Question 1

A 2-week-old infant can fixate on an object but cannot follow a light or bright toy.The nurse would:

Accepted Answer

By 2 to 4 weeks an infant can fixate on an object.By the age of 1 month,the infant should fixate and follow a bright light or toy.

Question 2

In a patient who has anisocoria,the nurse would expect to observe:

Accepted Answer

Unequal pupil size is termed anisocoria.It normally exists in 5% of the population but may also be indicative of central nervous system disease.

Question 3

In using the ophthalmoscope to assess a patient's eyes,the nurse notices a red glow in the patient's pupils.On the basis of this finding,the nurse would:

Accepted Answer

The red glow filling the person's pupil is the red reflex and is a normal finding caused by the reflection of the ophthalmoscope light off the inner retina.The other responses are not correct.

Question 4

During an examination of the eye,the nurse would expect what normal finding when assessing the lacrimal apparatus?

Accepted Answer

No swelling,redness,or drainage from the puncta should be observed when it is pressed.Regurgitation of fluid from the puncta,when pressed,indicates duct blockage.The lacrimal glands are not functional at birth.

Question 5

During an assessment,the nurse notices that an older adult patient has tears rolling down his face from his left eye.Closer examination shows that the lower lid is loose and rolling outward.The patient complains of his eye feeling "dry and itchy." Which action by the nurse is correct?

Accepted Answer

The condition described is known as ectropion,and it occurs in older adults and is attributable to atrophy of the elastic and fibrous tissues.The lower lid does not approximate to the eyeball,and,as a result,the puncta cannot effectively siphon tears; excessive tearing results.Ptosis is a drooping of the upper eyelid.These signs do not suggest the presence of a foreign body in the eye or basal cell carcinoma.

Question 6

When a light is directed across the iris of a patient's eye from the temporal side,the nurse is assessing for:

Accepted Answer

The presence of shadows in the anterior chamber may be a sign of acute angle-closure glaucoma.The normal iris is flat and creates no shadows.This method is not correct for the assessment of dacryocystitis,conjunctivitis,or cataracts.

Question 7

During an examination,a patient states that she was diagnosed with open-angle glaucoma 2 years ago.The nurse assesses for characteristics of open-angle glaucoma.Which of these are characteristics of open-angle glaucoma? Select all that apply.

Accepted Answer

Open-angle glaucoma is the most common type of glaucoma; virtually no symptoms are exhibited.Vision loss begins with the peripheral vision,which often goes unnoticed because individuals learn to compensate intuitively by turning their heads.The other characteristics are those of closed-angle glaucoma.

Question 8

An ophthalmic examination reveals papilledema.The nurse is aware that this finding indicates:

Accepted Answer

Papilledema,or choked disk,is a serious sign of increased intracranial pressure,which is caused by a space-occupying mass such as a brain tumor or hematoma.This pressure causes venous stasis in the globe,showing redness,congestion,and elevation of the optic disc,blurred margins,hemorrhages,and absent venous pulsations.Papilledema is not associated with the conditions in the other responses.

Question 9

A patient comes to the emergency department after a boxing match,and his left eye is swollen almost shut.He has bruises on his face and neck.He says he is worried because he "can't see well" from his left eye.The physician suspects retinal damage.The nurse recognizes that signs of retinal detachment include:

Accepted Answer

With retinal detachment,the person has shadows or diminished vision in one quadrant or one half of the visual field.The other responses are not signs of retinal detachment.

Question 10

The nurse is assessing a patient's eyes for the accommodation response and would expect to see which normal finding?

Accepted Answer

The accommodation reaction includes pupillary constriction and convergence of the axes of the eyes.The other responses are not correct.

Question 11

The nurse is assessing color vision of a male child.Which statement is correct? The nurse should:

Accepted Answer

Test boys only once for color vision between the ages of 4 and 8 years.Color vision is not tested in girls because it is rare in girls.Testing is performed with the Ishihara test,which is a series of polychromatic cards.

Question 12

The nurse is performing an eye assessment on an 80-year-old patient.Which of these findings is considered abnormal?

Accepted Answer

Pupils are small in the older adult,and the pupillary light reflex may be slowed,but pupillary constriction should be symmetric.The assessment findings in the other responses are considered normal in older persons.

Question 13

The nurse is examining a patient's retina with an ophthalmoscope.Which finding is considered normal?

Accepted Answer

The optic disc is located on the nasal side of the retina.Its color is a creamy yellow-orange to a pink,and the edges are distinct and sharply demarcated,not blurred.A pigmented crescent is black and is due to the accumulation of pigment in the choroid.

Question 14

The nurse notices the presence of periorbital edema when performing an eye assessment on a 70-year-old patient.The nurse should:

Accepted Answer

Periorbital edema occurs with local infections,crying,and systemic conditions such as heart failure,renal failure,allergy,and hypothyroidism.Periorbital edema is not associated with blepharitis.

Question 15

During a physical education class,a student is hit in the eye with the end of a baseball bat.When examined in the emergency department,the nurse notices the presence of blood in the anterior chamber of the eye.This finding indicates the presence of:

Accepted Answer

Hyphema is the term for blood in the anterior chamber and is a serious result of blunt trauma (a fist or a baseball)or spontaneous hemorrhage and may indicate scleral rupture or major intraocular trauma.(See Table 14-7 for descriptions of the other terms.)

Question 16

A patient comes into the clinic complaining of pain in her right eye.On examination,the nurse sees a pustule at the lid margin that is painful to touch,red,and swollen.The nurse recognizes that this is a:

Accepted Answer

Ahordeolum,or stye,is a painful,red,and swollen pustule at the lid margin.A chalazion is a nodule protruding on the lid,toward the inside,and is nontender,firm,with discrete swelling.Dacryocystitis is an inflammation of the lacrimal sac.Blepharitis is inflammation of the eyelids (see Table 14-3).

Question 17

When assessing the pupillary light reflex,the nurse should use which technique?

Accepted Answer

To test the pupillary light reflex,the nurse should advance a light in from the side and note the direct and consensual pupillary constriction.

Question 18

A 68-year-old woman is in the eye clinic for a checkup.She tells the nurse that she has been having trouble reading the paper,sewing,and even seeing the faces of her grandchildren.On examination,the nurse notes that she has some loss of central vision but her peripheral vision is normal.These findings suggest that she may have:

Accepted Answer

Macular degeneration is the most common cause of blindness.It is characterized by the loss of central vision.Cataracts would show lens opacity.Chronic open-angle glaucoma,the most common type of glaucoma,involves a gradual loss of peripheral vision.These findings are not consistent with vision that is considered normal at any age.

Question 19

The nurse is performing an eye-screening clinic at a daycare center.When examining a 2-year-old child,the nurse suspects that the child has a "lazy eye" and should:

Accepted Answer

Testing for strabismus is done by performing the corneal light reflex test and the cover test.The Snellen eye chart and confrontation test are not used to test for strabismus.

Question 20

A patient comes into the emergency department after an accident at work.A machine blew dust into his eyes,and he was not wearing safety glasses.The nurse examines his corneas by shining a light from the side across the cornea.What findings would suggest that he has suffered a corneal abrasion?

Accepted Answer

A corneal abrasion causes irregular ridges in reflected light,which produce a shattered appearance to light rays.No opacities should be observed in the cornea.The other responses are not correct.

Quiz 14: Eyes