Which cranial nerve is assessed by using the Snellen visual acuity chart?

Choice A rationale

Scleroderma is a chronic autoimmune disorder characterized by hardening and tightening of the skin and connective tissues. While it affects the skin, it is unrelated to emphysema and bronchitis, making it an unlikely finding in this client.

Choice B rationale

Pedal erythema, or redness of the feet, can result from various causes, including infections, allergies, and circulatory issues. However, it is not commonly associated with emphysema and bronchitis, making it an unlikely finding in this client.

Choice C rationale

Anasarca is generalized body swelling due to fluid retention, often seen in severe heart failure, liver disease, and kidney failure. While this condition involves significant swelling, it is not typically linked to emphysema and bronchitis.

Choice D rationale

Clubbing of the nails is a common finding in chronic respiratory conditions like emphysema and bronchitis. It involves bulbous enlargement of the fingertips and nail curvature, resulting from prolonged low oxygen levels, making it a likely finding in this client.

Choice A rationale

Separation of the retina from the choroid, also known as retinal detachment, is a different condition altogether. Retinal detachment can cause vision loss but is not related to macular degeneration. This condition often requires immediate medical attention to prevent permanent vision loss and is typically characterized by the sudden appearance of floaters, flashes of light, and a shadow or curtain over a portion of the visual field.

Choice B rationale

Peripheral vision loss and seeing halos around light are more commonly associated with conditions like glaucoma. Glaucoma involves increased intraocular pressure, which can damage the optic nerve and lead to peripheral vision loss and seeing halos around lights. This condition can be managed with medications or surgery to lower intraocular pressure and prevent further vision loss.

Choice C rationale

Complaints of severe pain and pressure in the eye are indicative of acute angle-closure glaucoma. This is a medical emergency and requires prompt treatment to reduce intraocular pressure and prevent optic nerve damage. The symptoms of acute angle-closure glaucoma are sudden and severe and can include headache, nausea, and vomiting, along with the eye pain and pressure.

Choice D rationale

Central vision loss with intact peripheral vision is characteristic of macular degeneration, particularly age-related macular degeneration (AMD). AMD affects the macula, the part of the retina responsible for sharp, central vision. As the macula deteriorates, central vision becomes blurry or wavy, making it difficult to read, drive, or recognize faces, while peripheral vision remains largely unaffected.