Chapter 14 Eyes

While examining a 50-year-old patient, the nurse observes raised, yellow plaques on the eyelids at the inner canthus. The laboratory reports show the presence of high cholesterol levels. What should the nurse interpret from these findings? 1 The patient has pingueculae. 2 The patient has arcus senilis. 3 The patient has xanthelasma. 4 The patient has pseudostrabismus.

3

While assessing the visual acuity of a patient by means of a Snellen chart, the nurse records the finding of the patient as having 20/100 vision. What does the finding indicate? 1 The vision of the patient is normal. 2 The patient has 20 percent of the normal vision. 3 The patient sees at 20 feet what normal eyes would see at 100 feet. 4 The patient must stand 100 feet from the chart to read it clearly.

3

Which technique does the nurse use to assess the vision of a 7-year-old child? 1 Cover test 2 Ishihara's test 3 Hirschberg test 4 Confrontation test

2

While assessing a newborn, the nurse finds epicanthal folds and large spacing between the eyes. Based on this finding, which condition is this infant at risk for? 1 Meningitis 2 Down syndrome 3 Horner's syndrome 4 Central nervous system injury

2

While doing the diagnostic position test, the nurse is still able to see the top portion of the iris while the patient is looking in the downward position. What complication should the nurse watch for in this patient? 1 Nystagmus 2 Hyperthyroidism 3 Cranial nerve dysfunction 4 Extraocular muscle dysfunction

2

While examining a patient with an eye infection, the nurse observes red, scaly, greasy flakes on the edge of the eyelids. The nurse asks the patient to describe the discomfort. What description is the patient most likely to provide? 1 "I can see two images of a single object." 2 "I feel like I have sand particles in my eyes." 3 "I have thick, yellow discharge from my eyes." 4 "I feel the movement of spots in front of my eyes."

2

While examining a patient, the nurse notices that the patient has scales on the eyebrows. Which condition would the nurse expect? 1 Ptosis 2 Ectropion 3 Seborrhea 4 Scleral icterus

3

A nurse is teaching a class on the pathophysiology of the eyes. Which statement by a student would indicate a need for further teaching? 1 "Glaucoma is a common disease in children." 2 "Diabetic retinopathy is an important cause of blindness." 3 "Cataracts are caused by the clouding of the crystalline lens." 4 "Age-related macular degeneration (AMD) is caused by drusen."

1

A patient tells the nurse, "I feel a throbbing pain in my eyes when I look at bright light." The nurse sees a dull red halo around the iris and cornea of the patient's eye. Which condition does this patient likely have? 1 Iritis 2 Glaucoma 3 Conjunctivitis 4 Corneal abrasion

1

A patient tells the nurse, "I got an eye injury while playing baseball." The nurse notices blood in the anterior chamber of the eye. What should the nurse conclude from these findings? 1 The patient has hyphema. 2 The patient has hypopyon. 3 The patient has pterygium. 4 The patient has a corneal abrasion.

1

After assessing a patient, the nurse concludes that the patient has strabismus. Which finding supports the nurse's conclusion? 1 The patient has deviation in the eye axis. 2 The patient is sensitive to high light intensity. 3 The patient perceives two images of a single object. 4 The patient visualizes a blind spot in the line of vision.

1

The nurse assesses the eye movements of a patient using the diagnostic positions test and finds that the patient is unable to turn his or her eyes in three cardinal positions of gaze—up and nasal, straight nasal, and down and temporal positions. Based on these findings, which cranial nerve paralysis could the patient have? 1 Oculomotor cranial nerve III 2 Trochlear cranial nerve IV 3 Trigeminal cranial nerve V 4 Abducens cranial nerve VI

1

The nurse is assessing an elderly patient and notices a white ring along the patient's cornea. The patient states, "I can see things clearly." What can the nurse conclude from the findings? 1 Arcus senilis 2 Xanthelasma 3 Pingueculae 4 Abnormal pterygium

1

The nurse shows a preschool child seven cards with pictures of familiar objects kept at a distance of 15 feet. Which tool is the nurse using to evaluate the child's vision? 1 Allen test 2 Cover test 3 Ishihara's test 4 Hirschberg test

1

Which condition may cause miosis in a patient? 1 Damage to the pons 2 Damage to the optic disc 3 Damage to the cerebral cortex 4 Damage to the oculomotor cranial nerveIII

1

Which response stimulates blinking in both eyes? 1 Corneal reflex 2 Ciliary body movement 3 Sympathetic nerve stimulation 4 Parasympathetic nerve stimulation

1

Which statement accurately describes the signs and symptoms of iritis? 1 A deep red halo is seen around iris and cornea. 2 The shape of the pupil remains unchanged. 3 The vision is unaffected in this disease. 4 Redness is more prominent at the periphery.

1

While assessing the eyes of a patient using an ophthalmoscope, the nurse finds that the patient has a scleral crescent. What could cause this finding in the patient? 1 Absence of pigment in the choroid layer 2 Extension of the cup into the disc border 3 Accumulation of pigment in the choroid layer 4 Presence of elevated yellow nodules on the sclera

1

While collecting the subjective data of a patient, the nurse finds that the patient has a previous history of glaucoma. The nurse also finds pilocarpine ophthalmic drops on the patient's prescription list. Which eye abnormality could this patient be at risk for? 1 Miosis 2 Tonic pupil 3 Anisocoria 4 Dacryocystitis

1

A patient develops sudden clouding of vision, severe eye pain, and halos around light. What should be the nurse's first intervention? 1 Administer analgesics as prescribed. 2 Refer the patient to the optician for glasses. 3 Let the patient rest their eyes in a dark room. 4 Report this to the primary health care provider.

4

After examining a patient, the nurse documents that the patient has arcus senilis. Which finding in the patient enabled the nurse to reach this conclusion? Select all that apply. 1 Presence of thickened and raised corneas 2 Presence of a gray-white arc around the limbus 3 Presence of scattered yellow dots on the retina 4 Presence of yellow plaques on the inner canthus 5 Presence of elevated yellow nodules on the sclera

1, 2

The nurse suspects that a 40-year old patient has age-related macular degeneration after observing yellow deposits under the patient's retina. What should the nurse ask the patient to evaluate the condition further? Select all that apply. 1 "Do you have any difficulty in reading?" 2 "Do you have any difficulty in sewing?" 3 "Do you have any difficulty in eye movements?" 4 "Do you have any difficulty opening the eyelids?" 5 "Do you have difficulty in seeing objects on either side?"

1, 2

Which are the two cranial nerves (CN) that are responsible for the pupillary light reflex? Select all that apply. 1 Optic 2 Oculomotor 3 Abducens 4 Trochlear 5 Trigeminal

1, 2

Which eye conditions may occur due to excessive exposure to sunlight? Select all that apply. 1 Pingueculae 2 Arcus senilis 3 Xanthelasma 4 Closure glaucoma 5 Basal cell carcinoma

1, 5

A patient complains of a burning and itching sensation of the eyelids. On assessment, the nurse finds that lid margins have thickened and formed crust. What condition would the nurse suspect? 1 Chalazion 2 Blepharitis 3 Hordeolum 4 Dacryocystitis

2

A patient has a beady nodule protruding from the eyelid. The nurse discovers the presence of swelling over the nodule that moves freely. What should the nurse infer from these findings? 1 The patient has blepharitis. 2 The patient has a chalazion. 3 The patient has a hordeolum. 4 The patient has dacryocystitis.

2

A patient has decreased visual acuity and decreased color vision. The nurse observes a grayish discoloration on the optic disc. Which abnormality will the nurse most likely find in the patient? 1 Papilledema 2 Optic atrophy 3 Narrowed artery 4 Arteriovenous crossing

2

A patient reports to the nurse that he is having trouble seeing nearby objects. Which type of reflex is associated with this type of adaptation? 1 Fixation 2 Accommodation 3 Direct light reflex 4 Consensual light reflex

2

A patient with a staphylococcus eye infection has seborrheic dermatitis of the eyelid. The patient also reports burning and the sensation of a foreign body in the eye. Which eyelid infection should the nurse look for in the patient? 1 Chalazion 2 Blepharitis 3 Hordeolum 4 Dacryocystitis

2

After an eye-assessment, the health care provider suspects that the patient may have a brain tumor. What sign or symptom would the nurse expect to find in this patient to support the health care provider's suspicion? 1 The patient has optic atrophy. 2 The patient has papilledema. 3 The patient has cataracts. 4 The patient has a corneal abrasion.

2

During an eye examination, the nurse finds yellowish elevated nodules on the conjunctiva of the patient's eyes. The nurse learns that the patient works in the wood recycling industry. What does the nurse infer from these findings? 1 The patient has arcus senilis. 2 The patient has pingueculae. 3 The patient has xanthelasma. 4 The patient has dacryocystitis.

2

During the diagnostic positions test, a patient's eye does not move to the down and nasal positions. Which cranial nerve may be affected in the patient? 1. III 2. IV 3. V 4. VI

2

The health care provider uses the red lens and adjusts the diopter setting of the ophthalmoscope while assessing a patient's eyes. Why is this assessment technique performed? 1 The patient has farsightedness. 2 The patient has nearsightedness. 3 The provider is observing the red reflex. 4 The provider is observing the corneal light reflex.

2

The nurse is caring for a patient who has been administered deep anesthesia. What visual response would the nurse find in the patient? 1 Miosis 2 Mydriasis 3 Anisocoria 4 Adie's pupil

2

The nurse is examining a patient who has open angle glaucoma and concludes that the patient has tunnel vision. Which finding supports the nurse's conclusion? 1 The patient's pupils are irregular and small bilaterally. 2 The patient reports a decrease in the peripheral vision. 3 The patient displays an asymmetric corneal light reflex. 4 The patient has fine oscillating movements around the iris.

2

The nurse performs a cover test to measure a patient's eye muscle strength. Which condition can be assessed with the cover test? 1 Esotropia 2 Esophoria 3 Entropion 4 Enophthalmos

2

What are the different functions of the eyelids? Select all that apply. 1 Secretion of tears 2 Prevention of injury 3 Protection from dust 4 Protection from bright light 5 Filtering out dust and dirt

2, 3, 4

Which conditions may cause periorbital edema in a patient? Select all that apply. 1 Albinism 2 Myxedema 3 Renal failure 4 Thyrotoxicosis 5 Congestive heart failure

2, 3, 4, 5

The nurse suspects the presence of a foreign particle in the eye of a patient who reports eye pain. In which order should the nurse perform these steps while caring for the patient? 1. Place the tip of the applicator stick on top of the upper eyelid. 2. Ask the patient to open both of the eyelids while looking down. 3. Hold the lashes against bony orbital rim and secure the position. 4. Gently push the applicator stick down while lifting the eyelashes. 5. Lift the eyelashes by sliding the upper eyelid up to the bony orbit. 6. Pull the eyelashes gently down and out with the thumb and finger.

2, 5, 6, 1, 4, 3

A nursing instructor is giving a lecture on eye diseases and racial variation. Which statement by the instructor indicates effective teaching? 1 "The occurrence of diabetic retinopathy is very high among Whites." 2 "The occurrence of cataracts is uncommon in young Black females." 3 "The occurrence of cataracts is more common in Whites compared to Hispanics." 4 "The occurrence of open-angle glaucoma is three times higher in Hispanics than in Blacks."

3

A patient tells the nurse, "Something is stuck in my eye, and I can't see anything." On examination, no foreign body is seen. The patient also reports tearing and sensitivity to light. What condition would the nurse suspect? 1 Arcus senilis 2 Dacryocystitis 3 Corneal abrasion 4 Cataract

3

A patient with a chronic illness has a cachectic appearance. Which eyelid abnormality would this patient most likely have? 1 Ptosis 2 Entropion 3 Enophthalmos 4 Periorbital edema

3

An older adult patient reports sudden, intense eye pain and sees halos around lights. On examination, the nurse observes a cloudy cornea and a dilated pupil. What does the nurse suspect from the patient's signs and symptoms? 1 Iritis 2 Conjunctivitis 3 Acute glaucoma 4 Horner's syndrome

3

The nurse is assessing a 1-month-old and documents that the infant has a doll's eye reflex. Which finding led the nurse to reach this conclusion? 1 The infant fixes the eyes towards a bright light for few seconds. 2 The infant's pupils constrict when they are exposed to bright lights. 3 The infant shift the eyes to opposite direction after quick beats of nystagmus. 4 The infant opens the eye when the head is lowered slowly in a supine position.

3

The nurse observes a health care provider assessing a patient. During the exam, the provider presses against the patient's lacrimal sac and a clear fluid is expelled through the puncta. What can the nurse deduce from this finding? 1 A normal finding that indicates a leakage of aqueous humor 2 A variation from normal that reflects the formation of a hordeolum 3 A variation from normal that may indicate a blocked nasolacrimal duct 4 A normal finding, because the fluid is a lubricating substance stored in the lacrimal sac

3

The nurse observes that a patient has a swollen and reddened upper eyelid. The nurse learns that the patient recently had infectious mononucleosis. Which condition does the nurse expect to see in the patient? 1 Blepharitis 2 Hordeolum 3 Dacryoadenitis 4 Basal cell carcinoma

3

Which sign does the nurse observe in a patient with Horner's syndrome? 1 Sunken eyes 2 Protruding eyes 3 Drooping eyelids 4 Periorbital edema

3

A nurse is teaching a class on the pathology and physiology of the eye. Which statement by the nurse about eversion of the eyelids during physical examination is accurate? 1 "The patient needs to close both eyes." 2 "The applicator stick should be placed on the lower lid." 3 "The lower lid should be slid up along the bony orbit by the examiner." 4 "The lashes need to be grasped between the examiner's thumb and forefinger."

4

A patient with an eye infection reports pain, warmth, and redness in the part of the eye closest to the nose. The nurse notices that the patient has purulent discharge when applying pressure on the conjunctival sac. Which condition does this patient likely have? 1 Ptosis 2 Blepharitis 3 Hordeolum 4 Dacryocystitis

4

During an assessment, the nurse documents that the patient's preauricular lymph node is swollen and painful. The nurse learns that the patient had a previous history of respiratory infections. Which eye complication should the nurse screen for in this patient? 1 Hyphema 2 Hypopyon 3 Pterygium 4 Conjunctivitis

4

The nurse is assessing a patient using the diagnostic positions test. Based on which finding does the nurse document paralysis of cranial nerve VI? 1 The patient is unable to turn the eye up and nasal. 2 The patient is unable to turn the eye straight nasal. 3 The patient is unable to turn the eye down and nasal. 4 The patient is unable to turn the eye straight temporal.

4

The nurse is teaching a class on anatomy and physiology of the human eye. Which statement by a student indicates effective learning? 1 "The sclera is a thin layer sensitive to touch." 2 "The bulbar conjunctiva lines the lids and is clear." 3 "The spinal nerves control the movement of extraocular muscles." 4 "The autonomic nervous system (ANS) determines the size of the pupil."

4

The nurse shines a light straight toward the bridge of the nose of the patient. A bright dot of light appears at the 3 o'clock position in the left eye and the 9 o'clock position in the right eye. What can the nurse interpret from the finding? 1 Pseudostrabismus 2 Asymmetry in red reflex 3 Lack of consensual light reflex 4 Asymmetry in corneal light reflex

4

Which finding indicates that a patient has a normal and healthy optic disc? 1 The color of the optic disc is gray. 2 The color of the optic disc is red. 3 The color of the optic disc is black. 4 The color of the optic disc is yellow-orange.

4

While assessing a patient with meningitis, the nurse finds that the patient has small and bilaterally irregular pupils and the patient has no problem with the near vision. Which pupillary abnormality should the nurse assess in the patient? 1 Anisocoria 2 Adie's pupil 3 Horner's syndrome 4 Argyll Robertson pupil

4

While assessing a patient, the nurse notices that the patient has a "shadow sign" and an anteriorly pushed iris. Which eye defect does the nurse suspect? 1 Pterygium 2 Hypopyon 3 Corneal abrasion 4 Shallow anterior chamber

4

While assessing the visual reflex of a patient, the nurse exposes the patient's right eye to light. The nurse notices that both eyes constrict at the same time. Which reflex does the nurse find in the left eye of the patient? 1 Red reflex 2 Foveal light reflex 3 Direct light reflex 4 Consensual light reflex

4

While caring for a 4-year-old child with strabismus, the nurse finds that the child has not received proper treatment for this condition. What complication does the nurse expect to find in the child? 1 Myopia 2 Esotropia 3 Exotropia 4 Amblyopia

4

While collecting data on a patient, the nurse observes bright red blood on the patient's left eyeball. On further examination, the nurse finds a round, bright red 1-mm patch over the lateral aspect of the globe. What condition does the nurse suspect in the patient? 1 Conjunctivitis 2 Corneal abrasion 3 Vitreous hemorrhage 4 Subconjunctival hemorrhage

4