The nurse documents that the client's pupillary reaction is PERRLA. What is the "A" in this assessment describing about the client's eyes?

Changes in peripheral vision in response to light

Involuntary blinking in the presence of bright light

Pupillary dilation when looking at a near object

Pupillary constriction when looking at a near object

Answer and Explanation

The Correct Answer is D

A) Changes in peripheral vision in response to light: While peripheral vision is important in a comprehensive eye assessment, it is not specifically evaluated through the PERRLA acronym. PERRLA focuses on how the pupils respond to light and accommodation, not on peripheral vision changes.

B) Involuntary blinking in the presence of bright light: Involuntary blinking is part of a reflex action known as the blink reflex, which helps protect the eyes from bright lights and foreign objects. However, this response is not what the "A" in PERRLA refers to, which is more specifically about pupillary reactions to focus.

C) Pupillary dilation when looking at a near object: When focusing on a near object, the pupils actually constrict rather than dilate. This process, known as accommodation, is important for clear vision at close distances but does not pertain to the dilation of pupils.

D) Pupillary constriction when looking at a near object: The "A" in PERRLA stands for accommodation, which specifically refers to the pupils constricting when a person looks at a nearby object. This reaction helps the eyes focus properly and is a normal finding in a healthy neurological assessment. Thus, option D accurately describes the "A" in the PERRLA assessment.

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Correct Answer is C

Explanation

A) Short stature: While body height can play a role in overall musculoskeletal health, short stature is not specifically identified as a risk factor for disc herniation. Other physical characteristics have a more direct impact on spinal issues.

B) Anorexia: Although nutritional status is important for general health, anorexia is not a recognized risk factor for disc herniation. The condition is more related to physical stressors and age rather than dietary habits alone.

C) 39 years of age: Age is a significant risk factor for disc herniation. Most cases occur in adults aged 30 to 50, as degenerative changes in the spine increase vulnerability to herniation. At 39, the client falls within this high-risk age range.

D) Female gender: While certain musculoskeletal conditions may vary by gender, disc herniation does not have a strong gender predisposition. Both men and women are equally affected, making this option less relevant as a specific risk factor.

A. Inflammation of the lamina of the involved vertebra B. Shifting of two adjacent vertebrae out of alignment C. Increased pressure of cerebral spinal fluid within the vertebral column D. Compression of the spinal cord by the extruding disc

Correct Answer is D

Explanation

A) Inflammation of the lamina of the involved vertebra: While inflammation can contribute to pain, it is not the primary cause in the context of a herniated disc. The pain associated with a herniated disc is typically related to nerve compression rather than inflammation of the lamina itself.

B) Shifting of two adjacent vertebrae out of alignment: This describes a different condition, such as spondylolisthesis. A herniated disc primarily involves the displacement of disc material, rather than a significant misalignment of the vertebrae.
C) Increased pressure of cerebral spinal fluid within the vertebral column: Increased cerebrospinal fluid pressure is not typically associated with herniated discs and does not directly cause the pain related to this condition.

D) Compression of the spinal cord by the extruding disc: This is the most accurate explanation for the patient's pain. A cervical herniated disc can protrude and compress nearby nerve roots or the spinal cord itself, leading to significant pain, weakness, and other neurological symptoms. This compression is the primary cause of pain in patients with this diagnosis.

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The nurse documents that the client's pupillary reaction is PERRLA. What is the "A" in this assessment describing about the client's eyes?

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