A client sustained a subconjunctival hemorrhage. The presence of which set of symptoms indicate that the client needs to be seen for further evaluation by an ophthalmologist?

Acute pain, change in visual acuity, and foreign body sensation.

Frequent burning, irritation and tearing of the eyes.

Bilateral itchy, red eyes with watery discharge.

Diminished ability to focus on close work and excessive illumination required.

Answer and Explanation

The Correct Answer is A

Rationale:
A. Acute pain, change in visual acuity, and foreign body sensation: These symptoms are concerning and require immediate ophthalmologic evaluation. Subconjunctival hemorrhages are usually benign and painless, so the presence of pain, vision changes, and foreign body sensation suggests a more serious underlying ocular injury or pathology.

B. Frequent burning, irritation and tearing of the eyes: These symptoms are commonly associated with dry eye syndrome or minor irritations. While uncomfortable, they do not typically indicate an urgent need for specialist referral unless severe or persistent.

C. Bilateral itchy, red eyes with watery discharge: This presentation is most consistent with allergic conjunctivitis. Although it may warrant treatment, it is not typically emergent and does not usually require urgent evaluation by an ophthalmologist.

D. Diminished ability to focus on close work and excessive illumination required: These are classic signs of presbyopia, an age-related decline in near vision. Presbyopia is a gradual process and not an emergency that requires immediate referral for urgent evaluation.

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Correct Answer is C

Explanation

Rationale:
A. Trapped subcutaneous air causing crepitus will be absorbed, so the finding is not significant: While small amounts of subcutaneous air can sometimes be reabsorbed without intervention, crepitus is never considered a benign finding without further evaluation. It may indicate underlying injury or air leakage that could worsen if ignored.

B. Since this client has only a small area of crepitus, it probably is not a significant finding: The size of the area does not determine clinical significance. Even a small amount of crepitus may signal conditions like pneumothorax, lung trauma, or chest wall injury, all of which require prompt and thorough assessment.

C. Crepitus is always abnormal and should be followed up with a more detailed assessment: Crepitus from subcutaneous emphysema is always an abnormal finding. It suggests air leakage into the soft tissues and warrants further diagnostic workup, such as imaging studies, to identify and manage the underlying cause appropriately.

D. Since a fractured rib often creates crepitus, a chest x-ray should be scheduled immediately: While a rib fracture is one possible cause of crepitus, immediately assuming a fracture and skipping a more comprehensive assessment could miss other serious conditions like pneumothorax. Broader evaluation must occur before proceeding with specific diagnostic tests.

A. Shiny blue skin sacs around anal opening and a linear split. B. Flabby skin sac around the anal orifice that is painless. C. Presence of dried brown stool around the perianal area. D. Anus is moist, hairless, and has pigmented sphincter folds.

Correct Answer is A

Explanation

Rationale:
A. Shiny blue skin sacs around anal opening and a linear split: This description is consistent with thrombosed external hemorrhoids and an anal fissure, both of which are common in clients with chronic constipation. The linear split and bright red bleeding on toilet paper strongly suggest an anal fissure, which should be reported for appropriate treatment.

B. Flabby skin sac around the anal orifice that is painless: A flabby, painless skin sac is likely a skin tag, which is generally benign and not typically associated with active bleeding or significant discomfort following bowel movements.

C. Presence of dried brown stool around the perianal area: Dried stool suggests poor hygiene or fecal incontinence but does not specifically correlate with the complaint of bright red bleeding after bowel movements. It is not the primary concern related to the client's report.

D. Anus is moist, hairless, and has pigmented sphincter folds: This describes a normal finding for the perianal area. No pathology such as fissures, hemorrhoids, or bleeding would be associated with this description.

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A client sustained a subconjunctival hemorrhage. The presence of which set of symptoms indicate that the client needs to be seen for further evaluation by an ophthalmologist?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

During a routine physical examination of a middle-aged female client, chest palpation is determined to be normal except for a 2 inch diameter area of crepitus over the upper right anterior chest. Which is the most accurate interpretation of this finding?

Correct Answer is C

Explanation

The nurse is assessing the perianal area of a female client who reports she has chronic constipation and has bright red blood on the toilet paper after having a bowel movement. Which finding should the nurse report to the healthcare provider (HCP) that is most consistent with the client's report?

Correct Answer is A

Explanation

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