The nurse assesses a client’s eyes by testing the cardinal fields of vision for coordination and alignment. Which eye characteristic is being assessed by this process?

Visual acuity

Extraocular movements

Peripheral vision

Existence of cataracts

Answer and Explanation

The Correct Answer is B

Choice A reason: Visual acuity measures the clarity of vision, typically tested using a Snellen chart to assess retinal and optic nerve function. Testing cardinal fields of vision evaluates eye muscle coordination, not visual sharpness. This assessment involves cranial nerves III, IV, and VI, not the retina’s ability to resolve fine details, making it irrelevant here.

Choice B reason: Extraocular movements are assessed by testing the cardinal fields of vision, evaluating the coordinated movement of eyes in six directions. This tests cranial nerves III (oculomotor), IV (trochlear), and VI (abducens), which control eye muscles. Misalignment or uncoordinated movement may indicate neurological or muscular issues, making this the correct characteristic being assessed.

Choice C reason: Peripheral vision is tested using confrontation tests, assessing the visual field’s outer edges, mediated by retinal rod cells. Cardinal fields of vision testing focuses on eye muscle coordination, not the extent of the visual field. This assessment does not evaluate peripheral retinal function, making peripheral vision an incorrect choice for this procedure.

Choice D reason: Existence of cataracts is assessed via lens opacity examination, often using an ophthalmoscope. Cardinal fields of vision testing evaluates eye movement coordination, not lens clarity. Cataracts impair light transmission to the retina, but this test targets extraocular muscle function and cranial nerve integrity, making cataract assessment irrelevant to this procedure.

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Correct Answer is A

Explanation

Choice A reason: Sodium 125 mEq/L (normal 135-145 mEq/L) indicates hyponatremia, likely from excessive sweating during running, causing water retention or sodium loss. Low sodium disrupts cellular osmosis, leading to cerebral edema, explaining lethargy and pallor. This critical imbalance affects nerve conduction and muscle function, requiring urgent correction to prevent seizures or coma.

Choice B reason: Potassium 4.2 mEq/L (normal 3.5-5.0 mEq/L) is within normal range. Potassium regulates muscle and nerve function, including cardiac rhythm. Normal levels do not explain lethargy or pallor, as they ensure proper membrane potential and muscle contraction. In this scenario, potassium is not a concern compared to severe hyponatremia affecting neurological status.

Choice C reason: Calcium 4.8 mg/dL (normal 8.5-10.2 mg/dL) indicates hypocalcemia, which can cause muscle cramps or tetany. However, lethargy and pallor are more directly linked to hyponatremia’s neurological effects. Calcium affects muscle contraction and nerve signaling, but its impact is less acute than sodium’s role in osmotic balance and cerebral function here.

Choice D reason: Magnesium 2.0 mEq/L (normal 1.7-2.2 mEq/L) is normal. Magnesium supports muscle and nerve function, including ATP production. Normal levels do not contribute to lethargy or pallor, which are more likely due to sodium imbalance affecting brain hydration. Magnesium is not a priority concern in this acute presentation.

A. It makes me feel better to talk to my clients. B. I do this so I will not be so afraid the client will die. C. I believe the client can hear me as long as the client is alive. D. I do not know; the client’s family asked me to do this.

Correct Answer is C

Explanation

Choice A reason: Stating that talking to the client makes the nurse feel better is inappropriate as it centers on the nurse's emotions rather than the patient’s needs. Communication with dying patients supports dignity, assuming they may retain awareness, which aligns with patient-centered end-of-life care principles.

Choice B reason: Suggesting that talking reduces the nurse’s fear of death is unprofessional and irrelevant. The focus should be on the patient’s potential awareness and dignity. This response dismisses the therapeutic value of communication, which may comfort the patient, per palliative care and psychosocial support guidelines.

Choice C reason: Believing the patient can hear while alive is accurate, as studies suggest hearing persists in dying patients, supporting communication to provide comfort and dignity. This response reflects evidence-based practice, respecting the patient’s potential awareness and aligns with compassionate end-of-life care, per palliative care principles.

Choice D reason: Claiming the family requested talking is inaccurate and deflects responsibility. The rationale should be based on the patient’s potential to hear, supporting dignity. This response lacks a clinical basis and undermines the nurse’s professional judgment in providing meaningful end-of-life communication, per nursing ethics.

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The nurse assesses a client’s eyes by testing the cardinal fields of vision for coordination and alignment. Which eye characteristic is being assessed by this process?

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An athlete runs 5 miles a day. His wife notices that after he runs, he becomes lethargic and pale. He is still talking and responding appropriately. After being taken to the E.R., and having his lab work assessed, which lab value might the nurse be most concerned with?

Correct Answer is A

Explanation

While caring for a client near end of life, a nurse talks to the client. An unlicensed assistive personnel asks why the nurse is talking to someone who is dying. Which response is accurate?

Correct Answer is C

Explanation

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