During a health history, a 48-year-old client states, "I've noticed that I need to hold my newspaper farther away so that I can read it." Which of the following would the nurse suspect?

Presbyopia

Cataracts

Tropia

Myopia

Answer and Explanation

The Correct Answer is A

A) Presbyopia: Presbyopia is an age-related condition where the lens of the eye loses elasticity, making it harder to focus on close objects. This condition typically begins to affect individuals around the age of 40, causing them to hold reading materials farther away to see them clearly. The client's complaint aligns perfectly with this common symptom of presbyopia.

B) Cataracts: Cataracts involve the clouding of the eye's lens, leading to overall blurry vision, glare, and difficulty with night vision. Although cataracts can interfere with reading, they do not specifically cause the need to hold reading materials farther away, which is more indicative of presbyopia.

C) Tropia: Tropia is a type of strabismus where one eye deviates from normal alignment, leading to symptoms like double vision or eye strain. This condition affects how the eyes coordinate but does not typically cause the specific symptom of needing to hold reading materials farther away.

D) Myopia: Myopia, or nearsightedness, results in clear vision for close objects but blurry vision for distant objects. The client's issue of needing to hold reading materials farther away to see clearly is inconsistent with myopia, which would cause difficulty with distant vision instead.

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Correct Answer is A

Explanation

A) Assess the nasolacrimal sac: Excessive tearing, or epiphora, can result from an obstruction in the nasolacrimal duct, which drains tears from the eye into the nasal cavity. By assessing the nasolacrimal sac, the nurse can determine if there is any blockage or infection causing the excessive tearing, making this the most appropriate next step.

B) Test pupillary reaction to light: While testing pupillary reaction to light is important in a comprehensive eye exam, it does not directly address the issue of excessive tearing. This test is more focused on evaluating neurological function and overall eye health.

C) Inspect the palpebral conjunctiva: Inspecting the palpebral conjunctiva can help identify inflammation, infection, or foreign bodies that may cause discomfort or tearing. However, it does not specifically address the cause of excessive tearing related to nasolacrimal duct obstruction.

D) Perform the eye positions test: The eye positions test assesses extraocular muscle function and cranial nerve integrity. While it is important for a complete eye examination, it is not directly related to the symptom of excessive tearing, which is more likely due to issues with tear drainage.

A. "Your metabolism is slowing down." B. "You should be exercising for longer periods of time." C. "You could be making healthier food choices." D. "You are retaining fluid."

Correct Answer is A

Explanation

(a) "Your metabolism is slowing down.":

Hypothyroidism leads to a decrease in the production of thyroid hormones, which are critical in regulating metabolism. With lower levels of these hormones, the body's metabolic rate decreases, resulting in reduced calorie burning and subsequent weight gain. This explanation directly addresses the underlying cause of weight gain in hypothyroidism.

(b) "You should be exercising for longer periods of time.":

While exercise is beneficial for overall health and can help manage weight, it does not directly address the reason for weight gain in hypothyroidism. The primary issue is the slowed metabolism due to thyroid hormone deficiency, not a lack of exercise.

Although diet plays a role in weight management, this response does not explain the root cause of weight gain in hypothyroidism. The condition itself slows metabolism, leading to weight gain even if dietary habits remain unchanged.

(d) "You are retaining fluid.":

Fluid retention can occur in hypothyroidism but is not the primary reason for weight gain in this condition. The main cause is a decreased metabolic rate, which leads to the accumulation of body fat. Fluid retention might contribute to some weight gain, but it is not the best explanation in this context.

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During a health history, a 48-year-old client states, "I've noticed that I need to hold my newspaper farther away so that I can read it." Which of the following would the nurse suspect?

Nursing Test Bank

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Correct Answer is A

Explanation

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Correct Answer is A

Explanation

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