NS 211 - Visual Study Guide
b. between the lens and retina.
1. In a patient who has a hemorrhage in the posterior cavity of the eye, the nurse knows that blood is accumulating a. in the aqueous humor. b. between the lens and retina. c. between the cornea and lens. d. in the space between the iris and lens.
With the right eye, the patient standing at 20 feet from a Snellen chart can read to the 40-foot line on the chart with 2 or fewer errors With the left eye, the patient can read only to the 50-foot line on the chart. This patient can read at 20 feet what a person with normal vision can read at 40 and 50 feet
10. Describe what is meant by the finding that the patient has a visual acuity of OD: 20/40; OS: 20/50.
a. Protective sunglasses when bicycling b. Taking part in a smoking cessation program c. Supplementing diet intake of vitamin C and beta-carotene d. Washing hands thoroughly before putting in or taking out contact lenses
10. Which patient behaviors would the nurse promote for healthy eyes (select all that apply)? a. Protective sunglasses when bicycling b. Taking part in a smoking cessation program c. Supplementing diet intake of vitamin C and beta-carotene d. Washing hands thoroughly before putting in or taking out contact lenses e. A woman avoiding pregnancy for 4 weeks after receiving MMR immunization
d. teaching the patient and caregivers good hygiene techniques.
11. The most important intervention for the patient with epidemic keratoconjunctivitis is a. cleansing the affected area with baby shampoo. b. monitoring spread of infection to the opposing eye. c. regular instillation of artificial tears to the affected eye. d. teaching the patient and caregivers good hygiene techniques.
d. Constriction of the pupils when an object is brought closer to the eyes
11. The nurse documents PERRLA following assessment of a patient's eyes. What assessment finding supports this statement? a. A slightly oval shape of the pupils b. The presence of nystagmus on far lateral gaze c. Dilation of the pupil when a light is shined in the opposite eye d. Constriction of the pupils when an object is brought closer to the eyes
a. corneal light reflex and cardinal field of gaze
12. Identify the assessment techniques used to obtain the following assessment data. Extraocular muscle functions: a. corneal light reflex and cardinal field of gaze b. snellen chart c. tono-pen or other tonometry equipment d. confrontation test e. jaeger chart
c. tono-pen or other tonometry equipment
12. Identify the assessment techniques used to obtain the following assessment data. Intraocular pressure a. corneal light reflex and cardinal field of gaze b. snellen chart c. tono-pen or other tonometry equipment d. confrontation test e. jaeger chart
e. jaeger chart
12. Identify the assessment techniques used to obtain the following assessment data. Near visual acuity: a. corneal light reflex and cardinal field of gaze b. snellen chart c. tono-pen or other tonometry equipment d. confrontation test e. jaeger chart
d. confrontation test
12. Identify the assessment techniques used to obtain the following assessment data. Peripheral vision field a. corneal light reflex and cardinal field of gaze b. snellen chart c. tono-pen or other tonometry equipment d. confrontation test e. jaeger chart
b. snellen chart
12. Identify the assessment techniques used to obtain the following assessment data. Visual acuity: a. corneal light reflex and cardinal field of gaze b. snellen chart c. tono-pen or other tonometry equipment d. confrontation test e. jaeger chart
c. a history of heart or lung disease.
3. Ask patients using eyedrops to treat their glaucoma about a. use of corrective lenses. b. their usual sleep pattern. c. a history of heart or lung disease. d. sensitivity to opioids or depressants.
c. Protective outer layer of the eyeball
3. What is the function of the sclera? a. Secrete aqueous humor b. Focus light rays on the retina c. Protective outer layer of the eyeball d. Photoreceptor cells stimulated in dim environments
C. deposition of lipids
7. Identify the causes of the following assessment findings of the eye that are associated with aging. Yellowish sclera: A. decreased tear secretion or composition B. increased rigidity of iris C. deposition of lipids D. chronic exposure to ultraviolet (UV) light or other environmental irritants E. vitreous liquefaction and retinal holes or tears F. cholesterol deposits in the peripheral cornea G. decrease in number of cones H. loss of orbital fat
c. "The cornea of the eye is uneven or irregular with astigmatism."
8. A patient says she was diagnosed with astigmatism. When she asks what that is, what is the best explanation the nurse can give to the patient? a. "It happens because the lens of the eye is absent." b. "People with astigmatism have abnormally long eyeballs." c. "The cornea of the eye is uneven or irregular with astigmatism." d. "Astigmatism occurs because the eye muscles weaken with age."
a. Corticosteroids
8. Priority Decision: When obtaining a health history from a patient with cataracts, it is most important for the nurse to ask about the patient's use of which drug? a. Corticosteroids b. Oral hypoglycemic agents c. β-Adrenergic blocking agents d. Antihistamines and decongestants
a. Allow the patient to express feelings of grief and anger.
9. Which intervention would be part of the plan of care for a patient who has new vision loss? a. Allow the patient to express feelings of grief and anger. b. Have the UAP perform all self-care activities for the patient. c. Address any family present first when discussing care concerns. d. Speak loudly and clearly, addressing the patient with each contact.
Lens
A
Iris
B
a. Keratitis
27. When the patient describes inflammation of the cornea, what does the nurse know this is called? a. Keratitis b. Blepharitis c. Hordeolum d. Conjunctivitis
a. Eye discomfort is often relieved with mild analgesics. d. Notify the provider if an increase in redness or drainage occurs. e. Following activity restrictions is essential to reduce intraocular pressure.
12. What should be included in the discharge teaching for the patient who had cataract surgery (select all that apply)? a. Eye discomfort is often relieved with mild analgesics. b. A decline in visual acuity is common for the first week. c. Stay on bed rest and limit activity for the first few days. d. Notify the provider if an increase in redness or drainage occurs. e. Following activity restrictions is essential to reduce intraocular pressure.
b. Older persons
13. In which patients should the nurse expect to find a yellow cast to the sclera? a. Infants b. Older persons c. Persons with brown irises d. Patients with eye infections
b. Fluorescein dye
14. To determine the presence of corneal abrasions or defects in a patient with an eye injury, what would the nurse provide? a. A tonometer b. Fluorescein dye c. Pocket penlight d. An ophthalmoscope
a. Ptosis c. Blepharitis
15. What are possible abnormal assessment findings when assessing the eyelid (select all that apply)? a. Ptosis b. Strabismus c. Blepharitis d. Anisocoria e. Swollen pinna
c. Protrusion of eyeball
16. When the patient has a diagnosis of hyperthyroidism, which abnormal assessment of the eye could be found? a. Light intolerance b. Unequal pupil size c. Protrusion of eyeball d. Deviation of eye position
c. A break in the retina at the site of the macula
17. When examining the patient's eye with an ophthalmoscope, the nurse would consider which finding to be of most concern? a. No blood vessels in the macula b. Depression at the center of the optic disc c. A break in the retina at the site of the macula d. Pieces of liquefied vitreous in the vitreous chamber
b. Involves IV dye injection to evaluate blood flow through retinal blood vessels
18. To prepare a patient for a fluorescein angiography, what should the nurse explain about the test? a. Measures curvature of the cornea b. Involves IV dye injection to evaluate blood flow through retinal blood vessels c. Includes application of eye drops containing a dye that will localize arterial abnormalities in the retina d. Anesthetizes the eye so that probes can be inserted into the anterior chamber to measure intraocular pressure
a. Excessive light refraction d. Corrected with concave lens e. Image focused in front of retina
19. Myopia is present in 30% of Americans. Which characteristics are associated with myopia (select all that apply)? a. Excessive light refraction b. Abnormally short eyeball c. Unequal corneal curvature d. Corrected with concave lens e. Image focused in front of retina
d. increased aqueous humor production by the ciliary process.
2. Increased intraocular pressure may occur because of a. edema of the corneal stroma. b. dilation of the retinal arterioles. c. blockage of the lacrimal canals and ducts. d. increased aqueous humor production by the ciliary process.
d. Vitreous humor
2. What is in the posterior cavity of the eye? a. Zonules b. Cornea c. Aqueous humor d. Vitreous humor
d. Loss of accommodation associated with age
20. The patient is diagnosed with presbyopia. When he asks the nurse what that is, what is the best explanation the nurse can give to the patient? a. Absence of the lens b. Abnormally long eyeballs c. Correctable with cylinder lens d. Loss of accommodation associated with age
a. Use a penlight to shine a light obliquely over the eyeball.
21. To determine if an unconscious patient has contact lenses in place, what should the nurse do? a. Use a penlight to shine a light obliquely over the eyeball. b. Apply drops of fluorescein dye to the eye to stain the lenses yellow. c. Touch the cornea lightly with a dry cotton ball to see if the patient reacts. d. Tense the lateral canthus to cause a lens to be ejected if it is present in the eye.
a. LASIK d. Intraocular lens implantation e. Photorefractive keratectomy (PRK)
22. What surgical choices are available for correction of a refractive error (select all that apply)? a. LASIK b. Contact lenses c. Corrective lenses d. Intraocular lens implantation e. Photorefractive keratectomy (PRK)
d. May be able to perform many tasks
23. A patient tells the nurse on admission to the health care facility that he has finally been classified as legally blind. What does the nurse understand about the patient's vision? a. Has lost usable vision but has some light perception b. Will need time for grieving and adjusting to living with total blindness c. Will be dependent on others to ensure a safe environment for functioning d. May be able to perform many tasks and activities with vision enhancement techniques
1) Address the patient, not others with the patient, in normal conversational tones 2) Face the patient and make eye contact 3) Introduce self when approaching the patient and let the patient know when you are leaving 4) Orient to sounds, activities, and physical surroundings 5) Use sight-guided technique to ambulate and orient patient
24. Identify 5 nursing measures that should be implemented to increase a visually impaired patient's safety and comfort.
c. Cover the eye with a dry sterile patch and a protective shield.
25. Priority Decision: A patient is admitted to the emergency department with a wood splinter imbedded in the right eye. Which intervention by the nurse is most appropriate? a. Irrigate the eye with a large amount of sterile saline. b. Carefully remove the splinter with a pair of sterile forceps. c. Cover the eye with a dry sterile patch and a protective shield. d. Apply light pressure on the closed eye to prevent bleeding or loss of aqueous humor.
b. Acute bacterial conjunctivitis
26. What best describes pink eye? a. Blindness b. Acute bacterial conjunctivitis c. Epidemic keratoconjunctivitis d. Chronic inflammation of sebaceous glands
d. Vision enhancement techniques may improve vision until surgery becomes an acceptable way to maintain desired activities.
30. A patient with early cataracts tells the nurse that he is afraid cataract surgery may cause permanent visual damage. What should the nurse teach the patient? a. The cataracts will only worsen with time and should be removed as early as possible to prevent blindness. b. Cataract surgery is very safe, and with the implantation of an intraocular lens, the need for glasses will be eliminated. c. Progression of the cataracts can be prevented by avoidance of ultraviolet (UV) light and good dietary management. d. Vision enhancement techniques may improve vision until surgery becomes an acceptable way to maintain desired activities.
c. A gradual loss of vision with abnormal color perception and glare
31. A 60-year-old patient is being prepared for outpatient cataract surgery. When obtaining admission data from the patient, what would the nurse expect to find in the patient's history? a. A painless, sudden, severe loss of vision b. Blurred vision, colored halos around lights, and eye pain c. A gradual loss of vision with abnormal color perception and glare d. Light flashes, floaters, and a "cobweb" in the field of vision with loss of central or peripheral vision
a. Assess the visual acuity in the unoperated eye to plan the need for postoperative assistance.
32. A patient with bilateral cataracts is scheduled for an extracapsular cataract extraction with an intraocular lens implantation of 1 eye. What should be done by the nurse preoperatively? a. Assess the visual acuity in the unoperated eye to plan the need for postoperative assistance. b. Inform the patient that the operative eye will need to be patched for 3 to 4 days postoperatively. c. Assure the patient that vision in the operative eye will be improved to near normal on the first postoperative day. d. Teach the patient routine coughing and deep-breathing techniques to use postoperatively to prevent respiratory complications.
a. Cryopexy d. Laser photocoagulation
33. For the patient with a retinal break, what extraocular techniques may be used with sclera buckling to seal the break by creating an inflammatory reaction that causes a chorioretinal adhesion or scar (select all that apply)? a. Cryopexy b. Vitrectomy c. Pneumatic retinopexy d. Laser photocoagulation e. Penetrating keratoplasty
b. Emphasize the use of vision enhancement techniques to improve what vision is present.
35. Priority Decision: What nursing action is most important for the patient with age-related dry macular degeneration (AMD)? a. Teach the patient how to use topical eyedrops for treatment of AMD. b. Emphasize the use of vision enhancement techniques to improve what vision is present. c. Encourage the patient to undergo laser treatment to slow the deposit of extracellular debris. d. Explain that nothing can be done to save the patient's vision because there is no treatment for AMD.
c. Completely cover all the skin to avoid a thermal burn from sunlight.
36. A patient with wet AMD is treated with photodynamic therapy. What does the nurse instruct the patient to do after the procedure? a. Maintain the head in an upright position for 24 hours. b. Avoid blowing the nose or causing jerking movements of the head. c. Completely cover all the skin to avoid a thermal burn from sunlight. d. Expect to experience blind spots where the laser has caused retinal damage.
c. Promote measurements of intraocular pressure every 2 to 4 years for early detection and treatment of glaucoma.
37. What is an important health promotion nursing intervention for a middle-aged adult related to glaucoma? a. Teach people at risk for glaucoma about early signs and symptoms of the disease. b. Prepare patients with glaucoma for lifestyle changes necessary to adapt to eventual blindness. c. Promote measurements of intraocular pressure every 2 to 4 years for early detection and treatment of glaucoma. d. Inform patients that glaucoma is curable if eye medications are administered before visual impairment has occurred.
a. Gradual loss of peripheral vision d. May be caused by increased production of aqueous humor f. Resistance to aqueous outflow through trabecular meshwork
38. When teaching the patient about the new diagnosis of glaucoma, which characteristics relate only to primary open-angle glaucoma (POAG) (select all that apply)? a. Gradual loss of peripheral vision b. Treated with iridotomy or iridectomy c. Causes loss of central vision with corneal edema d. May be caused by increased production of aqueous humor e. Treated with cholinergic agents, such as pilocarpine (Pilocar) f. Resistance to aqueous outflow through trabecular meshwork
a. Caused by lens blocking papillary opening c. Causes loss of central vision with corneal edema e. Causes sudden, severe eye pain associated with nausea and vomiting f. Treated with hyperosmotic oral and IV fluids to lower intraocular pressure
39. Which characteristics of glaucoma are associated with only acute primary angle-closure glaucoma (PACG) (select all that apply)? a. Caused by lens blocking papillary opening b. Treated with trabeculoplasty or trabeculectomy c. Causes loss of central vision with corneal edema d. Treated with β-adrenergic blockers, such as betaxolol (Betoptic) e. Causes sudden, severe eye pain associated with nausea and vomiting f. Treated with hyperosmotic oral and IV fluids to lower intraocular pressure
a. visual acuity.
4. Always assess the patient with an eye problem for a. visual acuity. b. pupillary reactions. c. intraocular pressure. d. confrontation visual fields.
c. Transparent mucous membrane lining the eyelids
4. What accurately describes the conjunctiva? a. Junction of the upper and lower eyelids b. Point where the optic nerve exits the eyeball c. Transparent mucous membrane lining the eyelids d. Drains tears from the surface of the eye into the lacrimal canals
d. Small, white nodule on the upper lid margin
5. When examining the patient's eyes, which finding would be of most concern to the nurse? a. Intraocular pressure of 16 mm/Hg b. Slightly yellowish cast of the sclera c. Outward turning of the lower lid margin d. Small, white nodule on the upper lid margin
CN VII
6. Identify the cranial nerves that are responsible for the following eye functions. Closing eyelids
CN III
6. Identify the cranial nerves that are responsible for the following eye functions. Elevating eyelids
CN II
6. Identify the cranial nerves that are responsible for the following eye functions. Visual acuity
b. the lens becomes inflexible.
6. Presbyopia occurs in older people because a. the eyeball elongates. b. the lens becomes inflexible. c. the corneal curvature becomes irregular. d. light rays are focusing in front of the retina.
a. obtain an emesis basin. d. inform patient that skin may turn yellow.
7. Before injecting fluorescein for angiography, it is important for the nurse to (select all that apply) a. obtain an emesis basin. b. ask if the patient is fatigued. c. administer a topical anesthetic. d. inform patient that skin may turn yellow. e. assess for allergies to iodine-based contrast media.
F. cholesterol deposits in the peripheral cornea
7. Identify the causes of the following assessment findings of the eye that are associated with aging. Arcus senilis: A. decreased tear secretion or composition B. increased rigidity of iris C. deposition of lipids D. chronic exposure to ultraviolet (UV) light or other environmental irritants E. vitreous liquefaction and retinal holes or tears F. cholesterol deposits in the peripheral cornea G. decrease in number of cones H. loss of orbital fat
G. decrease in number of cones
7. Identify the causes of the following assessment findings of the eye that are associated with aging. Changes in color perception: A. decreased tear secretion or composition B. increased rigidity of iris C. deposition of lipids D. chronic exposure to ultraviolet (UV) light or other environmental irritants E. vitreous liquefaction and retinal holes or tears F. cholesterol deposits in the peripheral cornea G. decrease in number of cones H. loss of orbital fat
B. increased rigidity of iris
7. Identify the causes of the following assessment findings of the eye that are associated with aging. Decreased pupil size: A. decreased tear secretion or composition B. increased rigidity of iris C. deposition of lipids D. chronic exposure to ultraviolet (UV) light or other environmental irritants E. vitreous liquefaction and retinal holes or tears F. cholesterol deposits in the peripheral cornea G. decrease in number of cones H. loss of orbital fat
A. decreased tear secretion or composition
7. Identify the causes of the following assessment findings of the eye that are associated with aging. Dry, irritated eyes: A. decreased tear secretion or composition B. increased rigidity of iris C. deposition of lipids D. chronic exposure to ultraviolet (UV) light or other environmental irritants E. vitreous liquefaction and retinal holes or tears F. cholesterol deposits in the peripheral cornea G. decrease in number of cones H. loss of orbital fat
H. loss of orbital fat
7. Identify the causes of the following assessment findings of the eye that are associated with aging. Ectropion: A. decreased tear secretion or composition B. increased rigidity of iris C. deposition of lipids D. chronic exposure to ultraviolet (UV) light or other environmental irritants E. vitreous liquefaction and retinal holes or tears F. cholesterol deposits in the peripheral cornea G. decrease in number of cones H. loss of orbital fat
E. vitreous liquefaction and retinal holes or tears
7. Identify the causes of the following assessment findings of the eye that are associated with aging. Floaters: A. decreased tear secretion or composition B. increased rigidity of iris C. deposition of lipids D. chronic exposure to ultraviolet (UV) light or other environmental irritants E. vitreous liquefaction and retinal holes or tears F. cholesterol deposits in the peripheral cornea G. decrease in number of cones H. loss of orbital fat
D. chronic exposure to ultraviolet (UV) light or other environmental irritants
7. Identify the causes of the following assessment findings of the eye that are associated with aging. Pinguecula: A. decreased tear secretion or composition B. increased rigidity of iris C. deposition of lipids D. chronic exposure to ultraviolet (UV) light or other environmental irritants E. vitreous liquefaction and retinal holes or tears F. cholesterol deposits in the peripheral cornea G. decrease in number of cones H. loss of orbital fat
Pupil
E
Cornea
C
Anterior chamber
D
Posterior chamber
F
Ciliary body
G
Vitreous humor
H
Optic disc
I
Optic nerve
J
Retina
K
Choroid
L
Sclera
M
