During the health history a client describes recent episodes of intermittent facial pain lasting several minutes. The vital signs are 98.6°F orally, pulse 86, respirations 20, blood pressure 142/88 and O2 saturation of 96%. The nurse should recognize that this complaint is suggestive of what health problem?

Choice A reason: Impaired judgment suggests frontal lobe pathology, like dementia, not normal aging. Age-related changes slow processing, not executive function, making this a disease sign, not a typical neurological shift in an 81-year-old fully here.
Choice B reason: Loss of remote memory indicates Alzheimer’s, not normal aging. Aging may slow recall, but long-term memory typically persists, excluding this as an expected age-related change in this neurological assessment entirely and accurately here.
Choice C reason: Intention tremors signal cerebellar disease, like Parkinson’s, not aging. Normal aging may reduce fine motor speed, but not cause action tremors, distinguishing this as pathological, not a standard age-related finding fully here.
Choice D reason: Reduced distal sensation, from nerve conduction slowing, is a common age-related change. Aging thins myelin, impairing peripheral nerves, making this the expected finding in an 81-year-old’s neurological exam accurately and comprehensively here.

Choice A reason: Angle closure glaucoma causes peripheral vision loss and pain from pressure, not central loss. This acute condition contrasts with the client’s central vision complaint, excluding it as the suspected diagnosis in this scenario entirely here.
Choice B reason: Presbyopia blurs near vision from lens stiffness, not central loss. This age-related change affects focus, not macular function, making it unrelated to the specific central vision impairment the client reports fully and accurately here.
Choice C reason: Macular degeneration degrades central vision via retinal damage, common in older adults. This matches the client’s loss, as the macula processes sharp central sight, making it the likely suspect for this visual complaint comprehensively here.
Choice D reason: Cataracts cause diffuse blurriness, not isolated central loss. Lens opacity scatters light broadly, differing from macular-specific damage, rendering this less likely than macular degeneration for the client’s central vision issue fully here.