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

Decrease in tear production

Unequal pupillary constriction in response to light

Loss of the outer hair on the eyebrows attributable to a decrease in hair follicles

Presence of arcus senilis observed around the cornea

Answer and Explanation

The Correct Answer is B

A. Decrease in tear production: This is a common age-related change and is not considered abnormal.

B. Unequal pupillary constriction: Correct. Unequal pupillary constriction (anisocoria) is not normal and may indicate neurological issues.

C. Loss of outer eyebrow hair: This is a normal age-related change due to decreased hair follicles.

D. Arcus senilis: This is a common finding in older adults and is typically benign, caused by lipid deposits around the cornea.

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Correct Answer is D

Explanation

A. Asking about cramping or tingling is unnecessary without other signs of compromised circulation.

B. Referral is not needed if perfusion is adequate.

C. Checking for claudication relates to arterial insufficiency, not absence of ulnar pulse.

D. Proceeding with the evaluation is appropriate if perfusion is adequate, as indicated by normal capillary refill and warm skin.

A. Using the smallest speculum to decrease the amount of discomfort B. Once the speculum is in the ear, releasing the traction C. Tilting the person's head forward during the examination D. Pulling the pinna up and back before inserting the speculum

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.

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

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