Question 1

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 old age,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 2

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:

Accepted Answer

Macular degeneration is the most common cause of blindness.It is characterized by 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.

Question 3

During an ophthalmoscopic examination of the eye,the nurse notices areas of exudate that look like "cotton wool" or fluffy gray-white cumulus clouds.This finding indicates which possible problem?

Accepted Answer

Soft exudates or "cotton wool" areas look like fluffy gray-white cumulus clouds,They occur with diabetes,hypertension,subacute bacterial endocarditis,lupus,and papilledema of any cause.These exudates are not found with hyperthyroidism,glaucoma,or hypotension.

Question 4

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

Accepted Answer

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

Question 5

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 6

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 7

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 anterior chamber 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 8

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 9

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

Accepted Answer

A hordeolum,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 10

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 11

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 "lazy eye" and should:

Accepted Answer

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

Question 12

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.It is a creamy yellow-orange to pink color,and the edges are distinct and sharply demarcated,not blurred.A pigmented crescent is black,and it is due to the accumulation of pigment in the choroid.

Question 13

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 look to light rays.There should be no opacities in the cornea.The other responses are not correct.

Question 14

During an assessment the nurse notices that an elderly 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 aging due to atrophy of elastic and fibrous tissues.The lower lid does not approximate to the eyeball,and,as a result,the puncta cannot siphon tears effectively,and excessive tearing results.Ptosis is drooping of the upper eyelid.These are not signs of a foreign body in the eye or basal cell carcinoma.

Question 15

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

Accepted Answer

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

Question 16

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

Accepted Answer

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

Question 17

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 it is a normal finding caused by the reflection of the ophthalmoscope light off the inner retina.The other responses are not correct.

Question 18

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 is not the correct method for assessment for dacryocystitis,conjunctivitis,or cataracts.

Question 19

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 20

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.

Quiz 14: Eyes