess apocrine glands in the feet are not related to vitiligo. Apocrine glands are sweat glands found primarily in the underarm and genital areas and are responsible for the secretion of a thick, odorless fluid. Their overactivity does not result in the white patches seen in vitiligo.

Choice C rationale

Impetigo is a bacterial skin infection characterized by red sores, blisters, and crusting. It is not related to vitiligo and does not cause depigmentation. Impetigo is treated with antibiotics, whereas vitiligo requires different management strategies to address the loss of pigment.

Choice D rationale

Vitiligo is not caused by an excess of melanin pigment. Rather, it is the result of melanin loss or the absence of melanocytes in certain areas of the skin, leading to the characteristic white patches.