A nurse document that a client has a normal pupillary light reflex. The nurse should recognize that this reflex indicates which of the following?

The eye focuses the image in the center of the pupil

Constriction both pupils occurs in response to bright light

The eye focuses the light on the sclera

Dilation of both pupils occurs in response to bright light

Answer and Explanation

The Correct Answer is B

A) The eye focuses the image in the center of the pupil:
This option describes the accommodation reflex, not the pupillary light reflex. The accommodation reflex involves the focusing of the eye to bring an image to the center of the retina, but it does not relate to the constriction of the pupils in response to light. Therefore, it is not the correct answer for describing the pupillary light reflex.

B) Constriction of both pupils occurs in response to bright light:
This is the correct description of the pupillary light reflex. When light is shined into one eye, the normal response is for both pupils (direct and consensual response) to constrict. The pupillary light reflex tests the integrity of the optic nerve (cranial nerve II) and the oculomotor nerve (cranial nerve III), which control the constriction of the pupil in response to light. A normal pupillary light reflex is characterized by the constriction of both pupils when exposed to light.

C) The eye focuses the light on the sclera:
This statement is inaccurate. The sclera is the white part of the eye, and light is focused on the retina (specifically the fovea) for proper vision. This does not relate to the pupillary light reflex, which specifically refers to the constriction of the pupils in response to light.

D) Dilation of both pupils occurs in response to bright light:
This is incorrect. Dilation of the pupils occurs in low light conditions as part of the pupillary dilation reflex (also called the "dark reflex") to allow more light into the eye. However, in response to bright light, the pupils constrict, not dilate. The constriction of the pupils in bright light is the primary characteristic of a normal pupillary light reflex.

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Correct Answer is A

Explanation

A) The pupils constrict when the examiner's index finger slowly moves toward the client's nose: This is the correct description of the process of visual accommodation. Visual accommodation refers to the ability of the eyes to focus on a near object. When the examiner's finger is moved toward the client's nose, the pupils should constrict to focus the light on the retina. This response is an indicator that the client’s eyes are properly adjusting to focus on a close object.

B) The client's peripheral vision becomes sharper when the examiner shines a light over the pupils: This is not correct, as shining a light over the pupils is related to assessing the pupillary light reflex, not visual accommodation. Visual accommodation focuses on the ability to focus on a near object, while peripheral vision is related to the ability to see objects outside of the central vision, and is not influenced by the light shining directly into the pupil.

C) The pupils dilate when the examiner's finger slowly moves toward the client's nose: This is incorrect. When assessing visual accommodation, the pupils should constrict (become smaller) as the object moves closer to the face, not dilate. Dilation of the pupils would suggest a lack of accommodation and could indicate a neurological or eye condition.

D) The client involuntarily blinks in the presence of bright light directed at the pupils during the eye exam: This describes the corneal reflex, which is a response to bright light or a foreign object approaching the eye, rather than a test of visual accommodation. This reflex is mediated by the trigeminal nerve and is unrelated to the accommodation response, which focuses on the pupil's reaction to near objects.

A. Frontal sinusitis B. Maxillary sinusitis C. Nasal fracture D. Nasal polyps

Correct Answer is B

Explanation

A) Frontal sinusitis:
This is incorrect. Frontal sinusitis typically causes pain and tenderness in the forehead area, above the eyes, and along the brow ridge. While frontal sinusitis can lead to headaches and facial pain, it generally does not cause pain in the teeth, cheeks, or nasal discharge as specifically as maxillary sinusitis. Pain in the cheeks and upper teeth, along with purulent nasal discharge, is more characteristic of maxillary sinus involvement.

B) Maxillary sinusitis:
This is the correct answer. Maxillary sinusitis is the inflammation or infection of the maxillary sinuses, which are located behind the cheeks. Common symptoms include throbbing pain in the cheeks, teeth, and upper jaw, swollen turbinates (the structures inside the nose that help with airflow and filtering), and purulent nasal discharge. These symptoms match the description provided, making maxillary sinusitis the most likely diagnosis.

C) Nasal fracture:
This is incorrect. A nasal fracture typically presents with pain, swelling, bruising, and sometimes deformity of the nose, often accompanied by epistaxis (nosebleeds). While a nasal fracture can cause pain, it would not typically cause the throbbing pain in the face, teeth, and cheeks, nor would it be associated with swollen turbinates and purulent nasal discharge as seen in sinusitis.

D) Nasal polyps:
This is incorrect. Nasal polyps are non-cancerous growths that form in the nasal passages or sinuses due to chronic inflammation. They often cause nasal obstruction, reduced sense of smell, or frequent sinus infections. However, they do not typically cause the throbbing facial pain, particularly in the teeth and cheeks, that is characteristic of maxillary sinusitis. They also do not cause the purulent discharge seen in sinus infections.

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A nurse document that a client has a normal pupillary light reflex. The nurse should recognize that this reflex indicates which of the following?

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Naxlex Comprehensive Predictor Exams

A nurse is testing a client's visual accommodation. Which of the following should the nurse recognize as an assessment finding from visual accommodation?

Correct Answer is A

Explanation

A nurse is caring for a client complaining of throbbing pain in the face, teeth, and cheeks. Upon palpation, the nurse notes swollen turbinates and a purulent discharge the nose. The nurse should recognize that the client's symptoms best correlate with which problem?

Correct Answer is B

Explanation

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