Name: Samantha Green

Provider: G. Pane, MD

Code Status: Full Code

Allergies: None known

Age: 45 years

Weight: 120.6 kg (265.32 lb)

The nurse cares for a client with a urinary tract infection. Which vital sign(s) indicate the client is improving? Select all that apply.

Respiratory Rate	19	18
Blood Pressure	90/56	120/80
Oxygen Saturation	95% on room air	95% on room air
Pain	2/10 lower back"	6/10 lower back
Temperature	102.3 F (39 C)	99.9 F(37.7 C)
Heart Rate	110	98

A. Shining a penlight assesses the pupillary light reflex, not accommodation. Parallel movement of the eyes does not evaluate the near-response mechanism.

B. During accommodation, the pupils constrict, not dilate, when focusing on a near object. Pupil dilation would be abnormal in this context.

C. The consensual light reflex occurs when shining light in one eye causes constriction in the opposite eye. This tests cranial nerves II (optic) and III (oculomotor) but does not assess accommodation.

D. To test accommodation, the nurse asks the client to focus on a distant object and then shift focus to a near object, such as a pen moved slowly toward the bridge of the nose. The nurse observes for convergence (eyes moving inward) and pupil constriction. This properly evaluates the accommodation response.

A. The client’s blood pressure improved from 90/56 (hypotension) to 120/80 (normal range). Hypotension can indicate systemic infection or early sepsis. A return to normal blood pressure suggests improved circulation and response to treatment. This is a significant sign of stabilization.

B. Oxygen saturation remained unchanged at 95% on room air. While this is within acceptable range, there was no improvement. It indicates stability but does not demonstrate change. Therefore, it does not reflect measurable improvement.

C. The respiratory rate decreased from 19 to 18 breaths per minute. Although both values are within normal limits (12–20 breaths per minute), infection and fever may cause mild tachypnea. The slight decrease reflects improved physiologic stress and stabilization.

D. The heart rate decreased from 110 (tachycardia) to 98 (within normal range). Fever and infection commonly cause tachycardia. A decrease toward normal indicates that the body is no longer under the same level of stress from infection. This is an important sign of recovery.

E. The temperature decreased from 102.3°F (39°C), which is clearly febrile, to 99.9°F (37.7°C), which is near normal. Fever is a hallmark sign of infection. A reduction in temperature is one of the strongest indicators that treatment is effective.

F. Pain improved from 6/10 to 2/10. Lower back pain can indicate kidney involvement (such as pyelonephritis). Decreasing pain suggests reduced inflammation and infection. Pain improvement is an important clinical indicator of recovery.