During the examination of a patient in her third trimester of pregnancy, the nurse notices that the patient's thyroid gland is slightly enlarged. No enlargement had been noted previously. The nurse suspects that:

Correct Answer: C

Rationale: Step-by-step rationale for why choice C is correct: 1. Enlargement of the thyroid gland during pregnancy is a normal finding due to hormonal changes. 2. The thyroid gland enlarges to meet the increased demands of thyroid hormone production. 3. This condition is known as gestational thyrotoxicosis and is usually benign. 4. No further testing is needed for thyroid cancer unless other concerning symptoms are present. Summary: A: Not relevant as iodine deficiency is not typically associated with thyroid enlargement in pregnancy. B: Incorrect as early signs of goitre would involve more pronounced symptoms than just slight enlargement. D: Unnecessary as thyroid cancer is not a common concern in this scenario of a slightly enlarged thyroid in the third trimester of pregnancy.

Correct Answer: C

Rationale: The correct answer is C because stimulation of the sympathetic branch of the autonomic nervous system results in the elevation of the eyelid (ptosis) and dilation of the pupil (mydriasis). This is due to the action of the dilator pupillae muscle and the superior tarsal muscle. Pupillary constriction (choice A) is controlled by the parasympathetic branch via the sphincter pupillae muscle. Adjusting the eye for near vision (choice B) is controlled by the ciliary muscle, which is under parasympathetic control, not sympathetic. Contraction of the ciliary body (choice D) is also controlled by the parasympathetic system for accommodation of near vision, not the sympathetic system.

Correct Answer: D

Rationale: The correct answer is D because a normal pupillary light reflex involves the constriction of both pupils in response to bright light. This reflex is controlled by the autonomic nervous system, specifically the parasympathetic nervous system. When light is detected by the retina, signals are sent to the brain which then triggers the constriction of both pupils to reduce the amount of light entering the eye. Choices A, B, and C are incorrect because they do not accurately describe the pupillary light reflex. Vision convergence, light reflection, and focusing the image at the center of the pupil are not directly related to the pupillary light reflex.

Correct Answer: D

Rationale: The correct answer is D because floaters are a common and typically benign phenomenon caused by condensed vitreous fibers in the eye. A nurse should educate the patient that floaters are usually not significant and do not require immediate intervention. Option A is incorrect because counting the number of floaters is unnecessary. Option B is incorrect because presuming glaucoma without proper assessment is inappropriate. Option C is incorrect because seeing occasional floaters is a common and normal occurrence in many individuals.

Correct Answer: A

Rationale: The correct answer is A: poor vision. In the 20/80 visual acuity notation, 20 represents the test distance in feet, and 80 represents the line on the eye chart that the patient can read. Therefore, a person with 20/80 vision can only see at 20 feet what a person with normal vision can see at 80 feet. This indicates poor vision as the patient's visual acuity is significantly below normal. Summary: - Choice B (acute vision) is incorrect as 20/80 vision indicates poor vision, not exceptional sharpness. - Choice C (normal vision) is incorrect as 20/80 vision is below normal range. - Choice D (presbyopia) is incorrect as presbyopia is a condition related to aging and difficulty focusing on close objects, not specifically indicated by 20/80 vision.