When assessing the pupillary light reflex or PERRL (pupils, round, reactive to light), the nurse should use which technique?

Shine a light across the pupil from the side, and observe for direct and consensual pupillary constriction.

Ask the patient to follow the penlight in eight directions, and observe for bilateral pupil constriction.

Shine a penlight from directly in front of the patient, and inspect for pupillary constriction.

Ask the patient to focus on a distant object. Then ask the patient to follow the penlight to approximately 7 cm from the nose.

Answer and Explanation

The Correct Answer is A

A. Shine a light across the pupil from the side: To assess the pupillary light reflex, the nurse should shine a light across the pupil from the side and observe for both direct and consensual constriction (the constriction of both pupils when one is exposed to light).

B. Follow the penlight: This tests for accommodation (focusing on near objects) rather than the pupillary light reflex.

C. Shine a penlight directly in front: This method doesn’t assess both direct and consensual constriction properly.

D. Focus on a distant object: This assesses accommodation, not the pupillary light reflex.

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Correct Answer is C

Explanation

A. Atrophy of calf veins: Vein atrophy is not a normal aging process, although venous insufficiency is common due to other causes.

B. Narrowing of the inferior vena cava: This is not a typical age-related change.

C. Peripheral blood vessels growing more rigid: Arteriosclerosis (hardening of the arteries) is common with aging and leads to increased systolic blood pressure.

D. Hormonal changes causing vasodilation: Aging tends to cause vascular rigidity, not vasodilation, and is more likely to lead to hypertension.

A. Liver enlargement B. Spleen enlargement C. Ovarian infection D. Kidney inflammation

Correct Answer is D

Explanation

A. Liver enlargement: Pain from liver enlargement is typically felt in the right upper quadrant, not along the costovertebral angle.

B. Spleen enlargement: Splenic pain is usually located in the left upper quadrant, not in the costovertebral area.

C. Ovarian infection: Pain from ovarian infection is typically felt in the lower abdomen or pelvis, not the back.

D. Kidney inflammation: Pain along the costovertebral angles often indicates kidney inflammation or infection, such as pyelonephritis.

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When assessing the pupillary light reflex or PERRL (pupils, round, reactive to light), the nurse should use which technique?

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Naxlex Comprehensive Predictor Exams

During an assessment of an older adult, the nurse should expect to notice which finding as a normal physiologic change associated with the aging process?

Correct Answer is C

Explanation

A patient is reporting sharp pain along the costovertebral angles. What does this symptom most often indicate?

Correct Answer is D

Explanation

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