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. Air conduction greater than bone conduction: This is tested with the Rinne test, not the Weber test.

B. Bilateral hearing loss: This is not a normal finding in the Weber test.

C. No lateralization of vibrations: In a normal Weber test, the vibrations are heard equally in both ears, indicating no conductive or sensorineural hearing loss.

D. Unilateral hearing loss: This would be abnormal and suggest hearing impairment in one ear.

A. Assess for pretibial edema B. Palpate pedal pulses bilaterally C. Allen test D. Homan sign

Correct Answer is B

Explanation

A. Pretibial edema: Edema is more indicative of venous function, not arterial function.

B. Palpate pedal pulses bilaterally: Palpation of the pedal pulses is essential to assess arterial circulation in the lower extremities.

C. Allen test: This assesses arterial blood flow to the hand, not the lower extremities.

D. Homan sign: Homan sign is used (though controversial) to assess for deep vein thrombosis (DVT), which is related to venous, not arterial, function.

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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

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Correct Answer is C

Explanation

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Correct Answer is B

Explanation

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