Prep U Chapter 11
A client is diagnosed with a scotoma. What question is appropriate for the nurse to ask to obtain more data about this condition?
"Are the blind spots constant or intermittent?" A scotoma is the presence of blind spots that can be constant or intermittent. If they are constant it may indicate retinal detachment. Intermittent blind spots may be due to vascular spasm or pressure on the optic nerve. Floaters are a common finding in individuals with myopia or in person over the age of 40 years and are a sign of normal aging. Redness or tearing is associated with allergies or inflammation of the eye. Night blindness is associated with optic nerve atrophy, glaucoma, or vitamin A deficiency.
You are assessing visual fields on a patient newly admitted for eye surgery. The patient's left eye repeatedly does not see your fingers until they have crossed the line of gaze. You would document that the patient has what?
A left temporal hemianopsia
The nurse is preparing to assess a client's visual fields to evaluate her gross peripheral vision. Which test would the nurse perform?
Confrontation test The confrontation test evaluates peripheral vision. The cover test, corneal light reflex test, and eye position test would be used to evaluate extraocular muscle function.
A nurse examines a client's retina and finds cotton-wool patches. Which of the following would the nurse suspect?
Diabetes Mellitus Cotton-wool patches are associated with diabetes mellitus and hypertension. An enlarged physiologic cup would be associated with glaucoma. A swollen optic disc with blurred margins suggests papilledema. A white optic disc and lack of disc vessels suggests optic atrophy.
Which action by the nurse indicates the appropriate use of ophthalmoscope?
Employ the right eye to examine the client's right eye The nurse should employ the right eye to examine the client's right eye; this action of the nurse indicates the correct use of the ophthalmoscope. The nurse should hold the ophthalmoscope with the left hand and the index finger on the lens wheel. The nurse should ask the client to gaze at an object straight ahead and slightly upward, not downward.
When examining the eye with an ophthalmoscope, where would the nurse look to visualize the optic disc?
Medially toward the nose
During a health history, a 62-year-old male client reveals that he occasionally sees spots before his eyes. The nurse interprets this finding as the result of which of the following?
Normal finding for the clients age Spots or floaters are common among clients with myopia or in clients over age 40. Blind spots or halos would suggest increased intraocular pressure associated with glaucoma. Intermittent blind spots would suggest vascular spasm. Trouble seeing at night would suggest a vitamin A deficiency.
The nurse performs the action shown when assessing a client's eyes. What is the nurse assessing?
Ocular alignment The assessment pictured is the cover test. The cover test assesses ocular alignment. The Jaeger chart is used to assess the near vision. The Snellen chart is used to assess distant vision. Ishihara cards are used to assess color discrimination.
During a client's eye assessment, the nurse is testing for consensual pupillary constriction. Which technique should the nurse implement?
Place a barrier between the client's eyes. When testing for consensual response, the nurse should place a hand or another barrier to light between the client's eyes to avoid an inaccurate finding. Holding a pencil 12 inches from the tip of the nose is appropriate when testing for accommodation. The nurse should shine a light obliquely onto the eye when testing direct pupillary response.
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 The nurse should place an opaque card in between the eyes of the client when assessing the client for consensual response to avoid inaccurate results. The light should not be focused directly into the eye to be tested; it should be focused obliquely into one eye, and the response should be checked in the other eye. The client should not be instructed to close the other eye not focused with light because the response is checked in the other eye.
During a health history, a 48-year-old client states, "I've noticed that I need to hold my newspaper farther away so that I can read it." Which of the following would the nurse suspect?
Presbyopia
When testing the near reaction, an expected finding includes which of the following?
Pupillary constriction on near gaze; dilation on distant gaze
What systemic diseases may cause nodular episcleritis? (Mark all that apply.)
Systemic lupus erythematosus Rheumatoid arthritis If you need a fuller view of the eye, rest your thumb and finger on the bones of the cheek and brow, respectively, and spread the lids. The local redness below is from nodular episcleritis, often self-limiting in younger adults; it is also seen in rheumatoid arthritis and system lupus erythematosus.
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
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
During adolescence, what vision change is common?
nearsightedness
Straight movements of the eye are controlled by the
rectus muscles
OD, OS, OU
right eye, left eye, both eyes
