The nurse is assessing a patient's pupillary response and observes that both pupils constrict when light is directed into one eye. What does this finding indicate?

Correct Answer: B

Rationale: The correct answer is B: Consensual light reflex. When both pupils constrict in response to light directed into one eye, it indicates a consensual light reflex. This response occurs due to the connection between the optic nerves, causing both pupils to constrict simultaneously. This reflex is an involuntary response and ensures that both eyes react to changes in light intensity equally. Choice A (Direct light reflex) refers to the constriction of the pupil in response to light directly shining into that same eye, not both eyes simultaneously. Choice C (Accommodation) involves the adjustment of the lens to focus on near objects and is not related to pupillary response. Choice D (Convergence) refers to the inward movement of both eyes when focusing on a nearby object and is not related to pupillary response to light.

Correct Answer: D

Rationale: The correct answer is D: Review of systems. In a health history, the review of systems involves asking about specific symptoms related to different body systems. In this case, the information provided relates to symptoms associated with the cardiovascular system. The patient denying chest pain, palpitations, orthopnea, and paroxysmal nocturnal dyspnea indicates a review of symptoms related to the cardiovascular system. Choices A, B, and C are incorrect because the information provided does not pertain to the patient's primary reason for seeking care (chief complaint), the current symptoms and duration (present illness), or personal and social history.

Correct Answer: A

Rationale: The correct answer is A: Hematuria. Hematuria is the presence of blood in the urine, which is a symptom directly related to the genitourinary system. It can indicate various conditions affecting the kidneys, bladder, or other parts of the urinary tract. Tinnitus (choice B) is related to the ear, not the genitourinary system. Rhinorrhea (choice C) refers to a runny nose, which is associated with the respiratory system. Dyspnea (choice D) is a symptom of difficulty breathing, typically related to the respiratory system or cardiovascular system, not the genitourinary system.

Correct Answer: B

Rationale: The correct answer is B because the general survey component of the physical examination focuses on observations related to the patient's appearance, behavior, and mobility. This step is crucial in gathering initial information about the patient's overall health status and can provide important clues for further evaluation. Assessing the patient's appearance can reveal signs of distress, nutritional status, or hygiene. Observing behavior can indicate mental status or emotional state. Mobility assessment can identify physical limitations or abnormalities. A, C, and D are incorrect: A: Assessing the patient's chief complaint is part of the focused history taking, not the general survey component. C: Documenting findings from a review of systems is part of the comprehensive history taking, not the general survey. D: Evaluating vital signs is a separate component of the physical examination and not part of the general survey.

Correct Answer: A

Rationale: The correct answer is A: Rib fracture. Rationale: 1. The patient's presentation with chest pain, tenderness, and bruising after a motorcycle accident is highly suggestive of a traumatic injury like a rib fracture. 2. Rib fractures are common in blunt chest trauma and can cause significant pain with breathing and movement. 3. Tenderness over the affected area and pain on palpation are typical findings in rib fractures. 4. The vital signs of a stable blood pressure and tachycardia are consistent with a rib fracture without significant hemodynamic instability. Summary of incorrect choices: B: Pneumothorax - Less likely in this case as there is no mention of decreased breath sounds or respiratory distress. C: Pericarditis - Unlikely given the acute presentation after trauma and absence of classic pericarditis symptoms. D: Myocardial infarction - Not likely in a young patient with trauma and no risk factors for heart disease.