Which is the proper technique the nurse should use to test for accommodation?
The nurse shines a penlight on the client's eyes to observe for parallel movement of the eyes.
The nurse asks the client to follow a pen with their eyes, observing for pupil dilation as it moves closer.
The nurse shines a penlight on the client's eyes to observe for the consensual light reflex.
The nurse asks the client to follow a pen with their eyes, observing for convergence as it moves closer.
The Correct Answer is D
A. Shining a penlight assesses the pupillary light reflex, not accommodation. Parallel movement of the eyes does not evaluate the near-response mechanism.
B. During accommodation, the pupils constrict, not dilate, when focusing on a near object. Pupil dilation would be abnormal in this context.
C. The consensual light reflex occurs when shining light in one eye causes constriction in the opposite eye. This tests cranial nerves II (optic) and III (oculomotor) but does not assess accommodation.
D. To test accommodation, the nurse asks the client to focus on a distant object and then shift focus to a near object, such as a pen moved slowly toward the bridge of the nose. The nurse observes for convergence (eyes moving inward) and pupil constriction. This properly evaluates the accommodation response.
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Correct Answer is D
Explanation
A. This statement reflects understanding of cataracts, not AMD. Cataracts cause clouding or opacity of the lens, whereas AMD primarily affects the central portion of the retina (macula), impairing central vision.
B. This is more characteristic of glaucoma, where peripheral vision is lost first. AMD affects central vision, so this statement demonstrates a misunderstanding.
C. This is relevant for diabetic retinopathy, not AMD. While maintaining overall eye health is beneficial, glycemic control does not prevent AMD progression.
D. This statement accurately reflects the impact of AMD on central vision, which is required for detailed tasks such as reading, sewing, or recognizing faces. Clients with AMD often maintain peripheral vision but experience difficulty with tasks that require fine visual acuity. This demonstrates effective learning about the functional limitations associated with AMD.
Correct Answer is D
Explanation
A. The difference between systolic and diastolic pressures is called the pulse pressure. It does not describe the systolic pressure itself. Pulse pressure is calculated by subtracting the diastolic pressure from the systolic pressure (e.g., 140 − 90 = 50 mmHg), but this is not the definition of systolic pressure.
B. This describes diastolic pressure, not systolic pressure. Diastolic pressure represents the lowest pressure in the arteries, occurring when the ventricles relax and fill with blood between heartbeats.
C. Blood pressure readings (systolic and diastolic) refer to arterial pressure, not venous pressure. Venous pressure is measured differently, typically via central venous pressure monitoring, and is not part of routine blood pressure assessment.
D. Systolic pressure reflects the maximum arterial pressure generated when the ventricles contract during systole, forcing blood into the aorta and systemic circulation. In this reading of 140/90 mmHg, the 140 mmHg represents the systolic pressure. Elevated systolic pressure can indicate hypertension, increased cardiac workload, or arterial stiffness and is a critical measurement in cardiovascular assessment.
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