A nurse is assessing an older adult client. Which of the following findings should the nurse expect?

Choice A rationale An increase in the size of the pupils is not an expected finding in an older adult; instead, pupils typically become smaller with age. This condition, known as senile miosis, occurs because the muscles that control the iris weaken. Smaller pupils reduce the amount of light reaching the retina, which can impair vision in dim lighting. Therefore, observing dilated or larger pupils would be an abnormal finding rather than a standard expectation of the aging process. Choice B rationale Increased peripheral vision is not expected in older adults, as aging typically results in a gradual narrowing of the visual field. Changes in the retina and the loss of photoreceptor cells often lead to a reduction in the ability to see objects at the periphery. Conditions like glaucoma, which are more common in older populations, can also significantly diminish peripheral sight. Consequently, the nurse would expect a decrease, rather than an increase, in the client's peripheral vision. Choice C rationale Increased sensitivity to touch is not a typical finding in the elderly; rather, most older adults experience a decrease in tactile sensitivity. This is due to a reduction in the number of sensory receptors in the skin and changes in the peripheral nervous system. This diminished sense of touch can increase the risk of injury, as the client may not feel pressure or heat as acutely. The nurse should be aware of this reduced sensation during assessments. Choice D rationale An increase in cerumen in the ear canal is a common finding in older adults. With age, the cerumen-producing glands atrophy, leading to earwax that is drier and harder. Additionally, the hair in the ear canal becomes coarser, which can trap the wax and lead to impaction. This buildup can cause conductive hearing loss. It is a standard physiological change that nurses frequently observe and manage during the physical assessment of elderly clients.