Questions: Which of the following would the nurse expect to assess if a patient has a lesion of the sympathetic nervous system? a) Bilateral dilated pupils b) Unilateral dilated pupil c) Argyll Robertson pupils d) Constricted pupil unresponsive to light

The answer is b) Unilateral dilated pupil.

Explanation for each option:

a) Bilateral dilated pupils: This is typically associated with a more generalized sympathetic nervous system activation or other conditions affecting both eyes, rather than a lesion in the sympathetic nervous system.

b) Unilateral dilated pupil: A lesion in the sympathetic nervous system can lead to a condition known as Horner's syndrome, which typically presents with ptosis (drooping of the eyelid), miosis (constricted pupil), and anhidrosis (lack of sweating) on the affected side. However, if there is a disruption in the sympathetic pathway that affects only one side, it can sometimes result in a unilateral dilated pupil due to the loss of sympathetic input.

c) Argyll Robertson pupils: These are pupils that constrict with accommodation but not in response to light, often associated with neurosyphilis, not typically a lesion of the sympathetic nervous system.

d) Constricted pupil unresponsive to light: This is more characteristic of a parasympathetic nervous system issue or a direct ocular problem, rather than a sympathetic nervous system lesion.

In summary, the most likely assessment finding for a lesion of the sympathetic nervous system would be a unilateral dilated pupil, making option b the correct choice.