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 B

Explanation

A. Six: The abdomen is typically not divided into six sections.

B. Four: Most healthcare providers divide the abdomen into four quadrants: right upper, left upper, right lower, and left lower.

C. Eight: Eight sections are not commonly used for abdominal assessment.

D. Nine: Nine sections are used in more detailed assessments but are less common than the four-quadrant approach.

A. Ptosis B. Ectropion C. Exophthalmos D. Entropion

Correct Answer is B

Explanation

A. Ptosis: Drooping of the upper eyelid, often caused by nerve or muscle dysfunction.

B. Ectropion: This condition results from age-related weakening of eyelid muscles or facial nerve palsy, causing the lower eyelid to turn outward, exposing the conjunctiva.

C. Exophthalmos: Protrusion of the eyeball, commonly seen in conditions like Graves' disease.

D. Entropion: Inward rolling of the eyelid, leading to eyelashes rubbing against the eye.

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

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

When assessing the abdomen most health care providers divide the abdomen into how many sections?

Correct Answer is B

Explanation

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:

Correct Answer is B

Explanation

Which of the following should the nurse perform to assess the arterial function of the lower extremities?

When performing a peripheral vascular assessment of the lower extremities, a nurse should place the fingertips just posterior to the medial malleolus in order to assess for which of the following peripheral pulses?

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In performing a voice test to assess hearing, which of these actions would the nurse perform?

When performing the corneal light reflex assessment, the nurse notes that the light is reflected at 2 o'clock in each eye. The nurse should:

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