A nurse in the emergency department assesses a client's pupillary reaction and observes pinpoint pupils. The client seems lethargic but oriented to person and place. There is a significant other at the bedside who notes this is not "normal" for them. The nurse interprets this finding as suggesting which of the following?

Macular degeneration

Recent eye trauma

Bilateral cataracts

Narcotic use

Answer and Explanation

The Correct Answer is D

Choice A reason: Macular degeneration impairs central vision, not pupil size. Pinpoint pupils and lethargy suggest systemic effects, not retinal aging, making this unrelated to the neurological and ocular findings in this emergency setting entirely and fully here.
Choice B reason: Eye trauma may dilate pupils from injury, not pinpoint them. Lethargy and change per the significant other point to systemic causes, not local trauma, excluding this as the likely explanation for this presentation comprehensively here.
Choice C reason: Bilateral cataracts cloud lenses, not affecting pupil size or alertness. Pinpoint pupils with lethargy suggest a neurological cause, not lens opacity, rendering this irrelevant to the acute change observed in this client fully here.
Choice D reason: Narcotic use, like opioids, causes pinpoint pupils via cranial nerve III stimulation and lethargy from CNS depression. This matches the sudden change and symptoms, making it the most likely interpretation in this emergency case accurately here.

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Correct Answer is A

Explanation

Choice A reason: Human papillomavirus (HPV), especially types 16 and 18, is the primary cervical cancer risk, causing 99% of cases. This STI triggers oncogenic changes in cervical cells, making it the key factor for this class accurately and fully here.
Choice B reason: HIV weakens immunity, raising HPV persistence risk, but isn’t a direct cervical cancer cause. Its role is secondary, amplifying HPV effects, not independently driving carcinogenesis, excluding it as the major factor comprehensively here entirely.
Choice C reason: Syphilis, a bacterial STI, causes sores, not cervical cancer. It lacks the viral oncogenic mechanism of HPV, rendering it irrelevant as a primary risk factor for this malignancy in the educational context fully here.
Choice D reason: Gonorrhea causes inflammation, not cancer. This bacterial STI doesn’t alter cervical DNA like HPV, making it an incorrect choice for a major risk factor in cervical cancer education for these students entirely here fully.

A. The client has a family history of cognitive disorders. B. The client has recently begun a new medication. C. The client's cognition has declined over a period of several months to a year. D. The client has a history of hypertension.

Correct Answer is B

Explanation

Choice A reason: Family history suggests dementia, not delirium. Dementia progresses slowly, unlike delirium’s acute onset, making this less indicative of the sudden cognitive shift typical of delirium, especially without a rapid trigger in this case fully here.
Choice B reason: New medication often causes delirium in older adults via anticholinergic effects or toxicity. This acute, reversible change aligns with delirium’s hallmark sudden onset, making it the most suggestive finding for this cognitive impairment accurately here.
Choice C reason: Decline over months to a year fits dementia, not delirium. Delirium is acute, not chronic, excluding this gradual progression as a sign of the rapid cognitive shift delirium presents in this assessment entirely and fully.
Choice D reason: Hypertension risks vascular dementia, not delirium. It’s a chronic factor, not an acute trigger, missing delirium’s sudden, reversible nature tied to immediate causes like drugs, rendering it less relevant here comprehensively and clearly.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is presenting a class to a group of high school students about sexually transmitted infections. What would the nurse include as a major risk factor for cervical cancer?

Correct Answer is A

Explanation

An older adult client has been admitted due to decreased cognition. What assessment finding is most suggestive of delirium as the cause of the client's cognitive impairment?

Correct Answer is B

Explanation

The nurse is assessing cranial nerve 5 (the trigeminal nerve) in a newly admitted client. What instruction should the nurse provide to the client during this phase of the assessment?

The nurse is performing a peripheral vascular assessment of an adult client. The nurse is palpating the client's peripheral pulses but knows that some are not palpable, even in healthy clients. What pulse is not palpable in a large proportion of healthy clients?

The nurse has placed her hands behind the client's head and flexed his neck forward as far as he can tolerate. During the test the client experiences leg pain and bends his knees. In addition, he complains of neck pain. This assessment finding is suggestive of what health problem?

While inspecting the tympanic membrane the nurse notes a pearly gray and shiny appearance. What would this finding indicate?

A client has a family history of prostate cancer and is committed to regular screening. What should the nurse teach the client about prostate-specific antigen (PSA) blood testing?

A client has sought care because of a sudden increase in the size of his scrotum after a cough. The nurse's assessment reveals the presence of a large scrotal mass. How can the nurse best assess for a scrotal hernia?

A nurse is providing a subjective data assessment for an older female. The client verbalizes a list of symptoms regarding their concern. Which findings would lead the nurse to supply education about menopause?