Deck 14: Eyes

Question 1

A client tells the nurse they are experiencing blurred vision. Which initial question should the nurse ask the client?

A) "Can you describe your vision?"
B) "Are you experiencing double vision?"
C) "Have you recently had any eye pain?"
D) "What kinds of activities do you perform at work?"

Answer 1

"Can you describe your vision?"

Question 2

The nurse is assessing the client's vision. Which information should the nurse provide the client?

A) "I am going to perform this test with you standing."
B) "You may leave your glasses on during the exam."
C) "I am going to have you close your covered eye."
D) "I will have you stand 20 feet from the chart."

Answer 2

"I will have you stand 20 feet from the chart."

Question 3

The nurse is preparing to perform the cover and uncover test on a client. Which explanation will the nurse provide the client prior to performing the exam?

A) This will test the muscles that control your eye movement.
B) This will test the ability of your pupil size to change.
C) This will test the balance mechanism that keeps your eyes parallel.
D) This will test the ability of your eyes to focus on distant objects.

Answer 3

This will test the balance mechanism that keeps your eyes parallel.

Question 4

During an eye examination, the nurse requests that the client read letters located on the Snellen E chart. The client's vision is determined to be 20/200. Which statements regarding this client's vision are accurate? Select all that apply.

A) The client is legally blind.
B) The client is unable to read from a paper at close range.
C) The client is found to be farsighted.
D) The client is myopic.
E) This is common in clients who are over 45 years old.

Question 5

The nurse is assessing a client's visual fields by confrontation. Which actions by the nurse indicate appropriate practice? Select all that apply.

A) The nurse asks the client to cover one of her eyes with a card.
B) The nurse uses a penlight to assist with performing the test.
C) The nurse asks the client to sit 20 feet away.
D) The client tells the nurse when she first sees the object.
E) The nurse asks the client to stand 4 feet away.

Question 6

The nurse is preparing to review the secondary sources of data for a patient with glaucoma. Which diagnostic testing should the nurse anticipate to be included?

A) Tonometry.
B) Ultrasonography.
C) Fluorescein angiography.
D) Refraction test.

Question 7

The nurse is reviewing the records of a client with astigmatism. Which visual changes should the nurse anticipate?

A) Double vision.
B) Presence of floaters.
C) Decreased field of vision.
D) Inability to see things at a close range.

Question 8

A client asks the nurse what is the name of the structure of the eye that is colored.

A) Optic disc.
B) Iris.
C) Cornea.
D) Sclera.

Question 9

During an eye assessment, a young adult client reports difficulty seeing items within close range. This assessment data is consistent with which factor?

A) Aging.
B) Presbyopia.
C) Hyperopia.
D) Astigmatism.

Question 10

The nurse taught the client how to self-administer eye drops. During the return demonstration, the client inadvertently touched the applicator to their cornea, which caused the client to blink and produce tears. Which term should the nurse describe the reflex elicited by the client?

A) Abnormal and should be reported to the healthcare provider.
B) Hyperactive.
C) A medication side effect.
D) A normal response.

Question 11

The nurse is assessing the eyes of an older adult client. Which finding is expected by the nurse based on the client's age?

A) The client has difficulty reading from a paper held at far range without corrective glasses.
B) There is a noticeable increase in fat within the orbit of the eye.
C) The client states that they feel that their tear production has increased over the years.
D) The client is unable to clearly read from a paper held at close range.

Question 12

A client tells the nurse they experience double vision. Which question should the nurse ask the client?

A) "Do you take any medications?"
B) "Do you have a history of hyperthyroidism?"
C) "Do you have a history of diabetes?"
D) "Do you have a history of renal disease?"

Question 13

A client asks the nurse why it is important to protect their eyes from the sun. Which response should the nurse provide to the client?

A) Excessive sun exposure places you at risk for cataracts.
B) Excessive sun exposure places you at risk for night blindness.
C) Excessive sun exposure places you at risk for increased intraocular pressure.
D) Excessive sun exposure places you at risk for excessive corneal dryness.

Question 14

The nurse reviewing the records of a client notes there is a diagnosis of nystagmus. Which should the nurse recognize is a causative factor of the condition?

A) Eye infection.
B) The development of cataracts.
C) Weakness in the extraocular muscles.
D) Inability of the lens of the eye to accommodate.

Question 15

The nurse is assessing the fundus of the older adult client's eye with an ophthalmoscope. The nurse determines that there is a cyst within the macula. Which client symptom does the nurse anticipate?

A) Impaired central vision.
B) Impaired peripheral vision.
C) Consistently elevated serum glucose levels.
D) Uncontrolled hypertension.

Question 16

The nurse notes that a client is unable to control the amount of light that enters the eye. Which structure's dysfunction is the most likely cause of this problem?

A) Cornea.
B) Sclera.
C) Conjunctiva.
D) Iris.

Question 17

The nurse is performing a visual examination on a client with complaints of black dots appearing in the visual field. Which statement by the nurse is most appropriate in this situation?

A) "The black dots are known as floaters and are usually normal."
B) "We need to refer you to an eye surgeon immediately."
C) "You may have glaucoma."
D) "You may have a cataract."

Question 18

The nurse has elicited a blink reflex in a client. Which structure of the eye is responsible for the reflex?

A) Lens.
B) Macula.
C) Cornea.
D) Iris.

Question 19

A client tells the nurse they see halos around light. Which question should the nurse ask the client?

A) "Do you take any routine medications?"
B) "Do you wear corrective lenses?"
C) "Have you experienced any eye trauma?"
D) "When was your last eye examination?"

Question 20

The nurse is preparing to visually inspect a client's eye. Which should the nurse anticipate to note? Select all that apply.

A) Clear lens.
B) Moist conjunctiva.
C) White Sclera.
D) Round irises.
E) Clear cornea.

Question 21

The nurse notes a client has an absence of the lateral third of the eyebrow. Which question should the nurse ask the client?

A) "Do you have a history of cardiovascular disease?"
B) "Do you have a history of obsessive-compulsive disorder?"
C) "Do you have a history of thyroid disease?"
D) "Do you have a history of diabetes?"

Question 22

The nurse is performing a focused interview and eye assessment on a client. Which assessment findings indicate the client's is experiencing a vision problem? Select all that apply.

A) The client is frowning and squinting while she is reading the Snellen chart.
B) The client exhibits a symmetrical pupillary light reflex response.
C) As the nurse checks for accommodation, the pupils remain dilated.
D) The client's near vision acuity is 14/14 bilaterally.
E) When the cornea is lightly touched in the right eye, both eyelids close.

Question 23

After a comprehensive eye examination, it is determined that the client requires corrective lenses for myopia. Which explanation by the nurse to the client is the most appropriate?

A) "Your glasses will help you to see objects in the distance."
B) "Your glasses will help you to see objects that are very close to you."
C) "Your glasses will help you to improve your eyes' ability to focus and reduce your blurred vision."
D) "Your age has made it more difficult to read items that are at close range. Your new glasses will help."

Question 24

The nurse is assessing the client's pupillary responses. The client is found to have no consensual response. Which conclusion by the nurse is the most appropriate?

A) Cranial nerve III may not be functioning appropriately.
B) This is a normal finding.
C) This is evidence of increased intracranial pressure.
D) This is evidence of optic nerve damage.

Question 25

The nurse notes there is a lack of convergence when testing a client's accommodation. Which cranial nerves should the nurse recognize are potentially dysfunctional? Select all that apply.

A) II.
B) III.
C) VII.
D) IV.
E) VI.

Question 26

The nurse notes that a client's pupils are fixed and dilated. Which should the nurse suspect has occurred?

A) Damage to the pons.
B) Syphilis.
C) Glaucoma.
D) Monocular blindness.

Question 27

The nurse examining the eyes of a client notes bilateral subconjunctival hemorrhage. Which next action should the nurse take?

A) Obtain a culture.
B) Assess the client's blood pressure.
C) Inquire about allergies.
D) Assess the client's blood glucose.

Question 28

The nurse is performing the cover test and notes inward turning of the client's eye. Which term will the nurse use to document this finding?

A) Exophoria.
B) Strabismus.
C) Esophoria.
D) Mydriasis.

Question 29

The nurse is assessing a client's eyes during a comprehensive health assessment. Which assessment finding would require immediate intervention?

A) Acute glaucoma.
B) Blepharitis.
C) Periorbital edema.
D) Anisocoria.

Question 30

Prior to conducting an eye assessment, which statement by the nurse is appropriate to prepare the client for the examination process?

A) "You can choose which eye to cover during your assessment."
B) "Are you able to read English words?"
C) "Apply pressure to the eye while it is covered during the examination."
D) "You will need to stand 10 feet from the chart for an accurate assessment."

Question 31

The nurse is preparing to test the near vision of a client. Which instructions should the nurse include?

A) Hold the chart 12 to 14 inches from the eyes.
B) Instruct the client to initially read the smallest line they can see.
C) Request the client to remove corrective lenses for reading prior to the exam.
D) Initially, have the client read the lines prior to covering a single eye at a time.

Question 32

During the assessment of a client's eyes, the nurse suspects that the client has ptosis. Which assessment data caused the nurse to come to this conclusion?

A) The palpebral conjunctiva is exposed.
B) The iris and cornea are reddened.
C) The eyelid is drooping.
D) The eyelids are swollen and puffy.

Question 33

During the assessment of a client's eyes, the nurse suspects the client has entropion. Which assessment data caused the nurse to come to this conclusion?

A) Eversion of the lower eyelid.
B) Inversion of the lid and eyelashes.
C) Swollen, red hair follicles.
D) Firm, non-tender nodule on the eyelid.

Question 34

The nurse is preparing to assess the vision of a 5-year-old child. Which Snellen chart is most appropriate for the nurse to use?

A) Chart with letters.
B) Chart with symbols.
C) Chart with numbers.
D) Chart with pictures.