Mr. Sprat is a 21-year-old patient who complains of nasal congestion. He admits to using recreational drugs. On examination, you have noted a septal perforation. Which recreational drug is commonly associated with nasal septum perforation?
heroin
ecstasy
cocaine
marijuana
The Correct Answer is C
A. Heroin use is generally associated with intravenous use and is less commonly linked to nasal septum perforation.
B. Ecstasy (MDMA) is primarily used in tablet form and is not typically associated with nasal use that would cause septal perforation.
C. Cocaine is frequently snorted, which can lead to irritation and damage to the nasal passages and septum, resulting in perforation.
D. Marijuana is usually smoked rather than snorted, and it is not commonly associated with nasal septum perforation.
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Correct Answer is A
Explanation
A. Presbyopia is a common age-related condition that affects the ability to see close objects clearly, which aligns with the client's difficulty in reading, sewing, and seeing faces up close.
B. While some vision changes are expected with aging, the specific difficulties the client is experiencing suggest a more definitive condition rather than "normal" vision changes.
C. While cataracts can cause vision issues, the specific symptoms described (trouble reading and seeing objects up close) are more characteristic of presbyopia.
D. Glaucoma typically involves peripheral vision loss rather than difficulty with near vision, so this option is not supported by the findings.
Correct Answer is B
Explanation
A. Observing for facial symmetry assesses cranial nerves VII (facial nerve) rather than cranial nerve III.
B. Checking the pupillary response to light assesses cranial nerve III (oculomotor nerve), which controls pupil constriction and extraocular eye movements.
C. Testing visual acuity assesses cranial nerve II (optic nerve), not cranial nerve III.
D. Eliciting the gag reflex assesses cranial nerves IX (glossopharyngeal) and X (vagus), not cranial nerve III.