A nurse is assessing a client in the emergency department when it is noted the left pupil is enlarged and fixed while the right pupil constricts to 2mm when exposed to light. Which of the following is a possible cause of unequal pupil sizing?
Normal variation in pupil size
Age-related changes
Ocular trauma
Excessive light exposure
The Correct Answer is C
A. There can be slight variations in pupil size but the difference described (one pupil enlarged and fixed, the other constricted and reactive to light) is not considered normal.
B. Age-related changes in pupil size typically involve a gradual decrease in pupil size, not a sudden and dramatic difference between the two eyes.
C. Unequal pupil size, especially when one pupil is fixed and dilated, is a classic sign of increased intracranial pressure (ICP), often caused by head trauma.
D. Exposure to light would cause both pupils to constrict, not one to dilate and fix.
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Related Questions
Correct Answer is D
Explanation
Methylprednisolone is a crucial medication in managing anaphylaxis but it takes longer to act compared to epinephrine and is not the immediate first-line treatment.
B. Dobutamine is a vasopressor used to treat heart failure. However, it's not indicated in the initial management of anaphylaxis.
C. Furosemide is a diuretic used for conditions like heart failure and edema. It has no role in treating anaphylaxis.
D. Epinephrine is the first-line treatment for anaphylactic shock. It rapidly reverses the life-threatening effects of anaphylaxis by constricting blood vessels, relaxing airway muscles, and stimulating the heart.
Correct Answer is B
Explanation
A. This is a late sign of shock. It occurs when the body's compensatory mechanisms fail to maintain blood pressure.
B. This is one of the earliest signs of shock. The body tries to compensate for decreased oxygen delivery by increasing the respiratory rate.
C. This is a very late sign of shock, indicating severe kidney damage due to decreased blood flow.
D. This is also a late sign of shock, occurring when the brain is deprived of oxygen.
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