A middle-aged school teacher complains of excessive tearing of the eyes every morning. Which assessment should the nurse perform next?
Assess the nasolacrimal sac
Inspect the palpebral conjunctiva
Test pupillary reaction to light
Perform the eye positions test
The Correct Answer is A
Choice A Reason:
The nasolacrimal sac is part of the tear drainage system. When a patient presents with excessive tearing, known as epiphora, it is important to assess for any obstruction in the lacrimal apparatus. The nasolacrimal sac can become blocked due to various reasons such as infection, inflammation, or structural abnormalities. Assessing this area can help determine if there is a blockage causing the tears to accumulate and overflow.
Choice B Reason:
Inspecting the palpebral conjunctiva is typically done if there is a complaint of eye pain or a sensation of a foreign body in the eye. While it is part of a comprehensive eye examination, it is not the first assessment to be performed for excessive tearing unless there are additional symptoms that suggest a problem with the conjunctiva.
Choice C Reason:
Testing the pupillary reaction to light is an assessment of the pupillary response and the function of the oculomotor nerve. This test is crucial when neurological issues are suspected or if there is a change in vision. However, it is not the primary assessment for excessive tearing without other associated symptoms.
Choice D Reason:
The eye positions test, which assesses eye muscle strength and cranial nerve function, is not necessary unless there are signs of problems with muscle strength, such as drooping. This test would not typically be the next step in assessing a patient with excessive tearing unless there are other indications of muscle or nerve impairment.

Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A Reason:
While falls are a common cause of injury in children, they are not the leading cause of TBI in adolescents. Falls tend to be more frequent in the younger population, particularly in children under the age of 4. In adolescents, sports-related injuries and motor vehicle accidents are more prevalent causes of TBI.
Choice B Reason:
The statement that females have twice the risk of TBI compared to males is incorrect. National data reveal that males are at increased risk of TBI compared to females, especially in the adolescent age group. This is likely due to higher engagement in risk-taking behaviors and contact sports.
Choice C Reason:
Concussions in sports and motor vehicle accidents are indeed the leading causes of TBI in adolescents. Engaging in contact sports such as football, hockey, and soccer can lead to concussions, which are a form of mild TBI. Motor vehicle accidents are also a significant risk factor due to high-impact collisions that can cause head injuries.
Choice D Reason:
Firearm incidents are a serious concern for TBI; however, they are not the most common cause of TBI in adolescents. While firearm-related injuries can be severe and are a leading cause of TBI-related deaths, concussions from sports and motor vehicle accidents account for a larger number of non-fatal TBIs in this age group.
Correct Answer is A
Explanation
Choice a reason:
Hypothyroidism is a condition where the thyroid gland does not produce enough thyroid hormones. This can lead to a variety of symptoms, including hoarseness, fatigue, and weight gain. The hoarseness can be due to the effect of hormone deficiency on the vocal cords, while fatigue and weight gain are common due to the slowed metabolism associated with hypothyroidism.
Choice b reason:
Gingivitis is inflammation of the gums and does not typically cause hoarseness, fatigue, or weight gain. It is more commonly associated with symptoms like red, swollen gums and bleeding during brushing or flossing.
Choice c reason:
Aphthous ulcers, also known as canker sores, are small, shallow lesions that develop on the soft tissues in the mouth or at the base of the gums. While they can be painful and cause difficulty with eating and speaking, they do not cause systemic symptoms such as hoarseness, fatigue, or weight gain.
Choice d reason:
Dysphagia, or difficulty swallowing, can lead to hoarseness if there is an associated throat disorder. However, it is not typically associated with systemic symptoms like fatigue and weight gain unless it is part of a broader condition that affects the body's metabolism or energy levels.
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