A nurse is auscultating the breath sounds of a client who has chronic obstructive pulmonary disease.
When the client exhales, the nurse hears continuous high-pitched whistling sound.
The nurse should document this as?

Choice A rationale

Myopia, or nearsightedness, is when distant objects appear blurry because light rays focus in front of the retina. A Snellen exam result of 20/50 means the client can see at 20 feet what someone with normal vision sees at 50 feet, indicating reduced distance vision. However, this condition does not correlate with the ability to read the Rosenbaum chart, which is for near vision, thus excluding myopia.

Choice B rationale

Normal vision is not indicated by a Snellen exam result of 20/50, as this signifies a visual impairment where the client sees at 20 feet what a person with normal vision sees at 50 feet. Normal vision would be indicated by 20/20 on the Snellen exam.

Choice C rationale

Presbyopia is the age-related loss of the eye's ability to focus on near objects, typically noticeable in people over 40. Although this condition involves difficulty reading at close range, the client's uncorrected Snellen exam result of 20/50 pertains to distance vision, which differentiates presbyopia from the given scenario.

Choice D rationale

Hyperopia, or farsightedness, is when close objects appear blurry because light rays focus behind the retina. The client's ability to read the Rosenbaum chart without difficulty indicates good near vision, while the Snellen exam result of 20/50 reflects reduced distance vision, thus supporting the diagnosis of hyperopia.

Choice A rationale

Glaucoma is characterized by increased intraocular pressure that can lead to optic nerve damage and peripheral vision loss. It does not typically cause central vision loss or the presence of a large black spot in the center of vision.

Choice B rationale

A detached retina often causes the sudden appearance of floaters or flashes of light, and a shadow or curtain effect in the peripheral vision. It does not typically present as a black spot in the center of vision.

Choice C rationale

Macular degeneration is an age-related condition that affects the central part of the retina (macula). It leads to central vision loss, which can manifest as a black or dark spot in the center of vision. This condition progressively impairs the ability to see fine details and perform activities like reading or recognizing faces.

Choice D rationale

Diabetic retinopathy is a complication of diabetes that affects the blood vessels in the retina. It can cause vision changes, such as floaters or blurred vision, but it does not typically present as a large black spot in the center of vision.