Deck 15: Eyes

Question 1

A patient's vision is recorded as 20/30 when the Snellen eye chart is used.The nurse interprets these results to indicate that:

A)At 30 feet the patient can read the entire chart.
B)The patient can read at 20 feet what a person with normal vision can read at 30 feet.
C)The patient can read the chart from 20 feet in the left eye and 30 feet in the right eye.
D)The patient can read from 30 feet what a person with normal vision can read from 20 feet.

Answer 1

The patient can read at 20 feet what a person with normal vision can read at 30 feet.

Question 2

When performing the corneal light reflex assessment, the nurse notes that the light is reflected at the 2 o'clock position in each eye.The nurse should:

A)Consider this a normal finding.
B)Refer the individual for further evaluation.
C)Document this finding as an asymmetrical light reflex.
D)Perform the confrontation test to validate the findings.

Answer 2

Consider this a normal finding.

Question 3

During eye assessment of a dark-skinned patient, what normal finding does the nurse observe?

A)Yellow fatty deposits over the cornea
B)Pallor near the outer canthus of the lower lid
C)Yellow coloration of the sclera that extends up to the iris
D)Presence of small brown macules on the sclera

Answer 3

Presence of small brown macules on the sclera

Question 4

The nurse is preparing to assess the visual acuity of a 16-year-old patient.How should the nurse proceed?

A)Perform the confrontation test.
B)Ask the patient to read the print on a handheld Jaeger card.
C)Use the Snellen chart positioned 20 feet away from the patient.
D)Determine the patient's ability to read newsprint at 14 inches (35 cm) from eye.

Question 5

A mother asks when her newborn infant's eyesight will be fully developed.The nurse should reply:

A)"Vision is not fully developed until 2 years of age."
B)"Infants develop the ability to focus on an object at approximately 8 months of age."
C)"By approximately 3 months of age, infants develop more coordinated eye movements and can fixate on an object."
D)"Most infants have uncoordinated eye movements for the first year of life."

Question 6

The nurse is conducting a visual examination.Which of these statements regarding visual pathways and visual fields is true?

A)The right side of the brain interprets the vision for the right eye.
B)The image formed on the retina is upside down and reversed from its actual appearance in the outside world.
C)Light rays are refracted through the transparent media of the eye before striking the pupil.
D)Light impulses are conducted through the optic nerve to the temporal lobes of the brain.

Question 7

A 60-year-old man with suspected ptosis of one eye is at the clinic for an eye examination.The nurse confirms ptosis by:

A)Performing the confrontation test.
B)Assessing the patient's near vision.
C)Observing the distance between the palpebral fissures.
D)Performing the corneal light test, and looking for symmetry of the light reflex.

Question 8

A 52-year-old patient describes the presence of occasional floaters or spots moving in front of his eyes.The nurse should:

A)Examine the retina to determine the number of floaters.
B)Presume the patient has glaucoma and refer patient for further testing.
C)Consider these to be abnormal findings and refer patient to an ophthalmologist.
D)Document the findings as common with patient age.

Question 9

The nurse is performing an external eye examination.Which statement regarding the outer layer of the eye is true?

A)The outer layer of the eye is very sensitive to touch.
B)The outer layer of the eye is darkly pigmented to prevent light from reflecting internally.
C)The trigeminal nerve (cranial nerve V) and the trochlear nerve (cranial nerve IV) are stimulated when the outer surface of the eye is stimulated.
D)The visual receptive layer of the eye in which light waves are changed into nerve impulses is located in the outer layer of the eye.

Question 10

The nurse reviews causes of increased intraocular pressure (IOP) with the patient using the following explanation:

A)"The pressure results from the thickness of the lens."
B)"The posterior chamber increases in pressure as it accommodates increased fluid."
C)"Contraction of the ciliary body in response to the aqueous within the eye increases pressure."
D)"The pressure results from the amount of aqueous produced and the resistance to its outflow at the angle of the anterior chamber."

Question 11

During the health history interview with a 65-year-old male patient of African descent with hypertension, the nurse encourages the patient to have regular eye examinations because of his risk for:

A)Cataract.
B)Glaucoma.
C)Strabismus.
D)Proptosis.

Question 12

A patient is unable to read even the largest letters on the Snellen chart.What should the nurse do next?

A)Refer the patient to an ophthalmologist or optometrist for further evaluation
B)Assess whether the patient can count the nurse's fingers when they are placed in front of his or her eyes
C)Ask the patient to put on his or her reading glasses and attempt to read the Snellen chart again
D)Shorten the distance between the patient and the chart until the letters are seen and record that distance

Question 13

The nurse is reviewing age-related changes of the eye for a class.Which of these physiological changes is responsible for presbyopia?

A)Degeneration of the cornea
B)Loss of lens elasticity
C)Decreased adaptation to darkness
D)Decreased distance vision abilities

Question 14

When examining a patient's eyes, the nurse uses eye drops to stimulate the sympathetic branch of the autonomic nervous system to:

A)Cause pupillary constriction.
B)Adjust the eye for near vision.
C)Elevate the eyelid and dilate the pupil.
D)Cause contraction of the ciliary body.

Question 15

The nurse recognizes that a patient has a normal pupillary light reflex when:

A)The eyes converge to focus on the light.
B)Light is reflected at the same spot in both eyes.
C)The eye focuses the image in the centre of the pupil.
D)Constriction of both pupils occurs in response to bright light.

Question 16

When testing a patient's visual accommodation the nurse notes a normal finding when the patient demonstrates:

A)Pupillary constriction when looking at a near object.
B)Pupillary dilation when looking at a far object.
C)Changes in peripheral vision in response to light.
D)Involuntary blinking in the presence of bright light.

Question 17

A patient's vision is recorded as 20/80 in each eye.The nurse interprets this finding to mean that the patient has:

A)Impaired vision.
B)Exophthalmos.
C)Normal vision.
D)Presbyopia.

Question 18

When examining the patient's eyes, the nurse notices that his eyelid margins approximate completely when closed.The nurse will:

A)Document this as a normal finding.
B)Evaluate the extraocular muscles.
C)Refer the patient for problems with tearing.
D)Assess for increased intraocular pressure.

Question 19

During ocular examinations, the nurse assesses the movement of the extraocular muscles by stimulating:

A)Cranial nerves VII and VIII.
B)The ciliary body.
C)The corneal reflex.
D)Cranial nerves III, IV, and VI.

Question 20

The nurse is performing the diagnostic positions test and notes normal findings with:

A)Convergence of the eyes.
B)Parallel movement of both eyes.
C)Nystagmus in extreme superior gaze.
D)Lid lag when moving the eyes from a superior to an inferior position.

Question 21

The nurse is performing an eye assessment on an 80-year-old patient and is concerned about finding that the patient has:

A)Decreased tear production.
B)Unequal pupillary constriction in response to light.
C)Arcus senilis around the cornea.
D)Loss of the outer hair on the eyebrows attributable to a decrease in hair follicles.

Question 22

When examining a 2-week-old infant the nurse notices that he watches an object but does not follow it with his eyes when moved to different positions.The nurse will:

A)Document this as a normal finding.
B)Assess the pupillary light reflex for possible blindness.
C)Refer the infant to a specialist.
D)Continue assessment with the Allen chart.

Question 23

During assessment of the lacrimal apparatus, the nurse would document the following as a normal finding:

A)Presence of tears along the inner canthus
B)Blocked nasolacrimal duct in a newborn infant
C)Slight swelling over the upper lid and along the bony orbit if the individual has a cold
D)Absence of drainage from the puncta when pressing against the inner orbital rim

Question 24

When assessing a male child for colour deficiency the nurse will:

A)Check colour vision annually until age 18 years.
B)Ask the child to identify the colour of his or her clothing.
C)Test for colour vision once between ages 4 and 8 years.
D)Begin colour vision screening at the child's 2-year checkup.

Question 25

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

A)Drainage from dacryocystitis.
B)Presence of conjunctivitis over the iris.
C)Presence of shadows, which may indicate glaucoma.
D)Scattered light reflex, which may be indicative of cataracts.

Question 26

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:

A)Macular degeneration.
B)Vision that is normal for someone her age.
C)The beginning stages of cataract formation.
D)Increased intraocular pressure or glaucoma.

Question 27

During examination of the patient's eyes, the nurse notes that the pupils become smaller when the patient looks at an object moved closer to the eyes.The nurse will document this finding as:

A)Dilation of the pupils.
B)Consensual light reflex.
C)Conjugation.
D)Accommodation.

Question 28

When assessing the pupillary light reflex, the nurse will:

A)Shine a penlight from directly in front of the patient, and inspect for pupillary constriction.
B)Ask the patient to follow the penlight in eight directions, and observe for bilateral pupil constriction.
C)Shine a light across the pupil from the side, and observe for direct and consensual pupillary constriction.
D)Ask the patient to focus on a distant object and then to follow the penlight to approximately 7 cm from the nose.

Question 29

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:

A)Loss of central vision.
B)Shadow or diminished vision in one quadrant or one-half of the visual field.
C)Loss of peripheral vision.
D)Sudden loss of pupillary constriction and accommodation.

Question 30

The nurse is examining a patient's retina with an ophthalmoscope and notes the normal finding of:

A)An optic disc that is a yellow-orange colour.
B)Optic disc margins that are blurred around the edges.
C)The presence of pigmented crescents in the macular area.
D)The presence of the macula located on the nasal side of the retina.

Question 31

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

A)Examine the external structures of the eye.
B)Assess visual acuity with the Snellen eye chart.
C)Assess the child's visual fields with the confrontation test.
D)Test for strabismus by performing the corneal light reflex test.

Question 32

Papilledema is revealed during an ophthalmic examination which the nurse recognizes as indicating:

A)Retinal detachment.
B)Diabetic retinopathy.
C)Acute-angle glaucoma.
D)Increased intracranial pressure.

Question 33

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:

A)Chalazion.
B)Hordeolum (stye).
C)Dacryocystitis.
D)Blepharitis.

Question 34

When using the ophthalmoscope to assess a patient's eyes, the nurse notices a red glow in the patient's pupils.The nurse will:

A)Document that an opacity is present in the lens or cornea.
B)Check the light source of the ophthalmoscope to verify that it is functioning.
C)Continue with the examination knowing that the red glow is a normal finding.
D)Refer the patient for further evaluation.

Question 35

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

A)Check for the presence of exophthalmos.
B)Suspect that the patient has hyperthyroidism.
C)Ask the patient if he or she has a history of heart failure.
D)Assess for blepharitis, which is often associated with periorbital edema.

Question 36

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.The nurse recognizes that the patient may have a corneal abrasion when:

A)The corneas are smooth and clear.
B)The lens behind the cornea is opaque.
C)There are areas of bleeding across the cornea.
D)There is a shattered look to the light rays reflecting off the cornea.

Question 37

During an assessment, the nurse notices that an older adult patient has tears rolling down his face from his left eye.Closer examination reveals 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?

A)Assessing the eye for a possible foreign body
B)Documenting the finding as ptosis
C)Assessing for other signs of ectropion
D)Contacting the referring physician; these are signs of basal cell carcinoma

Question 38

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 indicating the presence of:

A)Hypopyon.
B)Hyphema.
C)Corneal abrasion.
D)Pterygium.

Question 39

During an ophthalmoscopic examination of the eye, the nurse notices areas of exudate that appear similar to cotton wool or fluffy clouds.The nurse recognizes that the patient may have:

A)Diabetes.
B)Hyperthyroidism.
C)Glaucoma.
D)Hypotension.

Question 40

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

A)Dilated pupils.
B)Excessive tearing.
C)Pupils of unequal size.
D)Uneven curvature of the lens.

Question 41

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.)

A)Patient may experience sensitivity to light, nausea, and halos around lights.
B)Patient experiences tunnel vision in the late stages.
C)Immediate treatment is needed.
D)Vision loss begins with peripheral vision.
E)Open-angle glaucoma causes sudden attacks of increased pressure that cause blurred vision.
F)Virtually no symptoms are exhibited.

Question 42

The nurse is working at a community health fair to promote eye examinations for populations at higher risk to have vision problems, including: (Select all that apply.)

A)Indigenous people.
B)People of European descent.
C)People with diabetes.
D)People of African descent.
E)People of French descent.
F)People with a family history of glaucoma.