Deck 14: Eyes

Question 1

A 52-year-old patient describes the presence of occasional "floaters or spots" moving in front of his eyes.The nurse should:
1)examine the retina to determine the number of floaters.
2)presume the patient has glaucoma and refer him for further testing.
3)consider this an abnormal finding and refer him to an ophthalmologist.
4)know that "floaters" are usually not significant and are caused by condensed vitreous fibers.

Answer 1

4
Floaters are a common sensation with myopia or after middle age owing to condensed vitreous fibers.Usually,they are not significant.

Question 2

The nurse is testing a patient's visual accommodation,which refers to:
1)pupillary constriction when looking at a near object.
2)pupillary dilation when looking at a far object.
3)changes in peripheral vision in response to light.
4)involuntary blinking in the presence of bright light.

Answer 2

1
The muscle fibers of the iris contract the pupil in bright light and accommodate for near vision.

Question 3

A patient is unable to read the 20/100 line on the Snellen chart.The nurse would:
1)refer the patient to an ophthalmologist or optometrist for further evaluation.
2)assess whether the patient can count the nurse's fingers when they are placed in front of his or her eyes.
3)ask the patient to put on his or her reading glasses and attempt to read the Snellen chart again.
4)shorten the distance between the patient and the chart and ask him or her to read the smallest line of print possible.

Answer 3

1
If vision is poorer than 20/30,refer the person to an ophthalmologist or optometrist.

Question 4

In assessing the sclera of a black patient,which of the following would be an expected finding?
1)Yellow fatty deposits over the cornea
2)Pallor near the outer canthus of the lower lid
3)Yellow color of the sclera that extends up to the iris
4)The presence of small brown macules on the sclera

Question 5

A 60-year-old man is at the clinic for an eye examination.The nurse suspects that he has a ptosis of one eye.How would the nurse check for this?
1)Perform the confrontation test.
2)Assess the individual's near vision.
3)Observe the distance between the palpebral fissures.
4)Perform the corneal light test and look for symmetry of the light reflex.

Question 6

Which of the following physiological changes is responsible for presbyopia?
1)Degeneration of the cornea
2)Loss of lens elasticity
3)Decreased adaptation to darkness
4)Decreased distance vision abilities

Question 7

When the retina is examined,which of the following is considered a normal finding?
1)An optic disc that is a yellow-orange color
2)Optic disc margins that are blurred around the edges
3)The presence of pigmented crescents in the macular area
4)The presence of the macula located on the nasal side of the retina

Question 8

During an examination of the eye,the nurse would expect what normal finding when assessing the lacrimal apparatus?
1)The presence of tears along the inner canthus
2)A blocked nasolacrimal duct in a newborn infant
3)A slight swelling over the upper lid and along the bony orbit if the individual has a cold
4)The absence of drainage from the puncta when pressing against the inner orbital rim

Question 9

When performing the corneal light reflex assessment,the nurse notes that the light is reflected at 2 o'clock in each eye.The nurse would:
1)consider this a normal finding.
2)refer the individual for further evaluation.
3)document this as an asymmetric light reflex.
4)perform the confrontation test to validate the findings.

Question 10

During ocular examinations,the nurse keeps in mind that movement of the extraocular muscles is:
1)decreased in the elderly.
2)impaired in a patient with cataracts.
3)stimulated by cranial nerves I and II.
4)stimulated by cranial nerves III,IV,and VI.

Question 11

A 2-week-old infant can fixate on an object but not follow a light or bright toy.The nurse would:
1)consider this a normal finding.
2)assess the pupillary light reflex for possible blindness.
3)continue with the examination and assess visual fields.
4)expect that a 2-week-old infant should be able to fixate and follow an object.

Question 12

When examining a patient's eyes,the nurse recalls that stimulation of the sympathetic branch of the autonomic nervous system:
1)causes pupillary constriction.
2)adjusts the eye for near vision.
3)elevates the eyelid and dilates the pupil.
4)causes contraction of the ciliary body.

Question 13

When examining the eye,the nurse is aware that the bulbar conjunctiva:
1)overlies the sclera.
2)covers the iris and pupil.
3)is visible at the inner canthus of the eye.
4)is a thin mucous membrane that lines the lids.

Question 14

A patient has a normal pupillary light reflex.The nurse recognizes that this indicates that:
1)the eyes converge to focus on the light.
2)light is reflected at the same spot in both eyes.
3)the eye focuses the image in the center of the pupil.
4)constriction of both pupils occurs in response to bright light.

Question 15

A patient's vision is recorded as 20/80 in each eye.The nurse recognizes that this finding indicates that:
1)the patient has poor vision.
2)the patient has acute vision.
3)the patient has normal vision.
4)the patient is presbyopic.

Question 16

In using the ophthalmoscope to assess a patient's eyes,the nurse notes a red glow in the patient's pupils.On the basis of this finding,the nurse would:
1)suspect that there is an opacity in the lens or cornea.
2)check the light source of the ophthalmoscope to verify that it is functioning.
3)consider this a normal reflection of the ophthalmoscope light off the inner retina.
4)continue with the ophthalmoscopic examination and refer the patient for further evaluation.

Question 17

When assessing the pupillary light reflex,the nurse should use which technique?
1)Shine a penlight from directly in front of the patient and inspect for pupillary constriction.
2)Ask the patient to follow the penlight in eight directions and observe for bilateral pupil constriction.
3)Shine a light across the pupil from the side and observe for direct and consensual pupillary constriction.
4)Ask the patient to focus on a distant object.Then ask the patient to follow the penlight to about 7 cm from the nose.

Question 18

Which of the following would the nurse expect to find when examining the eyes of a black patient?
1)Increased night vision
2)A dark retinal background
3)Increased photosensitivity
4)Narrowed palpebral fissures

Question 19

Which of the following is an expected normal finding when performing the diagnostic positions test?
1)Convergence of the eyes
2)Parallel movement of both eyes
3)Nystagmus in extreme superior gaze
4)A slight amount of lid lag when moving the eyes from a superior to inferior position

Question 20

The nurse is assessing a patient's eyes for the accommodation response and would expect to see:
1)dilation of the pupils.
2)a consensual light reflex.
3)conjugate movement of the eyes.
4)convergence of the axes of the eyes.

Question 21

When a light is directed across the iris of the eye from the temporal side,the examiner is assessing for:
1)drainage from dacryocystitis.
2)the presence of conjunctivitis over the iris.
3)the presence of shadows,which may indicate glaucoma.
4)a scattered light reflex,which may be indicative of cataracts.

Question 22

An ophthalmic examination reveals papilledema.The nurse is aware that this finding indicates:
1)retinal detachment.
2)diabetic retinopathy.
3)acute-angle glaucoma.
4)increased intracranial pressure.

Question 23

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 notes the presence of blood in the anterior chamber of the eye.This finding indicates the presence of:
1)hypopyon.
2)hyphema.
3)corneal abrasion.
4)iritis.

Question 24

The nurse notes the presence of periorbital edema when performing an eye assessment on a 70-year-old patient.The nurse will:
1)check for the presence of exophthalmos.
2)suspect that the patient has hyperthyroidism.
3)ask the patient if he or she has a history of heart failure.
4)assess for blepharitis because this is often associated with periorbital edema.

Question 25

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?
1)Smooth and clear corneas
2)Opacity of the lens behind the cornea
3)Bleeding from the areas across the cornea
4)A shattered look to the light rays reflecting off the cornea

Question 26

To assess color vision on a male child,the nurse would:
1)check color vision annually until the age of 18 years.
2)ask the child to identify the color of his or her clothing.
3)test for color vision once between the ages of 4 and 8.4.begin color vision screening at the child's 2-year check-up.

Question 27

The nurse is performing an eye-screening clinic at the day care center.When examining a 2-year-old child,the nurse suspects that the child has "lazy eye" and would:
1)examine the external structures of the eye.
2)assess visual acuity with the Snellen eye chart.
3)assess the child's visual fields with the confrontation test.
4)test for strabismus by performing the corneal light reflex test.

Question 28

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
1)a chalazion.
2)a hordeolum (stye).
3)dacryocystitis.
4)blepharitis.

Question 29

In a patient who has anisocoria,the nurse would expect to observe:
1)dilated pupils.
2)excessive tearing.
3)pupils of unequal size.
4)an uneven curvature of the lens.

Question 30

The nurse is performing an eye assessment on an 80-year-old patient.Which of the following findings is considered abnormal?
1)A decrease in tear production
2)Unequal pupillary constriction in response to light
3)The presence of arcus senilis seen around the cornea
4)Loss of the outer hair on the eyebrows due to a decrease in hair follicles

Question 31

During an ophthalmscopic examination of the eye,the examiner notes areas of exudate that look like "cotton wool" or fluffy gray-white cumulus clouds.This finding indicates which possible problem?
1)Diabetes
2)Hyperthyroidism
3)Glaucoma
4)Hypotension

Question 32

A 68-year-old woman is in the eye clinic for a checkup.She tells the nurse that she has been having trouble with 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:
1)she may have macular degeneration.
2)her vision is normal for someone her age.
3)she has the beginning stages of cataract formation.
4)she has increased intraocular pressure or glaucoma.