NCLEX Exam: Eye Disorders and Care (26 Items)
The client with glaucoma asks the nurse is complete vision will return. The most appropriate response is:
"Although some vision as been lost and cannot be restored, further loss may be prevented by adhering to the treatment plan."
The client is being discharged from the ambulatory care unit following cataract removal. The nurse provides instructions regarding home care. Which of the following, if stated by the client, indicates an understanding of the instructions?
"I will wear my eye shield at night and my glasses during the day."
After the nurse instills atropine drops into both eyes for a client undergoing ophthalmic examination, which of the following instructions would be given to the client?
"Wear dark glasses in bright light because the pupils are dilated."
Tonometry is performed on the client with a suspected diagnosis of glaucoma. The nurse analyzes the test results as documented in the client's chart and understands that normal intraocular pressure is:
10-21 mmHg
The clinic nurse notes that the following several eye examinations, the physician has documented a diagnosis of legal blindness in the client's chart. The nurse reviews the results of the Snellen's chart test expecting to note which of the following?
20/200 vision
In preparation for cataract surgery, the nurse is to administer prescribed eye drops. The nurse reviews the physicians orders, expecting which type of eye drops to be instilled?
A mydriatic medication
The nurse is performing an admission assessment on a client with a diagnosis of detached retina. Which of the following is associated with this eye disorder?
A sense of a curtain falling across the field of vision
Cataract surgery results in aphakia. Which of the following statements best describes this term?
Absence of the crystalline lens
For a client having an episode of acute narrow-angle glaucoma, a nurse expects to give which of the following medications?
Acetazolamide (Diamox)
A male client has just had a cataract operation without a lens implant. In discharge teaching, the nurse will instruct the client's wife to:
Allow him to walk upstairs only with assistance
Legal blindness
defined as 20/200 or less with corrected vision (glasses or contact lenses) or visual acuity of less than 20 degrees of the visual field in the better eye.
retinal detachment
described by the client is the feeling that a shadow or curtain is falling across the field of vision
The nurse is performing an assessment in a client with a suspected diagnosis of cataract. The chief clinical manifestation that the nurse would expect to note in the early stages of cataract formation is:
Blurred vision
Early symptoms of cataracts
include slightly blurred vision and a decrease in color perception.
Severe pain or pain accompanied by nausea after cataract surgery
is an indicator of increased intraocular pressure and should be reported to the physician immediately.
During the early postoperative period, the client who had a cataract extraction complains of nausea and severe eye pain over the operative site. The initial nursing action is to:
Call the physician
The nurse is caring for a client with a diagnosis of detached retina. Which assessment sign would indicate that bleeding has occurred as a result of the retinal detachment?
Complaints of a burst of black spots or floaters
Tonometry
method of measuring intraocular fluid pressure; Pressures between 10 and 21 mmHg are considered within normal range.
A client with a visual acuity of 20/60
only can read at a distance of 20 feet of what a person with normal vision can read at 60 feet.
Mydriatic medications
produces mydriasis or dilation of the pupil; used preoperatively in the cataract client and constrict blood vessels
Which of the following instruments is used to record intraocular pressure?
Tonometer
The client sustains a contusion of the eyeball following a traumatic injury with a blunt object. Which intervention is initiated immediately?
Apply ice to the affected eye
he nurse is developing a plan of care for the client scheduled for cataract surgery. The nurse documents which more appropriate nursing diagnosis in the plan of care?
Disturbed sensory perception
The nurse is developing a teaching plan for the client with glaucoma. Which of the following instructions would the nurse include in the plan of care?
Eye medications will need to be administered lifelong
Which of the following symptoms would occur in a client with a detached retina?
Flashing lights and floaters
The client arrives in the emergency room after sustaining a chemical eye injury from a splash of battery acid. The initial nursing action is to:
Irrigate the eye with sterile normal saline
The nurse is caring for a client following enucleation. The nurse notes the presence of bright red blood drainage on the dressing. Which nursing action is appropriate?
Notify the physician
The client arrives in the emergency room with a penetrating eye injury from wood chips while cutting wood. The nurse assesses the eye and notes a piece of wood protruding from the eye, what is the initial nursing action?
Perform visual acuity tests
The client's vision is tested with a Snellen's chart. The results of the tests are documented as 20/60. The nurse interprets this as:
The client can read only at a distance of 20 feet what a client with normal vision can read at 60 feet.
When using a Snellen alphabet chart, the nurse records the client's vision as 20/40. Which of the following statements best describes 20/40 vision?
The client can see at 20 feet what the person with normal vision can see at 40 feet.
post op cataract surgery
The client is instructed to wear a metal or plastic shield to protect the eye from accidental and is instructed not to rub the eye.
During glaucoma:
The client needs to be instructed that medications will need to be taken for the rest of his or her life.
The clinic nurse is preparing to test the visual acuity of a client using a Snellen chart. Which of the following identifies the accurate procedure for this visual acuity test?
The right eye is tested followed by the left eye, and then both eyes are tested.
Which of the following procedures or assessments must the nurse perform when preparing a client for eye surgery?
Verifying the client has been NPO since midnight, or at least 8 hours before surgery.
aphakia
absence of the lens of the eye
Visual acuity
assessed in one eye at a time, and then in both eyes together with the client comfortably standing or sitting; measured with or without corrective lenses and the client stands at a distance of 20ft. from the chart.
