Prep U Chapter 58: Assessment and Management of Patients with Eye and Vision Disorders

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

10 to 20 mm Hg.

A patient is suspected of having glaucoma. What reading of IOP would demonstrate an increase resulting from optic nerve damage? 6 to 10 mm Hg 11 to 20 mm Hg 0 to 5 mm Hg 21 mm Hg or higher

21 mm Hg or higher

The nurse is establishing a visual test using the Snellen chart for a client experiencing visual changes. At which distance should the nurse instruct the client to stand? A 20-foot distance A 40-foot distance A 10-foot distance A 30-foot distance

A 20-foot distance

A client who presents for an eye examination is diagnosed as having a visual acuity of 20/40. The client asks the nurse what these numbers specifically mean. What is a correct response by the nurse? "A person whose vision is 20/40 can see an object from 20 feet away that a person with 20/20 vision can see from 40 feet away." "A person whose vision is 20/40 can see an object from 20 inches away that a person with 20/20 vision can see from 40 inches away." "A person whose vision is 20/40 can see an object from 40 feet away that a person with 20/20 vision can see from 20 feet away." "A person whose vision is 20/40 can see an object from 40 inches away that a person with 20/20 vision can see from 20 inches away."

"A person whose vision is 20/40 can see an object from 20 feet away that a person with 20/20 vision can see from 40 feet away."

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

"Are you able to raise both eyebrows?"

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

"My eyelids were stuck together this morning."

The nurse admits a client to the emergency department who has been referred by the eye clinic. Which condition is an emergency where the nurse should refer the client for medical treatment immediately? Chalazion Blepharitis Acute angle-closure glaucoma Hordeolum

Acute angle-closure glaucoma

Which type of glaucoma presents an ocular emergency? Normal tension glaucoma Ocular hypertension Chronic open-angle glaucoma Acute angle-closure glaucoma

Acute angle-closure glaucoma

The ophthalmologist tells a patient that he has increased intraocular pressure (IOP). The nurse understands that increased pressure resulting from optic nerve damage is indicated by a reading of: >21 mm Hg. 0 to 5 mm Hg. 11 to 20 mm Hg. 6 to 10 mm Hg.

IOP reading of >21 mm Hg

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? Pneumatic retinopexy Scleral buckle Pars plana vitrectomy Phacoemulsification

Scleral buckle

When conducting an eye exam, the nurse practitioner is aware that a diagnostic clinical manifestation of glaucoma is: Pain associated with a purulent discharge. A significant loss of central vision. The presence of halos around lights. Diminished acuity.

The presence of halos around lights.

A client is diagnosed with a corneal abrasion and the nurse has administered proparacaine hydrochloride per orders to assess visual acuity. The client requests a prescription for this medication because it completely took away the pain. What is the best response by the nurse? "It is standard for the doctor to write a prescription for this medication." "Prescriptions of this medication are generally not given because it can cause corneal problems." "Usually we will send you home with this bottle and written instructions for administering the medication." "I will let the doctor know."

"Prescriptions of this medication are generally not given because it can cause corneal problems."

The nurse is demonstrating how to perform punctal occlusion. Which activities does the nurse perform? Applies gentle pressure to the upper eyelid to keep the lid open while telling the client to gaze upward Holds down the lower lid of the eye by applying pressure on the eyeball and the cheekbone Applies gentle pressure bilaterally on the bridge of the nose to the inner canthus of each eye Applies firm pressure to the upper and lower eyelids at the outer edges to keep eyelids in approximation

Applies gentle pressure bilaterally on the bridge of the nose to the inner canthus of each eye

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? BUN and creatinine AST and ALT Platelet count Hemoglobin and hematocrit

BUN and creatinine

Which of the following is the main refracting surface of the eye? Conjunctiva Iris Cornea Pupil

Cornea

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

Explain the therapeutic effect and expected outcome of the medication.

The nurse should monitor for which manifestation in a client who has undergone LASIK? Halos and glare Stye formation Excessive tearing Cataract formation

Halos and glare

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

Hemangioma

Which type of benign tumor of the eyelids is characterized by superficial, vascular capillary lesions that are strawberry-red in color? Milia Hemangioma Nevi Xanthelasma

Hemangioma

Which type of benign tumor of the eyelids is characterized by superficial, vascular capillary lesions that are strawberry-red in color? Milia Nevi Xanthelasma Hemangioma

Hemangioma

The client with chronic open-angle glaucoma is receiving timolol eye drops. Which evaluation finding would indicate to the nurse the treatment is working? Intraocular pressure 15 mm Hg Decrease in nausea and vomiting Halos around lights Reduced peripheral vision

Intraocular pressure 15 mm Hg

The client with chronic open-angle glaucoma is receiving timolol eye drops. Which evaluation finding would indicate to the nurse the treatment is working? Reduced peripheral vision Intraocular pressure 15 mm Hg Decrease in nausea and vomiting Halos around lights

Intraocular pressure 15 mm Hg

A client comes to the eye clinic for a routine check-up. The client tells the nurse he thinks he is color blind. What screening test does the nurse know will be performed on this client to assess for color blindness? Snellen Rosenbaum Ishihara Jaeger

Ishihara

During an initial assessment, the nurse notes a symptom of a mild case of bacterial conjunctivitis and documents in the electronic medical record that the client is displaying which of the following ? Severe pain Mucopurulent ocular discharge Elevated intraocular pressure Blurred vision

Mucopurulent ocular discharge

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? Emmetropia Myopia Hyperopia Astigmatism

Myopia

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? Myopia Hyperopia Emmetropia Astigmatism

Myopia

To avoid the side effects of corticosteroids, which medication classification is used as an alternative to treat inflammatory conditions of the eyes? Cycloplegics NSAIDs Miotics Mydriatics

NSAIDs

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

Nonsteroidal anti-inflammatory drugs (NSAIDs)

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

Nonsteroidal anti-inflammatory drugs (NSAIDs)

A legally blind client is in the pre-op area prior to an appendectomy. What steps does the nurse take to effectively communicate with this client ? Make direct eye contact with the client when communicating. Inform the client that the nurse will be working nearby. Notify the client prior to touching the client. Sit near the client to provide reassurance of the strange surroundings.

Notify the client prior to touching the client.

A nurse practitioner is assessing a patient who is experiencing changes in her vision. The nurse performs the following steps. Place them in the order in which the nurse would complete them. Use all options. Click an option, hold and drag it to the desired position, or click an option to highlight it and move it up or down in the order using the arrows to the left. 1Obtain an ocular history 2Examine the external eye 3Perform direct ophthalmoscopy 4Test visual acuity

Obtain an ocular history Test visual acuity Examine the external eye Perform direct ophthalmoscopy

The nurse is assisting the eye surgeon in completing an examination of the eye. Which piece of equipment would the nurse provide to the physician to examine the optic disc under magnification? Amsler grid Ophthalmoscope Tonometer Retinoscope

Ophthalmoscope

Which of the following would be an inaccurate clinical manifestation of a retinal detachment? Cobwebs Bright flashing lights Sudden onset of a greater number of floaters Pain

Pain

Which term refers to swelling of the optic disc due to increased intracranial pressure? Papilledema Chemosis Photophobia Ptosis

Papilledema

A nurse is reviewing the medical records of several patients who have had their intraocular pressure (IOP) measured:Patient A: IOP 12 mm HgPatient B: IOP 15 mm HgPatient C: IOP 21 mm HgPatient D: IOP 24 mm HgWhich patient would the nurse identify as having increased IOP suggesting glaucoma? Patient A Patient B Patient C Patient D

Patient D

The nurse is caring for a client ordered for multiple eye screening. Following which procedure will the nurse instruct the client on a yellow coloring to the skin and urine as being normal? Retinal Imaging Retinal Angiography Retinoscopy Ultrasonography

Retinal Angiography

A diabetic patient is scheduled for surgery for repair of a detached retina that was caused by proliferative retinopathy. The nurse prepared the patient for surgery, aware that the type of detachment is most likely classified as which of the following? Rhegmatogenous Traction combined with rhegmatogenous Exudative Traction

Rhegmatogenous

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 20 feet away. Sees an object from 200 feet away that a person with normal vision sees from 200 feet away. Sees an object from 200 feet away that a person with normal vision sees from 20 feet away. Sees an object from 20 feet away that a person with normal vision sees from 200 feet away.

Sees an object from 20 feet away that a person with normal vision sees from 200 feet away.

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

The power of the lens to accommodate will be decreased.

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

The power of the lens to accommodate will be decreased.

A patient visits a clinic for an eye examination. He describes his visual changes and mentions a specific diagnostic clinical sign of glaucoma. What is that clinical sign? Pain associated with a purulent discharge Diminished acuity The presence of halos around lights A significant loss of central vision

The presence of halos around lights

A client is diagnosed with a corneal abrasion and the nurse has administered proparacaine hydrochloride per orders to assess visual acuity. The client requests a prescription for this medication because it completely took away the pain. What is the best response by the nurse? "It is standard for the doctor to write a prescription for this medication." "Prescriptions of this medication are generally not given because it can cause corneal problems." "Usually we will send you home with this bottle and written instructions for administering the medication." "I will let the doctor know."

The presence of halos around lights.

To straighten the ear canal in an adult for examination, the nurse practitioner would grasp the auricle and pull it: Slightly outward. Up and backward. Upward and outward. Downward.

Up and backward.

To straighten the ear canal in an adult for examination, the nurse practitioner would grasp the auricle and pull it: Slightly outward. Upward and outward. Downward. Up and backward.

Up and backward.

Which of the following types of conjunctivitis is preceded by symptoms of an upper respiratory infection? Toxic Allergic Vernal Viral

Viral

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

cones

A client has received a diagnosis of hyperopia and is wondering if there is a physical condition that has caused these vision changes. In explaining hyperopia, what does the nurse indicate is the cause of this client's vision changes? eyeballs that are shorter than normal irregularly shaped corneas eyeballs that are longer than normal unequal curvatures in the cornea

eyeballs that are shorter than normal.

A client suffered trauma to the sclera and is being treated for a subsequent infection. During client education, the nurse indicates where the sclera is attached. Which structure would not be included? iris pupil eyelids cornea

eyelids

A client has noticed recently having clearer vision at a distance than up close. What is the term used to describe this client's visual condition? emmetropia astigmatism myopia hyperopia

hyperopia

When obtaining the health history from a client with retinal detachment, a nurse expects the client to report: a recent driving accident while changing lanes. headaches, nausea, and redness of the eyes. frequent episodes of double vision. light flashes and floaters in front of the eye.

light flashes and floaters in front of the eye.

A 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? optic nerve trochlear nerve oculomotor nerve trigeminal nerve

optic nerve

A 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? trochlear nerve optic nerve trigeminal nerve oculomotor nerve

optic nerve

A client with multiple sclerosis is being seen by a neuro-ophthalmologist for a routine eye exam. The nurse explains to the client that during the examination, the client will be asked to maintain a fixed gaze on a stationary point while an object is moved from a point on the side, where it can't be seen, toward the center. The client will indicate when the object becomes visible The nurse further explains that the test being performed is called a: slit-lamp examination perimetry test color vision test retinal angiography

perimetry test

A client has noticed needing to hold printed material at arms length to make the print readable. What is the term used to describe this visual condition? hyperopia presbyopia emmetropia myopia

presbyopia

A nurse notices that a client's left upper eyelid is drooping. The nurse has observed: ptosis proptosis ptolemy nystagmus

ptosis

The nurse realizes that a client understands how to correctly instill ophthalmic medications when the client: rubs the eye after administering medication. wipes the lids and lashes prior to instillation in a direction toward the nose with moistened, soft gauze. allows the tip of the container to touch the eyelid while administering the medication. pulls the tissue near the cheek downward to instill medication.

pulls the tissue near the cheek downward to instill medication.

When the client tells the nurse that his vision is 20/200 and then asks what that means, the nurse informs the client 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. sees an object from 20 feet away just like a person with normal vision. sees an object from 200 feet away just like a person with normal vision. sees an object from 200 feet away that a person with normal vision sees from 20 feet away.

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

A client is scheduled to undergo surgery to remove a cataract in the left eye using phacoemulsification. When phacoemulsification is used, a: longer incision is made, and a laser is used to eradicate the cataract. Suction is then used to extract the lens. small portion of the anterior capsule is removed. Ultrasound is emitted through a probe, and suction is used to extract the lens. small incision is made, a laser is used to eradicate the cataract, and the lens is extracted in one piece. longer incision is made, and the lens is extracted in one piece.

small portion of the anterior capsule is removed. Ultrasound is emitted through a probe, and suction is used to extract the lens.