The nurse in the family practice clinic is educating a newly graduated nurse on how to correctly use a penlight. The nurse creates the expected outcome: After the review session, the newly graduated nurse will verbalize appropriate penlight examination techniques.

For each statement below, click to specify whether it indicates the outcome was met or not met.

I will confirm the patient's pupil size with the scale on the side of the penlight.

When putting the penlight at the bridge of the nose, the eyes converge and constrict

I will check the patient's pupillary reflex by shining a light into their eyes.

When shining the penlight into the patient's eyes, their pupils should dilate

Answer and Explanation

The Correct Answer is {"A":{"answers":"A"},"B":{"answers":"A"},"C":{"answers":"A"},"D":{"answers":"B"}}

New Nurse Statement	Met	Not Met
I will confirm the patient's pupil size with the scale on the side of the penlight.	✅
When putting the penlight at the bridge of the nose, the eyes converge and constrict	✅
I will check the patient's pupillary reflex by shining a light into their eyes.	✅
When shining the penlight into the patient's eyes, their pupils should dilate		✅

Rationale:

"I will confirm the patient's pupil size with the scale on the side of the penlight" (Met):

This is a correct use of the penlight to assess pupil size and document findings accurately.

"When putting the penlight at the bridge of the nose, the eyes converge and constrict" (Met):

This statement describes the normal accommodation reflex, where the eyes converge and pupils constrict when focusing on a near object.

"I will check the patient's pupillary reflex by shining a light into their eyes" (Met):

This correctly describes testing for the pupillary light reflex, where the pupil constricts in response to light.

"When shining the penlight into the patient's eyes, their pupils should dilate" (Not Met):

This is incorrect. The pupils should constrict in response to light, not dilate. Dilation occurs in response to low light or sympathetic stimulation.

Nursing Test Bank

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Free Nursing Study Resources

Correct Answer is D

Explanation

A. Smallest speculum: The smallest speculum may not provide the best view of the ear canal and tympanic membrane, especially in adults. The correct size should be chosen for adequate visualization.

B. Releasing the traction: Traction should be maintained to stabilize the ear and allow a better view of the ear canal.

C. Tilting the person's head forward: This is not the ideal positioning for the ear examination. The head should be tilted slightly away to straighten the ear canal.

D. Pulling the pinna up and back: This helps straighten the ear canal, especially in adults, providing better visualization during the otoscopic examination.

A. "If you notice an enlarged testicle or a painless lump, call your health care provider." B. "The testicle is egg shaped and movable. It feels firm and has a lumpy consistency." C. "Perform a testicular examination at least once a week to detect the early stages of testicular cancer." D. "A good time to examine your testicles is just before you take a shower."

Correct Answer is A

Explanation

A. This emphasizes recognizing abnormal findings, such as an enlarged testicle or a painless lump, which may indicate testicular cancer.

B. Testicles are smooth, firm, and egg-shaped but should not have a lumpy consistency.

C. Monthly, not weekly, self-examinations are recommended for early detection.

D. The best time to examine is during or after a warm shower when the scrotum is relaxed, not before.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is performing an otoscopic examination on an adult. Which of these actions is correct?

Correct Answer is D

Explanation

The nurse is describing how to perform a testicular self-examination to a patient. Which statement is most appropriate?

Correct Answer is A

Explanation

A nurse performs the Weber test on a healthy adult client. The nurse would expect which of the following normal finding?

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The nurse is performing an eye assessment on an 80-year-old patient. Which of these findings is considered abnormal?

During an eye examination, a client tells a nurse that their left eye feels dry and itchy and has noticed a lot of tearing. The nurse notices that the client's left lower eyelid is rolled out with exposure of the palpebral conjunctiva. The nurse would document these findings as:

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The nurse is reviewing in age-related changes in the eye for a class. Which of these physiologic changes is responsible for presbyopia?

During an abdominal assessment, the nurse is unable to hear bowel sounds in a patient's abdomen. How long should the nurse listen before reporting absent bowel sounds?