Eye and Vision Disorders

When assessing the pressure of the anterior chamber of the eye, a nurse normally expects to find a pressure of: a) 20 to 30 mm Hg. b) 5 to 10 mm Hg. c) 10 to 20 mm Hg. d) over 30 mm Hg

10 - 20 mm Hg

When a cataract is extracted, and an intraocular lens implant is not used.

Aphakia

Which of the following terms refers to the absence of the natural lens? a) Hyphema b) Keratoconus c) Scotoma d) Aphakia

Aphakia

A nurse is performing an eye examination. Which of the following questions would not be included in the examination? a) "Have you experienced blurred, double, or distorted vision?" b) "Are you able to raise both eyebrows?" c) "Do any family members have any eye conditions?" d) "What medications are you taking?"

Are you able to raise both eyebrows?

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. The boy says he went home and looked in the mirror and both eyes looked just alike. What is the school nurse's best response? a) "Astigmatism means that the lens of the eye is more of an oval shape than the lens in most eyes." b) "Astigmatism means that the cornea of the eye is shaped differently than the cornea in most eyes." c) "Astigmatism means that the eye is shaped more like an olive than most eyes." d) "Astigmatism means that the inside of the eye is shaped differently than the inside of most eyes."

Astigmatism means that the cornea of the eye is shaped differently than the cornea in most eyes

A patient is to have an angiography done using fluorescein as a contrast agent to determine if the patient has macular edema. What laboratory work should the nurse monitor prior to the angiography? a) Platelet count b) BUN and creatinine c) AST and ALT d) Hemoglobin and hematocrit

BUN and creatinine

decrease aqueous humor production.

Beta-blockers and Alpha-adrenergic agonists

A client, diagnosed with a cataract, comes into the clinic. What assessment should the nurse observe in this client? a) A burning sensation and the sensation of an object in the eye b) Blurred or cloudy visual image c) A swollen lacrimal caruncle d) Inability to produce sufficient tears

Blurred or cloudy visual image

inhibitors decrease aqueous humor production

Carbonic anhydrase

edema of the conjunctiva.

Chemosis

Which of the following medication classifications increases aqueous fluid outflow in the patient with glaucoma? a) Alpha-adrenergic agonists b) Cholinergic c) Beta-blockers d) Carbonic anhydrase inhibitors

Cholinergic

increase aqueous fluid outflow by contracting the ciliary muscle, causing miosis, and opening the trabecular meshwork.

Cholinergics

Which of the following medications needs to be withheld for 5 to 7 days prior to cataract surgery? a) Prednisone b) Lasix c) Glucophage d) Coumadin

Coumadin

refers to normal eyesight in which the image focuses precisely on the retina

Emmetropia

A patient has been prescribed eye drops for the treatment of glaucoma. At the yearly follow-up appointment, the patient tells the nurse that she has stopped using the medication because her vision did not improve. Which of the following is the appropriate action to be taken by the nurse? a) Explain the therapeutic effect and expected outcome of the medication. b) Refer the patient to the ED. c) Administer the medication immediately. d) Talk with the doctor about switching to a different glaucoma medication.

Explain the therapeutic effect and expected outcome of the medication

The nurse asks a client to follow the movement of a pencil up, down, right, left, and both ways diagonally. The nurse is assessing which of the following? a) Pupillary reaction b) Eyelid drooping c) Eyeball oscillation movements d) Extraocular muscle function

Extraocular muscle function

A patient is brought into the emergency department with chemical burns to both eyes. What is the priority action of the nurse for this patient's care? a) Applying hot compresses at 15-minute intervals b) Flushing the lids, conjunctiva, and cornea with tap water or normal saline c) Cleansing the conjunctiva with a small cotton-tipped applicator d) Administering local anesthetics and antibacterial drops for 24 to 36 hours

Flushing the lids, conjunctiva, and cornea with tap water or normal saline

The nurse should monitor for which of the following manifestations in a patient who has had LASIK surgery? a) Halos and glare b) Cataract formation c) Stye formation d) Excessive tearing

Halos and glare

Which type of benign tumor of the eyelids is characterized by superficial, vascular capillary lesions that are strawberry red in color? a) Xanthelasma b) Milia c) Molluscum contagiosum d) Hemangioma

Hemangioma

vascular capillary tumors that may be bright, superficial, strawberry-red lesions or bluish and purplish deeper lesions.

Hemangioma

A client has undergone enucleation. What complication of enucleation addressed by the nurse? a) Pneumonia b) Hemorrhage c) Hypotension d) Nausea and vomiting

Hemorrhage

blood in the anterior chamber of the eye

Hyphema

A patient presents to the ED complaining of a chemical burn to both eyes. Which of the following is the priority nursing intervention? a) Irrigate both eyes. b) Assess the pH of the corneal surface. c) Assess visual acuity. d) Obtain the Material Safety Data Sheet (MSDS).

Irrigate both eyes

A client comes to the eye clinic for a routine check-up. The client tells the nurse they think they are color blind. What screening test does the nurse know will be performed on this client to assess for color-blindness? a) Rosenbaum b) Snellen c) Ishihara d) Jaeger

Ishihara

Following an ophthalmologic exam, an anxious client asks the nurse, "How serious is a refraction error?" Which of the following is the best response from the nurse? a) "It is nothing serious." b) "Simple surgery can fix this problem." c) "This is normal for anyone your age." d) "It means corrective lenses are required."

It means corrective lenses are required

a cone-shaped deformity of the cornea.

Keratoconus

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. In your client education, after applying an ice pack, you explain to the client the functions of the various structures of the eye. What glands, contained in the eyelids, produce tears? a) Sebaceous b) Lacrimal c) Sweat d) Olfactory

Lacrimal

Which of the following surgical procedures involves flattening the anterior curvature of the cornea by removing a stromal lamella layer? a) Photorefractive keratectomy (PRK) b) Keratoconus c) Keratoplasty d) Laser-assisted stromal in situ keratomileusis (LASIK)

Laser-assisted stromal in situ keratomileusis (LASIK)

Which of the following is the most common cause of visual loss in people older than 60 years of age? a) Retinal detachment b) Cataracts c) Glaucoma d) Macular degeneration

Macular degeneration

The nurse is performing an assessment of the visual fields for a patient with glaucoma. When assessing the visual fields in acute glaucoma, what would the nurse expect to find? a) Marked blurring of vision b) Watery ocular discharge c) Clear cornea d) Constricted pupil

Marked blurring of vision

small, white, slightly elevated cysts of the eyelid that may occur in multiples.

Milia

used to cause the pupil to constrict.(medication)

Miotics

lesions flat symmetric growths along the lid margin caused by a virus that can result in conjunctivitis and keratitis if the lesion grows into the conjunctival sac

Molluscum contagiosum

cause the pupil to dilate. (medication)

Mydriatics

Assessment of visual acuity reveals that the client has blurred vision when looking at distant objects but no difficulty seeing near objects. The nurse documents this as which of the following? a) Astigmatism b) Myopia c) Hyperopia d) Emmetropia

Myopia

Choice Multiple question - Select all answer choices that apply. When an impaled object is in the eye, which of the following steps should be taken to ensure that no further damage occurs? Select all that apply. a) Protect object from jarring b) Apply gentle pressure to the eye c) Apply a patch to the eye d) No attempt should be made to remove the object e) Use metal shield

No attempt should be made to remove the object Use metal shield Protect object from jarring

To avoid the side effects of corticosteroids, which medication classification is used as an alternative to treating inflammatory conditions of the eyes? a) Miotics b) Nonsteroidal anti-inflammatory drugs (NSAIDs) c) Mydriatics d) Cycloplegics

Nonsteroidal anti-inflammatory drugs (NSAIDs)

A 63-year-old client has developed diabetic retinopathy and is seeing the physician regularly to prevent further loss of sight. From where do the nerve cells of the retina extend? a) Oculomotor nerve b) Trigeminal nerve c) Optic nerve d) Trochlear nerve

Optic nerve

Which is the term for swelling of the optic disc due to increased intraocular pressure (IOP)? a) Papilledema b) Chemosis c) Photophobia d) Ptosis

Papilledema

The nurse is reviewing the medical record of a client with glaucoma. Which of the following would alert the nurse to suspect that the client was at increased risk for this disorder? a) Hyperopia since age 20 years b) History of respiratory disease c) Prolonged use of corticosteroids d) Age younger than 40 years

Prolonged use of corticosteroids

A nurse in a primary care office is getting a client ready for an examination with a health care provider. While talking to the client, she notices that her left upper eyelid is drooping. She records on the client's record that she observed which of the following? a) Ptosis b) Nystagmus c) Proptosis d) Ptolemy

Ptosis

a drooping eyelid.

Ptosis

a blind or partially blind area in the visual field

Scotoma

A client comes to the occupational health nurse complaining of eye irritation. The client works in a dusty, outdoor environment. Why should the nurse advise periodic blinking to this client? a) To clear the dust and particles from the surface of the eyes b) To minimize the impact of the wind on the eye and to trap foreign debris c) To prevent the collection of tears over the surface of the eye d) To control the amount of sunlight that enters the eye

To clear the dust and particles from the surface of the eyes

The nurse is instructing a nursing student when a new client comes to the eye clinic. The client explains that he thinks he has a corneal abrasion. The nurse should explain what to the student nurse? a) "To detect corneal abrasions, a slit lamp is used." b) "To detect corneal abrasions, an ophthalmoscope is used." c) "To detect corneal abrasions, retinal angiography is used." d) "To detect corneal abrasions, ultrasonography is used."

To detect corneal abrasions, a slit lamp is used

A client is scheduled to have a cataract removed and an artificial lens implanted. What test would the nurse know would be useful in measuring for an intraocular lens implant in this client? a) Slit lamp b) Retinal angiography c) Visual field d) Ultrasonography

Ultrasonography

Which of the following types of conjunctivitis is preceded by symptoms of an upper respiratory infection? a) Allergic b) Toxic c) Viral d) Vernal

Viral

What type of medication would the nurse use in combination with mydriatics to dilate the patient's pupil? a) Corticosteroids b) Cycloplegics c) NSAIDs d) Anti-infectives

cycloplegics

cause paralysis of the iris sphincter. (medication

cycloplegics

Which of the following features should a nurse observe during an ophthalmic assessment? a) Internal eye function b) Visual acuity c) External eye appearance d) Intraocular pressure

external eye apperance

A 13-year-old client is visiting the ophthalmologist after severe eye injuries. The client suffered trauma to her sclera and is being treated for a subsequent infection. During your client education, you indicate where the sclera is attached. Which of the following structures would you NOT include? a) Eyelids b) Iris c) Cornea d) Pupil

eyelids

Which client statement would lead the nurse to suspect that the client is experiencing bacterial conjunctivitis? a) "It feels like there is something stuck in my eye." b) "My eyes hurt when I'm in the bright sunlight." c) "My eyelids were stuck together this morning." d) "My eyes feel like they are on fire."

my eyelids were stuck together this morning

swelling of the optic disc due to increased IOP.

papilledema

ocular pain on exposure to light.

photophobia

The nurse is assessing an older client's vision. The nurse integrates knowledge of which of the following during the assessment? a) The skin around the eyes will be more elastic. b) The depth of the eyeball will be increased, leading to myopia. c) The power of the lens to accommodate will be decreased. d) Increased fat will be around the orbit.

the power of the lens to accommodate will be decreased.

The nurse is giving a visual field examination to a 55-year-old male client. The client asks what this test is for. What would be the nurse's best answer? a) "This test measures visual acuity." b) "This test measures how well your eyes move." c) "This test is to see how well your eyes are aging." d) "This test measures peripheral vision and detects gaps in the visual field."

this test measures peripheral vision and detects gaps in the visual field

an irregularity in the curve of the cornea, which can affect both near and distant vision.

Astigmatism

It is determined that a patient is legally blind and will be unable to drive any longer. Legal blindness refers to a best-corrected visual acuity (BCVA) that does not exceed what reading in the better eye? a) 20/100 b) 20/50 c) 20/200 d) 20/150

20/200

When undergoing testing of visual acuity with a Snellen chart, the client can read the line labeled 20/50 but misses three letters on the line. The nurse documents this finding as which of the following? a) 20/20/50 b) 20/50 c) 20/50-3 d) 20/20 + 30

20/50-3

A client has undergone tonometry to evaluate for possible glaucoma. Which result would the nurse record as abnormal? a) 15 mm Hg b) 25 mm Hg c) 10 mm Hg d) 20 mm Hg

25 mm Hg

A patient has had cataract extractions and the nurse is providing discharge instructions. What should the nurse encourage the patient to do at home? a) Maintain bed rest for 1 week. b) Avoid bending the head below the waist. c) Lift weights to increase muscle strength. d) Lie on the stomach while sleeping.

Avoid bending the head below the waist

Choice Multiple question - Select all answer choices that apply. A patient has been brought to the emergency room after being hit in the head with a baseball. The nurse should be alert to which of the following clinical manifestations of a detached retina? Select all that apply. a) Sensation of a curtain coming across vision of one eye b) Sudden onset of floaters c) Cobwebs d) Bright flashing lights e) Pain

Bright flashing lights • Sudden onset of floaters • Cobwebs • Sensation of a curtain coming across vision of one eye

The nurse is administering an ophthalmic ointment to a patient with conjunctivitis. What disadvantage of the application of an ointment does the nurse explain to the patient? a) It has a lower concentration than eye drops. b) Blurred vision results after application. c) It has more side effects than eye drops. d) It does not work as rapidly as eye drops do.

blurred vision results after appilication

Leslie Waterman, a 57-year-old corrections officer, is being seen at the ophthalmic group where you practice nursing. Leslie is concerned about his vision changes because recently, he has started to see distance much more clearly than nearby sights. What is the term used to describe his visual condition? a) Emmetropia b) Hyperopia c) Astigmatism d) Myopia

Hyperopia

refers to the client's ability to see distant objects clearly, but sees near objects as blurry.

Hyperopia (farsightedness)

refers to the condition in which the client can see near objects but has blurred distant vision.

Myopia (nearsightedness)

What patient activity indicates to the nurse that a patient understands how to correctly instill ophthalmic medications? a) Client allows the tip of the container to touch the eyelid while administering the medication. b) Client wipes the lids and lashes prior to instillation in a direction toward the nose with moistened, soft gauze. c) Client pulls the tissue near the cheek downward to instill medication. d) Client rubs the eye after administering medication.

client pulls the tissue near the cheek downward to instill medication

An aging client is brought to the eye clinic by the son. The son states he has seen his parent holding reading materials at an increasing distance to focus properly. What age-related changes does this indicate? a) Cataract b) Presbyopia c) Macular degeneration d) Myopia

Presbyopia

A client is color blind. The nurse understands that this client has a problem with: a) aqueous humor. b) lens. c) cones. d) rods.

cones

Which of the following is an accurate statement regarding refractive surgery? a) Refractive surgery is an elective, cosmetic surgery performed to reshape the cornea. b) Refractive surgery may be performed on patients with an abnormal corneal structure as long as they have a stable refractive error. c) Refractive surgery may be performed on all patients, even if they have underlying health conditions. d) Refractive surgery will alter the normal aging of the eye.

Refractive surgery is an elective, cosmetic surgery performed to reshape the cornea

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? a) Pneumatic retinopexy b) Scleral buckle c) Phacoemulsification d) Pars plana vitrectomy

Scleral buckle

A client has just been diagnosed with early glaucoma. During a teaching session, the nurse should: a) provide instructions on eye patching. b) demonstrate eyedrop instillation. c) assess the client's visual acuity. d) teach about intraocular lens cleaning.

demonstrate eyedrop instillation

The school nurse is testing the kindergarten class with the Snellen chart. What is the nurse testing the children for? a) Near vision b) Color vision c) Hearing d) Visual acuity

Visual acuity

yellowish, lipoid deposits on both lids near the inner angle of the eye that commonly appear as a result of skin aging or a lipid disorder.

Xanthelasma

A patient's vision is assessed at 20/200. The patient asks what that means. Which of the following is the most appropriate response by the nurse? a) "You see an object from 20 feet away that a person with normal vision sees from 20 feet away." b) "You see an object from 200 feet away that a person with normal vision sees from 20 feet away." c) "You see an object from 200 feet away that a person with normal vision sees from 200 feet away." d) "You see an object from 20 feet away that a person with normal vision sees from 200 feet away."

You see an object from 20 feet away that a person with normal vision sees from 200 feet away

A 52-year-old woman comes to the clinic for a follow-up examination after being diagnosed with glaucoma. The client states, "I'm hoping that I don't have to use these drops for very long." Which response by the nurse would be most appropriate? a) "Most clients need to use the drops for only about a few months." b) "These drops are just the first step to make sure that your vision doesn't get worse." c) "You'll need to use the drops for the rest of your life to control the glaucoma." d) "If the drops don't work, surgery may be needed to cure your condition."

You'll need to used the drops for the rest of your life to control the glaucoma

Which of the following types of glaucoma presents an ocular emergency? a) Chronic open-angle glaucoma b) Ocular hypertension c) Acute angle-closure glaucoma d) Normal tension glaucoma

acute angle-closure glaucoma

James Robertson, a 62-year-old retired customer service agent, is awaiting elective surgery in the hospital unit where you practice nursing. Mr. Robertson is blind. What would you do to promote Mr. Robertson's control over his hospital environment? a) Ask Mr. Robertson where to store his self-care items. b) Arrange Mr. Robertson's tray in a way that's easiest for you to assist him. c) Open all containers without prompting to be helpful. d) Keep personal care items where you know their location.

ask Mr. Robertson where to store his self-care items.

Following cataract removal, discharge instructions will be provided to the client. Which of the following instructions is most important? a) Avoid washing face and eyes for first 24 hours. b) Apply protective patch to both eyes at bedtime. c) Avoid any activity that can increase intraocular pressure. d) Only sleep on back.

avoid any activity that can increase intraocular pressure