A nurse notices that a clients left upper eyelid is drooping. the nurse has observed:

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Title: PrepU Med Surg Chapter 63 Questions and Answers, GRADED A 2020
Description: NURSING Assessment PrepU Med Surg Chapter 63 Questions and Answers, GRADED A 2020

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Which of the following terms refers to the absence of the natural lens?
Aphakia
Explanation:

When a cataract is extracted, and an intraocular lens implant is not used, the patient demonstrates
aphakia
...
Keratoconus refers to a coneshaped deformity of the cornea
...

Which of the following would be an inaccurate clinical manifestation of a retinal detachment?
Pain
Explanation:

Patients do not complain of pain with retinal detachment
...

A client comes to the eye clinic for a routine check-up
...
What screening test does the nurse know will be performed on this client to assess for colorblindness?
Ishihara
Explanation:

Color vision is assessed with Ishihara polychromatic plates
...
The numbers are in colors that colorblind persons commonly cannot see
...
The Jaeger
and the Rosenbaum test near vision while the Snellen tests far vision
...
The other types of
conjunctivitis are not usually preceded by symptoms of a respiratory infection
...
The nurse
informs the patient that the isolated organism is which of the following?
Chlamydia trachomatis
Explanation:

Common organisms isolated are Streptococcus pneumoniae, Haemophilus influenzae, and
Staphylococcus aureus
...

Retinoblastoma is the most common eye tumor of childhood
...
It is hereditary in 30% to 40% of cases
...

A 15-year-old baseball player was fielding a ground ball when it bounced and struck him in the left eye,
leaving a large ecchymosis and edema
...
What glands, contained in the eyelids,
produce tears?
Lacrimal
Explanation:

The eyelids have multiple glands, including sebaceous, sweat, and accessory lacrimal glands
...
Lacrimal glands in the eyelids produce tears
...
Chemosis is edema of the conjunctiva
...
Photophobia is ocular pain on exposure to light
...
At the yearly follow-up
appointment, the patient tells the nurse that she has stopped using the medication because her vision
did not improve
...

Explanation:

The nurse needs to explain the therapeutic effect and expected outcome of the medication
...
The patient will not see
improvements in his or her vision with the use of the medication, but should see little to no
deterioration of vision
...
Administering the
medication immediately or referring the patient to the ED is not appropriate because this is not an
emergent situation
...
Legal blindness
refers to a best-corrected visual acuity (BCVA) that does not exceed what reading in the better eye?
20/200
Explanation:

Legal blindness is a condition of impaired vision in which a person has best corrected visual acuity that
does not exceed 20/200 in the better eye or whose widest visual field diameter is 20 degrees or less
(Prevent Blindness America, 2012)
...

PRK is used to treat myopia and hyperopia with or without astigmatism
...
Keratoplasty involves replacing abnormal host tissue with healthy donor
(cadaver) corneal tissue
...
What is the nurse testing the
children for?
Visual acuity
Explanation:

Th Snellen eye chart is a simple screening tool for determining visual acuity, the ability to see far images
clearly
...
Which piece of
equipment would the nurse provide to the physician to examine the fundus and interior of the eye?
Ophthalmoscope
Explanation:

The nurse is correct to provide an ophthalmoscope to the surgeon for examination of the fundus or
interior of the eye
...
A tonometer measures
intraocular pressure
...

Which of the following types of glaucoma presents an ocular emergency?
Acute angle-closure glaucoma
Explanation:

Acute angle-closure glaucoma results in rapid, progressive visual impairment
...
Ocular hypertension is treated with topical medication
...

A patient presents to the ED complaining of a chemical burn to both eyes
...

Explanation:

The eyes should immediately be irrigated to remove the chemical and preserve the eye
...
It is
appropriate to obtain the MSDS and assess the pH of the corneal surface after irrigation has begun
...
Visual acuity can be assessed once the emergent
phase is over
...
During a teaching session, the nurse should:
demonstrate eyedrop instillation
...
After demonstrating
eyedrop instillation to the client and family, the nurse should verify their ability to perform this measure
properly
...
Visual acuity assessment
isn't necessary before discharge
...

When assessing the pressure of the anterior chamber of the eye, a nurse normally expects to find a
pressure of:
10 to 20 mm Hg
...

Which of the following should the nurse recommend to a client with blepharitis?
Frequent washing of the face and hair
Explanation:

Frequent washing of the face and hair is recommended in a client with blepharitis because seborrhea or
excessive oiliness of the skin of the face and scalp is associated with blepharitis
...
This would be included for treatment of a sty
...

A patient is to have an angiography done using fluorescein as a contrast agent to determine if the
patient has macular edema
...
Fluorescein angiography
is used to evaluate clinically significant macular edema, document macular capillary nonperfusion, and
identify retinal and choroidal neovascularization (growth of abnormal new blood vessels) in age-related
macular degeneration
...
Prior to the angiography, the patient’s blood urea nitrogen (BUN) and creatinine should
be checked to ensure that the kidneys will excrete the contrast agent (Fischbach & Dunning, 2011)
...
The nurse knows that these clinical signs are diagnostic of the
type of glaucoma known as:
Acute angle-closure
...

When the patient tells the nurse that his vision is 20/200, and asks what that means, the nurse informs
the patient that a person with 20/200 vision
sees an object from 20 feet away that a person with normal vision sees from 200 feet away
...
Most people, positioned 20 feet from
the eye chart, can see the letters designated as 20/20 from a distance of 20 feet
...
Normal tension glaucoma
is treated with topical medication
...
Chronic openangle glaucoma is treated initially with topical medications, with oral medications added at a later time
...
”
Explanation:

Refractive errors can be corrected with glasses or contact lenses
...
The word surgery can increase fears
...

A patient presents to an eye clinic with a number of symptoms related to his diminished vision
...
Which
of the following symptoms would apply to this diagnosis? Select all that apply
...

The nurse is caring for a 63-year-old client who can neither read nor speak English
...

The nurse tests the distant visual acuity of several clients and records the findings
...
The top number is always 20, indicating
the distance from the client to the chart
...
The nurse knows this symptom
could represent:
macular degeneration

Which of the following would a nurse expect to assess in a client with esotropia?
Eye that turns inward

Esotropia is a term used to describe eyes that turn inward
...
Strabismus refers to a constant malalignment of the eyes
...
What
conclusion can the nurse make in regards to the client's vision based on these results?
The larger the bottom number, the worse the visual acuity

OD= right eye, OS= left eye
...
A client is considered legally blind when the vision in
the better eye with corrective lens is 20/200 or less
...
These findings are consistent with a problem in what
part of the eye?
Lacrimal apparatus

The lacrimal apparatus (which consists of the lacrimal gland, punctum, lacrimal sac, and nasolacrimal
duct) protects and lubricates the cornea and conjunctiva by producing and draining tears
...

The conjunctiva is a thin, transparent, continuous membrane that is divided into two portions: a
palpebral and a bulbar portion
...

An elderly client presents to the health care clinic with reports of decreased tearing in both eyes
...
What is an appropriate action by the nurse?
Document the finding as a normal sign of aging

Explanation:
Ectropion is when the lower eyelids evert, causing exposure and drying of the conjunctiva
...

A nurse is preparing to assess the distant visual acuity of a client who wears reading glasses
...

Explanation:
When testing distant visual acuity, the nurse should have the client remove the reading glasses, because
they blur distant vision
...
The nurse would still test the client's distant visual acuity
...
(

A nurse shines a light into one of the client's eyes during an ocular exam and the pupil of the other eye
constricts
...
Shining a light in one eye with the resulting constriction of that eye demonstrates the direct
reflex
...
Accommodation
occurs when the client moves the focus of vision from a distant point to a near object, causing the pupils
to constrict
...
Which of the following age-related changes is the nurse likely to have observed?
Presbyopia

Explanation:
Prebyopia denotes an age-related deficit in close vision
...

A client has an abnormal consensual pupillary reaction to light
...
An abnormal response to this test is if wither or both pupils do not
constrict in response to light
...
Convergence of
the eyes is called accommodation & occurs when a person moves his focus of vision from a far object to
a close object
...
The nurse examines the thin, transparent, continuous membrane that lines the inside of the eyelids
and covers most of the anterior eye
...
The palpebral conjunctiva lines the inside of the eyelids, and the bulbar
conjunctiva covers most of the anterior eye, merging with the cornea at the limbus
...
It receives visual stimuli and sends them to the
brain
...
The transparent cornea (the "window of the eye") permits the entrance of light, which passes
through the lens to the retina
...
The nurse knows that this means the
vision in his better eye, corrected by glasses, is what?
20/200 or less
Explanation:
In the United States, a person is usually considered legally blind when vision in the better eye, corrected
by glasses, is 20/200 or less
...
The client's right eye is swollen shut and
very painful
...
Blunt-force trauma often results in fracture of the orbit
...
Strabismus is the medical term for cross-eyed
...
Which of the following is the
most appropriate outcome for this patient's care planning?
The patient will remain free from harm resulting from a loss of vision
...

A nurse is collecting subjective data during a client's eye and vision assessment
...

A 6-year-old boy has come to the clinic with his mother because of recent eye redness and discharge
...
What should the nurse tell the
mother about her son's eye?
"This might have been the result of an allergy, but most likely it was caused by a bacteria or virus
...
Severe pain and vision damage are not common con

You are assessing visual fields on a patient newly admitted for eye surgery
...
You would document that
the patient has what?
A left temporal hemianopsia

Explanation:
When the patient's left eye repeatedly does not see your fingers until they have crossed the line of gaze,
a left temporal hemianopsia is present
...
The nurse should explain to
the client that night blindness is often associated with
vitamin A deficiency
...

A diabetes educator is teaching a group of adults about the risks to vision that result from poorly
controlled blood glucose levels
...

Explanation:
In diabetic retinopathy, the vessels that feed the retina change and weaken
...
Diabetes does not directly cause
an increase in pressure in the eye, osmotic changes in the aqueous humor or corneal infection
...
What food would the nurse
include as a response?
Deep-water fish

Explanation:
Foods that promote eye health include deep-water fish, fruits, and vegetables

The middle layer of the eye is known as the
choroid layer
...

A client performs the test for distant visual acuity and scores 20/50-2
...

Explanation:

The Snellen chart tests distant visual acuity by seeing how far the client can read the letters standing 20
feet from the chart
...
A reading of 20/50 means the client sees at 20 feet what a
person with normal vision can see at 50 feet
...

A nurse has performed the corneal light reflex test during a client's eye examination
...
Constriction, color of the sclerae, and
blinking are not appraised
...

A client presents to the health care clinic and reports pain in the eyes when working on the computer
for long periods of time
...
He works for a computer software company
and has noticed he is experiencing difficulty reading the manuals that accompany the software he
installs for companies
...
The client is aware of
the dangers of driving due to changes in his vision
...

When testing the pupils for consensual response, how can the nurse increase the accuracy of the test?
Place a barrier between the eyes

Explanation:
To increase the accuracy of the consensual pupil response, the nurse should place a hand or other
barrier between the client's eyes to avoid an inaccurate finding
...
Closing of one eye will not improve the accuracy of the test

client presents to a primary care office with a complaint of double vision (diplopia)
...
Which of the following underlying conditions should
the nurse most suspect in this client?
Brain tumor

Explanation:
Double vision (diplopia) may indicate increased intracranial pressure due to injury or a tumor
...
Allergies are usually indicated by burning or itching pain in the
eye
...

Straight movements of the eye are controlled by the
rectus muscles
...
These
muscles control six different directions of eye movement
...

An adult client tells the nurse that his father had cataracts
...
The nurse should instruct the client that a potential risk factor is
ultraviolet light exposure
...
Consistent use of sunglasses during exposure minimizes the client's risk
...
The nurse is aware
that which of the following is the function of the retina?
Transforms light rays into nerve impulses that are conducted to the brain

Explanation:
Visual perception occurs as light rays strike the retina, where they are transformed into nerve impulses,
conducted to the brain through the optic nerve, and interpreted
...
Muscles in the iris adjust to control the pupil's size, which controls the amount
of light entering the eye
...

When examining the eye with an ophthalmoscope, where would the nurse look to visualize
the optic disc?
Medially toward the nose

Explanation:
Follow the blood vessels as they get wider
...

A nurse has completed the assessment of a client's direct pupillary response and is now assessing
consensual response
...
This does not involve a
comparison between maximum and minimum pupil size, however
...
The nurse explains to the client that
the client has impaired near vision and discusses a possible reason for the condition
...

Explanation:
Presbyopia (impaired near vision) is indicated when the client moves the chart away from the eyes to
focus on the print
...

The nurse is examining an adult client's eyes
...

The nurse determines that the client needs further instructions when the client says that the positions
Requires the covering of each eye separately
...
Instruct the
client to focus on an object you are holding (approximately 12 inches from the client's face)
...

A client tells the clinic nurse that she has sought care because she has been experiencing excessive
tearing of her eyes
...

Explanation:
Excessive tearing is caused by exposure to irritants or obstruction of the lacrimal apparatus
...
Inspecting the palpebral conjunctiva would be done if the
client complains of pain or a feeling of something in the eye
...
Testing the pupillary reaction to light
evaluates pupillary response and function of the oculomotor nerve
...

A client recently diagnosed with Grave's diseases exhibits protruded eyeballs
...
"

Explanation:
Exopthalmos, or protruding eyeballs, is commonly caused by Grave's disease
...
The client should have
regular eye exams and can wear an eyepatch and use moisturizing eye drops for dryness
...
Wearing UV blocking glasses does not affect the
progression of this condition, but does help with cataracts
...
These drops are not commonly prescribed for exopthalmos
...

The nurse is preparing to assess a client's visual fields to evaluate her gross peripheral vision
...
The cover test, corneal light reflex test, and eye
position test would be used to evaluate extraocular muscle function
...
The nurse should
document the findings in the client's records
...
This is necessary to verify that
the data are reliable and accurate
...

A woman who is 5 months pregnant is being assessed at a routine visit
...
This is known as what?
Chloasma

Explanation:
Chloasma, or increased pigmentation around the eyes, may result from increased progesterone levels in
pregnant women
...
Hyphema is blood in the
anterior chamber
...

Which action by the nurse indicates the appropriate use of an ophthalmoscope?
Employ the right eye to examine the client's right eye

Explanation:
The nurse should employ the right eye to examine the client's right eye; this action of the nurse
indicates the correct use of the ophthalmoscope
...
The nurse should ask the client to gaze at an object straight ahead and
slightly upward, not downward
...

The nurse observes a young client holding a newspaper up close to read
...
Asthenopia is eye strain,
and symptoms include fatigue, red eyes, eye pain, blurred vision, and headaches
...
Presbyopia commonly occurs naturally due to the aging process; therefore it's rare to
observe this condition in young adults

A nurse inspects the eyes of a young child and notices the inward turning of the eyes
...
To test
the corneal light reflex, the nurse shines a penlight about 12 inches from the face, directing it towards
the bridge of the nose
...
If not, this is considered abnormal and requires further assessment
...
The confrontation test examines peripheral vision
...

A nurse is completing a comprehensive health history of a 69-year-old woman who is a new client of the
clinic
...
Exercise, use of
pain medications, and visual acuity are not closely correlated with the development of cataracts
...
Which of the findings would the nurse document
as abnormal?
Drooping of the upper lid

Explanation:
Drooping of the upper lid is ptosis and may be attributed to oculomotor nerve damage, myasthenia
gravis, weakened muscle or tissue, or a congenital disorder
...
Raised yellow
plaques near the inner canthus are a normal variation associated with increasing age and high lipid
levels
...
Amblyopia is also known as "lazy
eye"
...
Presbyopia is the decreased ability for one to focus on

near objects and is more common in the adult as they age
...

Explanation:
Deficits in cranial nerves III, IV, and VI can manifest as impaired extraocular movements or diplopia
...

The optic nerves from each eyeball cross at the
optic chiasma
...

A nurse has performed the corneal light reflex test during a client's eye examination
...
Constriction, color of the sclerae, and
blinking are not appraised
...
Which of
the following would the nurse suspect?
Chalazion

Explanation:
A chalazion is an infection of the meibomian gland that produces extreme swelling of the lid, and
moderate redness, but minimal pain
...
Hordeolum is an infection of the hair follicle causing local redness, swelling, and pain
...

What is the primary purpose of the health history in relation to the eyes?
To identify changes

Explanation:
The purpose of the health history is to identify changes in the eyes
...
The client tells the nurse that he has a
consistent blind spot in his right eye
...

Explanation:
Consistent blind spots may indicate retinal detachment
...

A nurse notices a middle-aged client in the waiting room pick up a magazine to read while she waits to
be seen
...
Which
condition does the nurse most suspect in this client?
Presbyopia

Explanation:
Presbyopia, which is impaired near vision, is indicated when the client moves a reading chart or other
reading material away from the eyes to focus on the print
...
With the cover test, the eyes of the client
should remain fixed straight ahead
...
If the eye turns outward it is called exotropia
...
Strabismus is constant malalignment of the eyes

A client presents to the health care clinic with red, watery eyes and constant tearing
...
The meibomian glands, which are located in the tarsal plates of the upper eyelid, secrete an oily
substance that lubricates the eyelid
...
Sebaceous glands are glands located in the dermis of the skin that open to hair follicles and
that secrete an oily substance known as sebum
...
When
examining this client, the nurse should expect what finding?
Eye turning inward

Explanation:
Esotropia is a term used to describe eyes that turn inward
...
Strabismus refers to a constant malalignment of the eyes
...

The chambers of the eye contain aqueous humor, which helps to maintain intraocular pressure and
cleanse the cornea and the lens
...

The nurse is caring for a healthy adult client with no history of vision problems
...

Explanation:

A thorough eye examination is recommended for healthy clients without risk factors every 2 years, for
ages 18 through 60; annually for those age 61 and older
...
The nurse should refer the client for evaluation of possible
glaucoma
...
It
may be from glaucoma
...
What should the nurse do next in relation to this finding?
Ask the client about previous trauma to the eyes

Explanation:
Unequal pupil size is termed anisocoria
...
The nurse should ask the client about previous trauma to the
eye to determine whether this is a new finding or new onset
...

nurse examines a client's retina during the ophthalmic examination and notices light-colored spots on
the retinal background
...
Anemia, renal insufficiency, and retinal detachment do not cause this appearance on
the retina
...
Which of the following is the most appropriate nursing action at
this time?
Document the finding and proceed with the examination

Explanation:
Yellowish nodules on the bulbar conjunctiva are called pinguecula
...
Therefore, the
nurse should document this finding and proceed with the examination
...
Having trouble focusing when reading up close is a sign of presbyopia, or
impaired near vision, which is not associated with the finding of pinguecula
...

The nurse is using the ophthalmoscope to examine the patient's eyes
...

The nurse is teaching about the importance of regular eye examinations and should include information
about which conditions that place clients at highest risk for blindness? (Select all that apply
...
Hypertensive
retinopathy is another high risk factor for blindness over hypothyroidism, hyperlipidemia, and
osteoarthritis
...
It
started this morning
...
There is no visual disturbance
...
Based on this description, what is the most likely diagnosis?
Stye

Explanation:
A hordeolum or stye is a painful, tender, erythematous infection in a gland at the margin of the eyelid
...
As part of the
presentation, the nurse explains how visual perception occurs
...

Explanation:
Visual perception occurs as light rays strike the retina, where they are transformed into nerve impulses,
conducted to the brain through the optic nerve, and interpreted
...
Accommodation is the process that allows the eyes to focus on near objects
...
The nurse interprets this
finding as suggesting which of the following?
Narcotic use

Explanation:
Pinpoint pupils suggest narcotic use or brain damage
...

Dilated and fixed pupils typically result from central nervous system injury, circulatory collapse, or deep
anesthesia

A nurse assesses the pupillary reaction to light for a client who has lost vision in one eye
...
The light should not be focused directly into the eye to
be tested; it should be focused obliquely into one eye, and the response should be checked in the other
eye
...

A client has sought care because she states that she has begun to see halos around headlights and
streetlights when she is out at night
...
This symptom is not associated
with episcleritis, strabismus, or macular degeneration
...
How should the
nurse document this finding in the client's record?
Exotropia

Explanation:
With the cover test, the eyes of the client should remain fixed straight ahead
...
If the eye turns outward it is called exotropia
...
Strabismus is constant malalignment of the eyes
...

What features would most likely be noted on fundoscopic examination of someone with glaucoma?
Increased cup-to-disc ratio

Explanation:
It is important to screen for glaucoma on fundoscopic examination
...
AV nicking and cotton wool spots are seen in hypertension
...

A client reports the appearance of rings around lights
...
Diabetes produces change
in the retina that can cause blurred vision
...

Hypertension affects the blood vessels of the eyes which may not cause any eye symptoms until the
damage is severe
...
The nurse should
efer the client to an optometrist
...
The higher the second number, the poorer the vision
...
The nurse should assess for which condition?
Hyphema

Explanation:
Hyphema is blood in the anterior chamber of the eye, usually caused by blunt trauma
...
Chalazion is a cyst in the eyelid
...
The latter 3 conditions are not commonly attributed to blunt force trauma to the
head as hyphema is
...

• Penlight
• Ophthalmoscope
• Snellen chart
• Occlusive covers

Explanation:
Common equipment used for eye assessment includes penlight, cotton wisps, cotton-tipped applicators,
ophthalmoscope, Snellen chart, Jaeger chart, occlusive covers for individual eye testing, and Ishihara

plates (optional for testing color vision)
...
(

A nurse cares for a client with optic atrophy
...
This
condition is caused by the death of optic nerve fibers
...
5 mm wide is normal
...

Which of the following statements most accurately describes the maintenance of normal intraocular
pressure?
Aqueous humour is continuously circulating through the eye with production equalling drainage
...
It is not a closed system, and pressure is not adjusted through muscular control of
eye volume

A nurse is performing an eye and vision assessment on a client who has an inner ear disorder
...
Strabismus or tropia would refer to a constant
malalignment of the eyes due to a muscle weakness detected with the corneal light reflex test
...
When uncovering the
previously covered eye, the nurse should observe for which response to indicate a normal finding?
Covered eye remains fixed straight ahead

Explanation:
The covered eye should remain fixed straight ahead upon uncovering the eye
...
The eyes
should not turn toward the object to establish focus
...

When obtaining the health history from a client with retinal detachment, a nurse expects the client to
report:
light flashes and floaters in front of the eye
...
Difficulty seeing cars in another driving lane suggests gradual loss of peripheral
vision, which may indicate glaucoma
...
Double vision is common in clients with cataracts
...

Explanation:

Blinking expels an instilled eye drop from the conjunctival sac, which interferes wtih the efficacy of the
medication
...
The size of the
conjunctival sac does change with blinking
...

Which type of cataract is caused by central opacity of the lens?
Nuclear
Explanation:

A nuclear cataract is caused by central opacity in the lens and has a substantial genetic component
...
Vision is worse in very
bright light
...
Near vision is
diminished, and the eye is increasingly sensitive to glare from bright light
...

Which of the following medications needs to be withheld for 5 to 7 days prior to cataract surgery?
Coumadin
Explanation:
It has been common practice to withhold any anticoagulant therapy such as Coumadin to reduce the risk
for retrobulbar hemorrhage (after retrobulbar injection) for 5 to 7 days before surgery
...
The nurse recognizes that the patient most
likely has conjunctivitis, as evidenced by what symptom?
A mucopurulent ocular discharge
Explanation:

Bacterial conjunctivitis manifests with an acute onset of redness, burning, and discharge
...
The exudates are variable but
are usually present on waking in the morning
...
Purulent discharge occurs in severe acute bacterial infections, whereas
mucopurulent discharge appears in mild cases
...
The main markers of the efficacy of the medication
in glaucoma control are lowering of the IOP to the target pressure, appearance of the optic nerve head,
and the visual field
...
These procedures do not
cause excessive tearing or result in cataract or stye formation
...
Chemosis is edema of the conjunctiva
...
Photophobia is ocular pain on exposure to light
...
Legal blindness
refers to a best-corrected visual acuity (BCVA) that does not exceed what reading in the better eye?
20/200
Explanation:
Legal blindness is a condition of impaired vision in which a person has best corrected visual acuity that
does not exceed 20/200 in the better eye or whose widest visual field diameter is 20 degrees or less
(Prevent Blindness America, 2012)
...

Explanation:

Normally, pressure in the anterior chamber of the eye remains relatively constant at 10 to 20 mm Hg
...
Milia are small, white, slightly elevated cysts of the eyelid that may
occur in multiples
...
Nevi are freckles
...
Miotics are used to cause the pupil to constrict
...
Cycloplegics cause paralysis of the iris sphincter
...
The most common site of metastasis in patients diagnosed with rhabdomyosarcoma is
which of the following?
Lung
Explanation:

The most common site of metastasis in patients diagnosed with rhabdomyosarcoma is the lung
...

A nurse practitioner examines a patient and documents a best corrected visual acuity (BCVA) ratio in his
better eye that qualifies him for government financial assistance based on the definition of legal
blindness
...

A client is color blind
...

Explanation:

Cones provide daylight color vision, and their stimulation is interpreted as color
...
Rods are sensitive to low levels of illumination but
can't discriminate color
...
Aqueous humor is a clear watery
fluid and isn't involved with color perception
...
"
Explanation:

Burning, a sensation of a foreign body, and pain in bright light (photophobia) are signs and symptoms
associated with any type of conjunctivitis
...

Christin Victor, a 24-year-old medical transcriptionist, is awaiting an appendectomy as a client in the
hospital unit where you practice nursing
...
Victor is blind
...
Victor's
control over her hospital environment?
Ask Ms
...

Involving the client promotes his or her control over the environment
...

While talking to the client, she notices that her left upper eyelid is drooping
...
Ptolemy is not a medical condition
...
Proptosis is the extended or protruded
upper eyelid that delays closing or remains partially open
...
Nystagmus is uncontrolled oscillating movement of the eyeball
...

Which is the term for swelling of the optic disc due to increased intraocular pressure (IOP)?
Papilledema
Explanation:

Papilledema is swelling of the optic disc due to increased IOP
...

Ptosis is a drooping eyelid
...

Which type of glaucoma presents an ocular emergency?
Acute angle-closure glaucoma
Explanation:

Acute angle-closure glaucoma results in rapid progressive visual impairment
...
Ocular hypertension is treated with topical medication
...

Which of the following surgical procedures involves taking a piece of silicone plastic or sponge and
sewing it onto the sclera at the site of a retinal tear?
Scleral buckle
Explanation:

The scleral buckle is a procedure in which a piece of silicone plastic or sponge is sewn onto the sclera at
the site of the retinal tear
...
The
other surgeries do not use this type of procedure
...
The client suffered trauma
to her sclera and is being treated for a subsequent infection
...
Which of the following structures would you NOT include?
Eyelids
Explanation:

The sclera does not attach to the eyelids
...
It connects directly to
the cornea, anterior chamber, iris, and pupil
...
The nurse anticipates which of the following symptoms to be exhibited
in this client? Select all that apply
...
Complete vision loss can occur in the affected eye
...

The nurse should monitor for which of the following manifestations in a patient who has had LASIK
surgery?
Halos and glare
Explanation:

After LASIK surgery, symptoms of central islands and decentered ablations can occur that include
monocular diplopia or ghost images, halos, glare, and decreased visual acuity
...

A patient is to have an angiography done using fluorescein as a contrast agent to determine if the
patient has macular edema
...
Fluorescein angiography
is used to evaluate clinically significant macular edema, document macular capillary nonperfusion, and
identify retinal and choroidal neovascularization (growth of abnormal new blood vessels) in age-related
macular degeneration
...
Prior to the angiography, the patient’s blood urea nitrogen (BUN) and creatinine should
be checked to ensure that the kidneys will excrete the contrast agent (Fischbach & Dunning, 2011)
...
The nurse knows that these clinical signs are diagnostic of the
type of glaucoma known as:
Acute angle-closure
...

A patient has been diagnosed with bacterial conjunctivitis that was sexually transmitted
...
Two sexually transmitted agents associated with conjunctivitis are Chlamydia
trachomatis and Neisseria gonorrhoeae
...

Explanation:

Normally, pressure in the anterior chamber of the eye remains relatively constant at 10 to 20 mm Hg
...
The nurse is assessing which of the following?
Extraocular muscle function
Explanation:

The nurse is testing the client's extraocular eye muscle function by having the client follow an object
through the six cardinal directions of gaze (up, down, right, left, and both diagonals)
...
The nurse observes the position of the eyelids for drooping
...

The nurse is assessing an older client's vision
...

Explanation:

In the older adult, the accommodative power of the lens decreases, resulting in the need to hold reading
materials at increasing distances to focus
...
The depth of the
eyeball does not change with age
...
The nurse documents this as which of the following?
Myopia
Explanation:

Myopia, or nearsightedness, refers to the condition in which the client can see near objects but has
blurred distant vision
...
Hyperopia, or farsightedness, refers to the client's ability to see distant objects
clearly, but sees near objects as blurry
...

Which of the following is the role of the nurse toward a client who is undergoing an eye examination
and tests? Select all that apply
...
The nurse should provide current
recommendations
...
A careful assessment of the function and the structure of
the eyes are also important because it provides the nurse with a baseline
...
The nurse would review the
recommendations with the client
...
Which of the following
instructions is most important?
Avoid any activity that can increase intraocular pressure
...
Clients may sleep on back or unaffected side
...
An eye shield is often ordered for the first 24 hours and during the night to
prevent rubbing or trauma to the operative eye
...
When assessing
the visual fields in acute glaucoma, what would the nurse expect to find?
Marked blurring of vision
Explanation:

Glaucoma is often called the “silent thief of sight” because most patients are unaware that they have
the disease until they have experienced visual changes and vision loss
...

During assessment of a patient with a hearing loss, the nurse notes a defect in the tympanic membrane
...

Explanation:
A defect in the tympanic membrane or interruption of the ossicular chain disrupts normal air
conduction, which results in a conductive hearing loss
...
These procedures do not
cause excessive tearing or result in cataract or sty formation
...
From where do the nerve cells of the retina extend?
Optic nerve
Explanation:

The nerve cells of the retina extend from the optic nerve
...
Following which procedure will the nurse
instruct the client on a yellow coloring to the skin and urine as being normal?
Retinal Angiography
Explanation:

The nurse is most correct to instruct the client that his skin and urine may turn yellow following a retinal
angiography
...
The dye then travels
to the retinal arteries and capillaries, where pictures are obtained of the vascular supply
...

An eight-grade boy tells the school nurse that the eye doctor told him he had astigmatism and that
meant his eyeball wasn’t shaped right
...
What is the school nurse’s best response?
“Astigmatism means that the cornea of the eye is shaped differently than the cornea in most eyes
...
Many people have both
astigmatism and myopia or hyperopia
...

Which of the following surgical procedures involves flattening the anterior curvature of the cornea by
removing a stromal lamella layer?
Laser-assisted stromal in situ keratomileusis (LASIK)
Explanation:

LASIK involves flattening the anterior curvature of the cornea by removing a stromal lamella or layer
...
Keratoconus is cone-shaped
deformity of the cornea
...

What type of medication would the nurse use in combination with mydriatics to dilate the patient’s
pupil?
Cycloplegics
Explanation:

Mydriasis, or pupil dilation, is the main objective of the administration of mydriatics and cycloplegics
(Table 63-3)
...

The ophthalmologist tells a patient that he has increased intraocular pressure (IOP)
...

Explanation:

Normal intraocular pressure is 10 to 21 mm Hg
...

A patient visits a clinic for an eye examination
...
What is that clinical sign?
The presence of halos around lights
Explanation:

Colored halos around lights is a classic symptom of acute-closure glaucoma
...
Which of the following is
the most important teaching point that the nurse should advise the patient of?
Adhere to the medication regimen
...

A client accidentally splashes chemicals into one eye
...
What is the primary purpose of this
first-aid treatment?
To prevent vision loss
Explanation:

Prolonged eye irrigation after a chemical burn is the most effective way to prevent formation of
permanent scar tissue and thus help prevent vision loss
...
Eye irrigation isn't considered a stopgap measure
...
Which client statement indicates that the outcome of the teaching plan has been
met?
"I should avoid pulling or pushing any object that weighs more than 15 lbs
...
Sunglasses should be worn
when outdoors during the day because the eye is sensitive to light
...
The eye patch is
worn for 24 hours after surgery, followed by eyeglasses worn during the day and a metal shield worn at
night for 1 to 4 weeks
...
The client asks what this test is
for
...
”
Explanation:

A visual field examination or perimetry test measures peripheral vision and detects gaps in the visual
field
...

Leslie Waterman, a 57-year-old corrections officer, is being seen at the ophthalmic group where you
practice nursing
...
What is the term used to describe his visual condition?
Hyperopia
Explanation:

Hyperopia is farsightedness
...
Hyperopia is the term used to describe seeing objects that are far away better than
objects that are close
...

While talking to the client, she notices that her left upper eyelid is drooping
...
Ptolemy is not a medical condition
...
Proptosis is the extended or protruded
upper eyelid that delays closing or remains partially open
...
Nystagmus is uncontrolled oscillating movement of the eyeball
...

During a routine eye examination, a patient complains that she is unable to read road signs at a distance
when driving her car
...

The nurse is administering an ophthalmic ointment to a patient with conjunctivitis
...

Explanation:

Ophthalmic ointments have extended retention time in the conjunctival sac and provide a higher
concentration than eye drops
...
In general, eyelids and eyelid margins are best treated with ointments
...
During a teaching session, the nurse should:
demonstrate eyedrop instillation
...
After demonstrating
eyedrop instillation to the client and family, the nurse should verify their ability to perform this measure
properly
...
Visual acuity assessment
isn't necessary before discharge
...

A 52-year-old woman comes to the clinic for a follow-up examination after being diagnosed with
glaucoma
...
" Which
response by the nurse would be most appropriate?
"You'll need to use the drops for the rest of your life to control the glaucoma
...
The nurse
needs to provide additional information to the client that the condition can be controlled but not cured
...
Eye medications would most likely be
needed for the long term, not just a few months
...
The goal of therapy is to reduce the intraocular
pressure to prevent optic nerve damage
...
In other
cases, additional or combintation treatment with surgery or laser procedures may be necessary
...
It is the most anterior portion of the eyeball and is the main refracting surface of the eye
...
The pupil is a space that dilates and constricts in response to light
...
The conjunctiva
provides a barrier to the external environment and nourishes the eye
...
After his examination by the physician, you discuss his diagnosis with his parents
...

Explanation:

Myopia occurs in people with elongated eyeballs
...
Which of the following questions would not be included in
the examination?
“Are you able to raise both eyebrows?”
Explanation:

Asking to raise both eyebrows is a test for cranial nerve VII, the facial nerve, and would not be included
in an eye assessment
...

The nurse is evaluating the client while taking the color vision test
...

Explanation:

The nurse is correct to anticipate the client being able to identify numbers and shapes dictated by
different color codes
...

A client is diagnosed with uveitis
...
Chemical exposure and extended contact use are not
indicated with uveitis
...

A client with chronic open-angle glaucoma is now presenting with eye pain and intraocular pressure of
50 mm Hg
...
Which of the following describes the desired effects of
this procedure?
Improve outflow drainage
Explanation:

Laser iridotomy or standard iridotomy is a surgical procedure that provides additional outlet drainage of
aqueous humor
...
Once optic nerve damage occurs, it cannot be reversed, and vision is not restored
...

A patient is diagnosed with a corneal abrasion and the nurse has administered proparacaine
hydrochloride (Ophthaine 0
...
The patient requests a prescription
for this medication because it completely took away the pain
...
”
Explanation:

Proparacaine hydrochloride (Ophthaine 0
...
Patients with corneal abrasions or other painful eye disorders have a tendency to overuse the
medication, thus leading to the complications
...
Telling the patient that you will let the doctor know does not provide the education
needed about this medication
...
If the
health care provider wants to inspect the optic nerve, the nurse would prepare the patient for:
Ophthalmoscopy
...

Which group of medications causes pupillary constriction?
Miotics
Explanation:

Miotics cause pupillary constriction
...
Beta-blockers decrease aqueous
humor production
...

The nurse is providing care to a client who has been admitted to the hospital for treatment of an
infection
...
Which of the following would be most appropriate for the nurse
to do when interacting with the client?
Face the client when speaking directly to him
...
It is not necessary to raise the voice unless the client
asks the nurse to do so and it is not necessary to avoid the terms, "see" or "look" when interacting with
the client
...

A client is being examined by her ophthalmologist during her routine eye examination
...
The
procedure being performed is known as ________ and it is routinely done to test for ________
...
It is done by using a tonometer to indent or flatten the
surface of the eye
...

An elderly client with macular degeneration has received injections of angiogenesis inhibitors
...
Blurred vision is the initial symptom of the disease and does not signify worsening
...

Which of the following would be an accurate clinical manifestation of a retinal detachment?
Bright flashing lights
Patients can complain of bright flashing lights as a clinical manifestation of retinal detachment
...
Colored halos around lights is specific to glaucoma
...

During assessment of a patient with a hearing loss, the nurse notes a defect in the tympanic membrane
...

Explanation:

A defect in the tympanic membrane or interruption of the ossicular chain disrupts normal air
conduction, which results in a conductive hearing loss
...
The nurse is not involved in conducting the various tests
to determine the status of the eyes and in determining if further action is warranted
...

Which of the following medication classifications increases aqueous fluid outflow in the patient with
glaucoma?
Cholinergics
Explanation:

Cholinergics increase aqueous fluid outflow by contracting the ciliary muscle, causing miosis and
opening the trabecular meshwork
...
Alpha-adrenergic
agonists decrease aqueous humor production
...

Megan McKenna is a 43-year-old woman who tripped on a toy in her home, fell, and hit her head on the
corner of a table
...
She
tells the nurse caring for her that her symptoms began with seeing spots or moving particles in her field
of vision but she didn’t think anything was wrong because she wasn’t having any pain in her eye
...
What is the most likely cause of Ms
...
Retinal detachment may follow a sudden blow, penetrating injury, or eye surgery
...
Retinal detachment may follow a sudden blow, penetrating injury, or eye
surgery
...
The nurse knows
to prepare what test for the physician to give the client?
Amsler grid
Explanation:

Clients with macular problems are tested with an Amsler grid
...
The examiner instructs the client to stare at the central
fixation spot on the grid and report if they see any distortion of the squares
...
An Ishihara polychromatic plate, visual field,
or slit lamp test will not diagnose macular degeneration
...
Some individuals
state needing assistance with seeing writing far away, and others need assistance with closer vision
...
Accommodation occurs when the ciliary muscles contract
or relax to focus an image on the retina
...
I have to hold my book at a distance to read
...

Explanation:

Presbyopia is a refractive change that occurs with age
...

Opacity in the lens indicates a cataract
...
Cataracts occur when there is a clouding of the lens
...
Myopia is nearsightedness
...

Marshall Dunbar, a 7-year-old second grader, is being seen by the pediatric ophthalmologist due to a
recent skateboarding accident that resulted in trauma to his right cornea and he is now at risk of
developing an infection
...

Explanation:

Avoid contaminating the medication dropper or tube by holding the tip above the eye and adjacent
tissue
...
Maintaining asepsis prevents the introduction and
transmission of infection
...

A client with multiple sclerosis is being seen by a neuroophthalmologist for her routine eye exam
...
The
client will indicate when she can see the object
...

perimetry test
Explanation:

A visual field test or perimetry test measures peripheral vision and detects gaps in the visual field
...

Title: PrepU Med Surg Chapter 63 Questions and Answers, GRADED A 2020
Description: NURSING Assessment PrepU Med Surg Chapter 63 Questions and Answers, GRADED A 2020