Question 1

The nurse is using an Amsler grid to assess the vision of a client. The client tells the nurse, "I am noticing black spots while looking through the grid." Which interpretation does the nurse associate with the assessment finding?

Accepted Answer

The Amsler grid is a tool used to detect vision problems resulting from damage to the macula (the central part of the retina) or the optic nerve. The presence of black spots or areas while looking at the Amsler grid can indicate age-related macular degeneration, a condition where the central vision is affected, leading to symptoms such as seeing black spots or lines. This symptom is not typically associated with cataracts, retinoblastoma, or diabetic retinopathy in the context of Amsler grid testing.

Question 2

The nurse is performing a physical assessment on a client. When assessing the client's eyes, the nurse notes a change in the pupil when examined with a pen light. Which reaction indicates normal functioning?

Accepted Answer

Miosis is the normal constriction of the pupils in response to light, indicating normal functioning of the eye's reflexes.

Question 3

Which vision impairment is associated with elongation of the eyeball?

Accepted Answer

Myopia, or nearsightedness, is associated with the elongation of the eyeball, which causes light to focus in front of the retina rather than directly on it, leading to blurred distance vision.

Question 4

A client who is middle-aged has impaired vision corrected with reading glasses. Which vision impairment does the nurse place in the client's medical history?

Accepted Answer

Presbyopia is a common age-related condition where the eye's lens loses flexibility, making it difficult to focus on close objects, often corrected with reading glasses.

Question 5

On reviewing a client's eyeglass prescription, the nurse finds that the client is prescribed concave lenses for the treatment of impaired vision. Which condition does the nurse identify in the client?

Accepted Answer

Concave lenses are used to correct myopia, or nearsightedness, allowing the person to see distant objects more clearly by diverging the light rays before they enter the eye.

Question 6

While assessing the eye of a client, the nurse finds that the skin around the eye is flaking, and the client has greasy eyelids that appear scaly. Which interpretation does the nurse make from these findings?

Accepted Answer

The symptoms described are indicative of blepharitis, a condition characterized by inflammation of the eyelid margins, often with flaking and scaling skin around the eyes and greasy eyelids.

Question 7

A client tells the nurse, "I am unable to tolerate light and have a gritty sensation in my eye." The health-care provider prescribes a fluorescent dye test for the client. Which condition does the nurse anticipate in the client?

Accepted Answer

The symptoms described by the client, such as intolerance to light (photophobia) and a gritty sensation in the eye, along with the prescription of a fluorescent dye test, suggest a corneal abrasion. This test helps in visualizing scratches on the cornea.

Question 8

A client reports sensations of dry and irritated eyes. After examination, the health-care provider diagnoses the client with exophthalmos. Which most common cause of this condition does the nurse identify?

Accepted Answer

Exophthalmos, characterized by bulging eyes, is most commonly caused by hyperthyroidism, particularly Graves' disease. This condition leads to inflammation and swelling in the eye muscles and tissues, pushing the eyeball forward.

Question 9

Which eye disorder is associated with irregular clumping of proteinaceous substances within the lens?

Accepted Answer

Cataracts are associated with the irregular clumping of protein in the lens, leading to clouding and vision impairment.

Question 10

The school nurse notices a number of children exhibiting redness and drainage of the eyes along with complaints of itching. For which suspected eye infection does the school nurse send the affected children home?

Accepted Answer

The symptoms described (redness, drainage of the eyes, and itching) are characteristic of conjunctivitis, commonly known as pink eye, which is highly contagious.

Question 11

The nurse is performing a physical assessment on a school-age client. When assessing the client's eyes, the nurse notes strabismus, eye redness, white spots in the pupil, and an absence of red reflex in both eyes. Which treatment strategy does the nurse expect will be beneficial for the client?

Accepted Answer

The absence of red reflex and white spots in the pupil can indicate retinoblastoma, a type of eye cancer. Enucleation surgery, which involves removing the affected eye, is a common treatment for this condition.

Question 12

During assessment of a client, the nurse finds the client has blurred vision and swelling of the optic disc. Which condition does the nurse interpret from the findings?

Accepted Answer

Papilledema is the swelling of the optic disc due to increased intracranial pressure, which can lead to symptoms such as blurred vision. It is not directly associated with cataracts, conjunctivitis, or retinal detachment.

Question 13

A client reports symptoms of severe headache, vomiting, and double vision. After assessing the client, the nurse determines the client has swelling of the optic nerve. Which interpretation does the nurse associate with these findings?

Accepted Answer

Papilledema is the swelling of the optic nerve due to increased intracranial pressure, which can cause symptoms such as headache, vomiting, and double vision.

Question 14

While assessing a client with glaucoma, the nurse uses a tonometry instrument. Which clinical information does the nurse document from this instrument?

Accepted Answer

Tonometry is a diagnostic test primarily used to measure the intraocular pressure (IOP) inside the eye, which is crucial for diagnosing and managing glaucoma.

Question 15

A client reports to a health-care provider a decrease in the ability to see faces and to read over a period of several months. Medical history reveals treatment for high cholesterol and a smoking habit of one pack of cigarettes daily. Which diagnosis is the health-care provider most likely to associate with the client's condition?

Accepted Answer

The answer of A client reports to a health-care provider...

Question 16

The health-care provider is examining a client who reports headache and intermittent diplopia since experiencing a head injury. Funduscopic examination reveals unclear and undefined borders of the optic disc. Which immediate response is expected from the health-care provider?

Accepted Answer

Unclear and undefined borders of the optic disc upon funduscopic examination suggest papilledema, which is often a sign of increased intracranial pressure, possibly due to the head injury. An MRI of the brain is the appropriate immediate response to investigate the underlying cause of the increased intracranial pressure and to assess for any potential serious conditions such as a brain tumor, hemorrhage, or swelling.

Question 17

The health-care provider is assessing a client presenting with eye irritation, excessive tearing, and eye dryness. The health-care provider diagnoses the client with ectropion. Which physical manifestation does the nurse expect to observe in the client?

Accepted Answer

Ectropion is characterized by the outward turning or eversion of the eyelid, which exposes the inner surface of the eyelid (conjunctiva) to the environment, leading to symptoms such as irritation, excessive tearing, and dryness.

Question 18

The nurse is assessing the eyes of a client and finds red, watery eyes with purulent exudates and obstruction in the nasolacrimal duct. Which condition does the nurse identify from these findings?

Accepted Answer

The symptoms described, including red, watery eyes with purulent exudates and obstruction in the nasolacrimal duct, are indicative of dacryocystitis, which is an infection of the lacrimal sac leading to inflammation.

Question 19

A client has a painful, swollen eyelid and reports severe pain on exposure to sunlight. The health-care provider prescribes surgical excision for the client. Which eye infection does the nurse identify in the client?

Accepted Answer

A chalazion is a swollen eyelid condition that may require surgical excision if it does not resolve on its own.

Question 20

A client with rheumatoid arthritis has purplish-red coloration in the eye and reports severe eye pain, which radiates to the eyebrow and jaw. Which treatment strategy is beneficial for the client?

Accepted Answer

The symptoms described are indicative of scleritis, which is an inflammation of the sclera (the white outer layer of the eyeball) often associated with autoimmune diseases like rheumatoid arthritis. Corticosteroids are effective in reducing inflammation and are commonly used to treat scleritis.

Quiz 43: Eye Disorders