Study set
A client in the clinic where you work is considered legally blind. The nurse knows that this means the vision in his better eye, corrected by glasses, is what?
20/200 or less
When visual acuity is tested using the Snellen eye chart, which result suggests better distance vision?
30/20
Lacrimal gland
A client presents to the health care clinic with red, watery eyes and constant tearing. The nurse understands that which of the following is the organ that produces tears?
You are assessing visual fields on a client newly admitted for eye surgery. The client's left eye repeatedly does not see your fingers until they have crossed the line of gaze. You would document that the client has what?
A left temporal hemianopsia
The nurse is performing visual acuity testing on an older adult who has fallen and fractured their femur. What finding would be considered normal for this client? (Select all that apply.)
Arcus senilis Small cataract Decreased central vision
A nurse assesses a client's pupils for the reaction to light and observes that the pupils are of unequal size. What should the nurse do next in relation to this finding?
Ask the client about previous trauma to the eyes
Which technique by the nurse demonstrates proper use of the ophthalmoscope?
Asks the client to fix the gaze upon an object and look straight ahead
_____________________ is eye strain, and symptoms include fatigue, red eyes, eye pain, blurred vision, and headaches.
Asthenopia
A client is being assessed following a motor vehicle accident. The client's right eye is swollen shut and very painful. Why does this require further assessment?
Blunt-force trauma often results in fracture of the orbit
A client tells the nurse that his eyes "are not working right." When the nurse asks what the client means, the client states, "It is like one eye is moving faster than the other." What test would be most appropriate for the nurse to use to assess this client?
Cardinal fields
A nurse is examining the eyes of a client who has complained of having a feeling of a foreign body in his eye. The nurse examines the thin, transparent, continuous membrane that lines the inside of the eyelids and covers most of the anterior eye. The nurse recognizes this membrane as which of the following?
Conjunctiva
The thin mucous membrane that lines the inner eyelid and covers the sclera is known as what?
Conjunctiva
he thin mucous membrane that lines the inner eyelid and covers the sclera is known as what?
Conjunctiva
wisp of cotton
Corneal (Instrument used/testing method) to stimulate a blink in both eyes... stimulated by the trigeminral nerve
A nurse inspects the eyes of a young child and notices the inward turning of the eyes. What test should the nurse perform to assess whether this finding is normal or abnormal?
Corneal light reflex
A nurse performs the cover test to assess for proper alignment of the eyes. When uncovering the previously covered eye, the nurse should observe for which response to indicate a normal finding?
Covered eye remains fixed straight ahead
An elderly client presents to the health care clinic with reports of decreased tearing in both eyes. The nurse observes the presence of ectropion. What is an appropriate action by the nurse?
Document the finding as a normal sign of aging
When performing the cover test, a nurse notices that the client's left eye turns outward. How should the nurse document this finding in the client's record?
Exotropia
The muscles of the ciliary body control the thickness of the lens, allowing the eye to:
Focus on near or distant objects
A nurse assesses the parallel alignment of a client's eyes by testing the corneal light reflex. Where should the nurse shine the penlight to obtain an accurate result?
Focused on the bridge of the nose
A client reports the appearance of rings around lights. A nurse should perform a further assessment to confirm the onset of what disorder?
Glaucoma
What information, acquired during an eye assessment and history, would the nurse document as lifestyle habits?
Has smoked for last 12 years Uses sunglasses when outdoors Uses protective eyewear when appropriate
What features would most likely be noted on fundoscopic examination of someone with glaucoma?
Increased cup-to-disc ratio
A middle-aged client reports difficulty in reading. Which action by the nurse is appropriate to test near visual acuity using a Jaeger reading card?
Instruct the client hold the chart 14 inches from the eyes
A nurse assesses the distant vision acuity of a client using the Snellen chart. Which action should the nurse implement to perform the test with accuracy?
Instruct the client to read without reading glasses
The nursing instructor is discussing the eye with the nursing students. What would the instructor cite as part of the lacrimal apparatus? (Select all that apply)
Lacrimal sac Lacrimal gland Nasolacrimal duct Punctum
When examining the eye with an ophthalmoscope, where would the nurse look to visualize the optic disc?
Medially toward the nose
The nurse observes a young client holding a newspaper up close to read. Which condition does the nurse suspect this client suffers from?
Myopia
nearsightedness
Myopia
The nurse asks the client to perform the action pictured. What is the nurse assessing?
Near vision
A client presents to the clinic reporting sudden visual loss in the left eye. What is the nurse's priority action?
Notify the healthcare provider immediately.
Which of the following health problems necessitates the use of an ophthalmoscope during assessment?
Papilledema
A nurse assesses the pupillary reaction to light for a client. Which precaution should the nurse follow to get an accurate result of consensual response?
Place an opaque card in between the eyes of the client
A nurse notices a middle-aged client in the waiting room pick up a magazine to read while she waits to be seen. She opens the magazine and then extends her arms to move it further from her eyes. Which condition does the nurse most suspect in this client?
Presbyopia
Which of the following is a symptom of the eye?
Scotomas
A client is assigned a visual acuity of 20/100 in her left eye. Which of the following is true?
She can see at 20 feet what a normal person could see at 100 feet.
A client is being assessed for indications of a possible obstructed nasolacrimal duct in the right eye. Under what circumstances should the nurse avoid compressing the lacrimal sac?
The area around the sac is inflamed.
A student nurse asks the nursing instructor what blood vessels go to the eye. What would be the instructor's best answer?
The choroids
Which area of the fundus is the central focal point for incoming images?
The fovea
A nurse performs the Snellen test on a client and obtains these results: OD 20/40, OS 20/30. 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.
What is the open space between the eyelids called?
The palpebral fissure
A client has an abnormal consensual pupillary reaction to light. A nurse understands that what reaction occurs in the client's eyes?
There is no reaction in the opposite pupil to light.
Which action by the nurse demonstrates correct assessment of the corneal reflex of a client during an eye examination?
Touch the cornea with a wisp of cotton
A nurse is inspecting a client's eyes to assess for the possibility of detached retinas. 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
A comprehensive physical examination of the eye includes tests for which of the following? Select all that apply.
Visual acuity Eye muscle function Internal ocular structures The external eye
A nurse is examining the eyes of a 7-year-old boy. The boy asks the nurse, "What's inside my eyeball?" The nurse explains that the biggest space inside the eyeball contains a clear, gelatinous substance that light passes through. Which of the following is the technical name for this gelatinous substance?
Vitreous humor
A nurse cares for a client with optic atrophy. The nurse recognizes that an ophthalmoscopic examination of the eye should reveal which characteristic finding in the optic disc?
White-colored
A client comes to the clinic, reporting that he woke up this morning with a painful right eye. What would be the most appropriate response from the nurse? You Selected:
You will need to see the doctor to have your eye checked."
The nurse should make it a priority to assess which client for papilledema?
a 45-year-old suspected of experiencing a subarachnoid hemorrhage
An adult client visits the outpatient clinic and tells the nurse that he has a throbbing aching pain in his right eye. The nurse should assess the client for
a foreign body in the eye.
The functional reflex that allows the eyes to focus on near objects is termed
accommodation
burning or itching in the eye is associated with
allergies or superficial irritation
when the palpebral and bulbar meet
allows movement of the eye
The meibomian glands secrete
an oily substance to lubricate the eyes
Halos or Rings Around Lights
associated w/ narrow-angle glaucoma
throbbing deep stabbing pain
associated with foreign object in eye
bilateral apparatus
associated with makeup, facial cleanser in the eye
intermittent blind spots
associated with vascular spasms or pressure on the optic nerve caused by a tumor or increased intracranial pressure. any reports of blind spots need immediate action and sent to the ophthalmologist
The conjunctiva of the eye is divided into the palpebral portion and the
bulbar portion.
excessive tearing in the eye
caused by irritate or obstruction of the lacrimal apparatus
An adult client tells the nurse that he has been experiencing gradual vision loss. The nurse should
check the client's blood pressure.
The middle layer of the eye is known as the
choroid layer.
The chambers of the eye contain aqueous humor, which helps to maintain intraocular pressure and
cleanse the cornea and the lens.
Cataracts
clouding of the lens thick and yellow leading cause of blindness
While assessing the eyes of an adult client, the nurse uses a wisp of cotton to stimulate the client's
corneal reflexes
trigeminal nerve
cranial nerve that stimulates blinking
double vision means
diplopia
The nurse observes an inward turning of the lower lid in a 77-year-old client. The nurse documents
entropion
Hyperopia is
farsightedness
When assessing the fundus of the eye, the nurse recognizes which normal characteristic represented in dark-skinned individuals?
fundus is grayish brown with a purplish cast
double vision may indicate
increased intracranial pressure due to injury or tumor
An adult client visits the clinic and tells the nurse that he has been experiencing double vision for the past few days. The nurse refers the client to a physician for evaluation of possible
increased intracranial pressure.
Glaucoma
increased intraocular pressure results in damage to the retina and optic nerve with loss of vision 2nd leading cause of blindness
discharge in the eye other than tears
indicate bacterial or virus infection
history in the eye or changes
indicate clues of the eye health
A nurse is testing a client's pupillary reaction to light, noting that the pupil constricts when shining light obliquely into it. The nurse understands that muscles in which of the following structures adjust to control the amount of light entering the eye through the aperture of the pupil?
iris
palpebral conjunctiva
lines the eyelids and contains blood vessels, nerves, hair follicles, and sebaceous glands
macular degeneration
loss of central vision
A client complains of feeling like he is slowly losing his central vision. The nurse knows this symptom could represent
macular degeneration
constant blind spots
may be linked with retinal detachment any reports of blind spots need immediate action and sent to the ophthalmologist
open angle glaucoma
most common form of glaucoma that results from degenerative changes that cause congestion and reduce flow of aqueous humor through the canal of Schlemm
Spots or floaters are common among clients with
myopia or older than 40 years old (normal and doesn't require intervention)
night blindness is associated with
optic atrophy, glaucoma, vitamin A deficiency
bulbar conjunctiva
overlays the eyeball, with the white sclera showing through
The nurse is preparing to examine an adult client's eyes, using a Snellen chart. The nurse should
position the client 609.6 cm (20 ft) away from the chart.
Straight movements of the eye are controlled by the
rectus muscles.
client visits the local clinic after experiencing head trauma. The client tells the nurse that he has a consistent blind spot in his right eye. The nurse should
refer the client to an ophthalmologist.
The nurse is examining an adult client's eyes. The nurse has explained the positions test to the client. The nurse determines that the client needs further instructions when the client says that the positions test
requires the covering of each eye separately.
What part of the eye receives and transmits visual stimuli to the brain for processing?
retina
A 45-year-old client tells the nurse that he occasionally sees spots in front of his eyes. The nurse should
tell the client that these often occur with aging.
Presbyopia commonly occurs naturally due to
the aging process; therefore it's rare to observe this condition in young adults.
When assessing the eye, the nurse recognizes that which physical structures of the face limit the normal visual field that a client can experience? Select all that apply.
the brow the medial aspect of the nose the cheek
aqueous humor
the clear fluid filling the space in the front of the eyeball between the lens and the cornea.
Entropion is a condition in which
the eyelid is turned inward (inverted), causing the eyelashes to rub against the eyeball
iris decrease
the pupil size which makes the pupil constrict for near vision. and dilates the eye for far vision
conjuctiva
thin mucous membrane allows for inspection of the underlying tissue and protects the eye from foreign bodies.
Ectropion is a condition in which the eyelid is
turned outward (everted) so that its edge does not touch the eyeball.
redness or swelling in the eye
usually related to inflammatory response caused by allergy, foreign body, or bacterial/viral infection
A client tells the nurse that she has difficulty seeing while driving at night. The nurse should explain to the client that night blindness is often associated with
vitamin A deficiency.
pinguecula
yellowish mass on the conjunctiva that may be related to long-term exposure to ultraviolet light, dry climates, and dust
