Adult Nursing - Chapter 63: Assessment and Management of Patients With Eye and Vision Disorders - PrepU

When assessing the pressure of the anterior chamber of the eye, a nurse normally expects to find a pressure of: - 5 to 10 mm Hg. - 20 to 30 mm Hg. - over 30 mm Hg. - 10 to 20 mm Hg.

- 10 to 20 mm Hg.

A patient has had cataract extractions and the nurse is providing discharge instructions. What should the nurse encourage the patient to do at home? - Avoid bending the head below the waist. - Maintain bed rest for 1 week. - Lie on the stomach while sleeping. - Lift weights to increase muscle strength.

- Avoid bending the head below the waist.

Which of the following medications needs to be withheld for 5 to 7 days prior to cataract surgery? - Prednisone - Glucophage - Lasix - Coumadin

- Coumadin

Assessment of visual acuity reveals that the client has blurred vision when looking at distant objects but no difficulty seeing near objects. The nurse documents this as which of the following? - Astigmatism - Myopia - Emmetropia - Hyperopia

- Myopia

To avoid the side effects of corticosteroids, which medication classification is used as an alternative in treating inflammatory conditions of the eyes? - Cycloplegics - Nonsteroidal anti-inflammatory drugs (NSAIDs) - Mydriatics - Miotics

- Nonsteroidal anti-inflammatory drugs (NSAIDs)

Which term refers to swelling of the optic disc due to increased intracranial pressure? - Photophobia - Papilledema - Chemosis - Ptosis

- Papilledema

The nurse is assessing an older client's vision. The nurse integrates knowledge of which of the following during the assessment? - The depth of the eyeball will be increased, leading to myopia. - The skin around the eyes will be more elastic. - Increased fat will be around the orbit. - The power of the lens to accommodate will be decreased.

- The power of the lens to accommodate will be decreased.

A client is color blind. The nurse understands that this client has a problem with: - aqueous humor. - rods. - cones. - lens.

- cones.

A nurse is performing an eye examination. Which question would not be included in the examination? - "Are you able to raise both eyebrows?" - Have you experienced blurred, double, or distorted vision?" - "What medications are you taking?" - "Do any family members have any eye conditions?"

- "Are you able to raise both eyebrows?"

A nurse is giving discharge teaching to a client with an eye injury. Which statement about preventing eye injuries should the nurse include? - "When working in a workshop, you don't need to wear safety goggles unless you're the person using the tools." - "Use a lighter or matches if you need to look at a car battery at night." - "Make sure you stand next to, not in front, of a moving lawn mower." - "Direct all spray nozzles away from your face before spraying."

- "Direct all spray nozzles away from your face before spraying."

Which client statement would lead the nurse to suspect that the client is experiencing bacterial conjunctivitis? - "It feels like there is something stuck in my eye." - "My eyelids were stuck together this morning." - "My eyes feel like they are on fire." - "My eyes hurt when I'm in the bright sunlight."

- "My eyelids were stuck together this morning."

The nurse is giving a visual field examination to a 55-year-old male client. The client asks what this test is for. What would be the nurse's best answer? - "This test measures visual acuity." - "This test measures how well your eyes move." - "This test is to see how well your eyes are aging." - "This test measures peripheral vision and detects gaps in the visual field."

- "This test measures peripheral vision and detects gaps in the visual field."

Which term refers to the absence of the natural lens? - Keratoconus - Aphakia - Scotoma - Hyphema

- Aphakia

The nurse is demonstrating how to perform punctal occlusion. Which activities does the nurse perform? - Holds down the lower lid of the eye by applying pressure on the eyeball and the cheekbone - Applies gentle pressure bilaterally on the bridge of the nose to the inner canthus of each eye - Applies firm pressure to the upper and lower eyelids at the outer edges to keep eyelids in approximation - Applies gentle pressure to the upper eyelid to keep the lid open while telling the client to gaze upward

- Applies gentle pressure bilaterally on the bridge of the nose to the inner canthus of each eye

Following cataract removal, discharge instructions will be provided to the client. Which of the following instructions is most important? - Apply protective patch to both eyes at bedtime. - Only sleep on back. - Avoid washing face and eyes for first 24 hours. - Avoid any activity that can increase intraocular pressure.

- Avoid any activity that can increase intraocular pressure.

A nurse instructs a client to refrain from blinking after administering eye drops based on which rationale? - Blinking keeps substances from entering the eye. - Blinking limits the size of the conjunctival sac for the needed amount of eye drop. - Blinking causes the eye drop to be expelled from the conjunctival sac. - Blinking slows absorption of the instilled eye drops.

- Blinking causes the eye drop to be expelled from the conjunctival sac.

The nurse is administering an ophthalmic ointment to a patient with conjunctivitis. What disadvantage of the application of an ointment does the nurse explain to the patient? - It has more side effects than eye drops. - It does not work as rapidly as eye drops do. - It has a lower concentration than eye drops. - Blurred vision results after application.

- Blurred vision results after application.

The nurse is caring for an older adult client who is frail in appearance. The client has been diagnosed with glaucoma and will be started on eye drops for the condition. Which medication would cause the nurse to call the health care provider before administering the first dose? - Timolol (Betimol) - Brinzolamide (Azopt) - Travoprost (Travatan-Z) - Brimonidine (Alphagan-P)

- Brimonidine (Alphagan-P)

A client has been prescribed eye drops for the treatment of glaucoma. At the yearly follow-up appointment, the client tells the nurse that she has stopped using the medication because her vision did not improve. Which action by the nurse is appropriate? - Administer the medication immediately. - Explain the therapeutic effect and expected outcome of the medication. - Talk with the doctor about switching to a different glaucoma medication. - Refer the patient to the emergency department.

- Explain the therapeutic effect and expected outcome of the medication.

A client has been prescribed eye drops for the treatment of glaucoma. At the yearly follow-up appointment, the client tells the nurse that she has stopped using the medication because her vision did not improve. Which action by the nurse is appropriate? - Refer the patient to the emergency department. - Talk with the doctor about switching to a different glaucoma medication. - Administer the medication immediately. - Explain the therapeutic effect and expected outcome of the medication.

- Explain the therapeutic effect and expected outcome of the medication.

The nurse should monitor for which manifestation in a client who has had LASIK surgery? - Excessive tearing - Cataract formation - Stye formation - Halos and glare

- Halos and glare

Which type of benign tumor of the eyelids is characterized by superficial, vascular capillary lesions that are strawberry-red in color? - Hemangioma - Nevi - Milia - Xanthelasma

- Hemangioma

A client has undergone enucleation. What complication of enucleation should be addressed by the nurse? - Hemorrhage - Pneumonia - Nausea and vomiting - Hypotension

- Hemorrhage

The client with chronic open-angle glaucoma is receiving timolol (Timoptic) eye drops. Which evaluation finding would indicate to the nurse the treatment is working? - Intraocular pressure 15 mm Hg - Halos around lights - Reduced peripheral vision - Decrease in nausea and vomiting

- Intraocular pressure 15 mm Hg

Which surgical procedure involves flattening the anterior curvature of the cornea by removing a stromal lamella? - Laser-assisted in situ keratomileusis (LASIK) - Keratoplasty - Keratoconus - Photorefractive keratectomy (PRK)

- Laser-assisted in situ keratomileusis (LASIK)

The nurse is reviewing the medical record of a client with glaucoma. Which of the following would alert the nurse to suspect that the client was at increased risk for this disorder? - Hyperopia since age 20 years - History of respiratory disease - Age younger than 40 years - Prolonged use of corticosteroids

- Prolonged use of corticosteroids

The nurse is caring for a client ordered for multiple eye screening. Following which procedure will the nurse instruct the client on a yellow coloring to the skin and urine as being normal? - Retinal Angiography - Ultrasonography - Retinal Imaging - Retinoscopy

- Retinal Angiography

Which of the following surgical procedures involves taking a piece of silicone plastic or sponge and sewing it onto the sclera at the site of a retinal tear? - Phacoemulsification - Pneumatic retinopexy - Pars plana vitrectomy - Scleral buckle

- Scleral buckle

A patient presents to an eye clinic with a number of symptoms related to his diminished vision. An initial history leads the nurse practitioner to suspect that the patient has acute angle-closure glaucoma. Which of the following symptoms would apply to this diagnosis? Select all that apply. - Severe eye pain - Gradual loss of peripheral vision - Reddening of the eye - Tunnel vision - Sudden onset of visual disturbance - Nausea and vomiting

- Severe eye pain - Reddening of the eye - Sudden onset of visual disturbance - Nausea and vomiting

A nurse is assessing a pediatric client in a public health clinic. The parent states that the client has been sneezing and rubbing the eyes. The nurses observes the client's eyes and documents objective symptoms of watery and red eyes. When reporting to the physician the assessment findings, which word is appropriate? - Signs and symptoms of ptosis - Signs and symptoms of conjunctivitis - Signs and symptoms of proptosis - Signs and symptoms of nystagmus

- Signs and symptoms of conjunctivitis

An older adult patient informs the nurse, "I don't see as well as I used to." What should the nurse explain to the patient about why vision becomes less efficient with age? Select all the apply. - There is an increase in lens opaqueness. - There is slowing of accommodation. - The optic nerve begins to degenerate. - Most older patients develop glaucoma. - There is a decrease in pupil size.

- There is an increase in lens opaqueness. - There is slowing of accommodation. - There is a decrease in pupil size.

A young client is being seen by a pediatric ophthalmologist due to a recent skateboarding accident that resulted in trauma to the right cornea, and is now at risk of developing an infection. Which nursing intervention would be contraindicated for a client at risk for infection? - To ensure correct application of antibiotic ointment, gently drag tip of tube along lower lid while squeezing ointment on to lid. - Avoid using a container of ophthalmic medication for anyone other than the client. - Wash hands before examining the eyes or performing any procedure about the face. - Change gauze eye bandages using aseptic technique.

- To ensure correct application of antibiotic ointment, gently drag tip of tube along lower lid while squeezing ointment on to lid.

Which of the following types of conjunctivitis is preceded by symptoms of an upper respiratory infection? - Viral - Vernal - Toxic - Allergic

- Viral

A client has just been diagnosed with early glaucoma. During a teaching session, the nurse should: - assess the client's visual acuity. - teach about intraocular lens cleaning. - provide instructions on eye patching. - demonstrate eyedrop instillation.

- demonstrate eyedrop instillation.

A client suffered trauma to the sclera and is being treated for a subsequent infection. During client education, the nurse indicates where the sclera is attached. Which structure would not be included? - pupil - cornea - eyelids - iris

- eyelids

When obtaining the health history from a client with retinal detachment, a nurse expects the client to report: - headaches, nausea, and redness of the eyes. - light flashes and floaters in front of the eye. - frequent episodes of double vision. - a recent driving accident while changing lanes.

- light flashes and floaters in front of the eye.

A client has developed diabetic retinopathy and is seeing the physician regularly to prevent further loss of sight. From where do the nerve cells of the retina extend? - oculomotor nerve - trochlear nerve - optic nerve - trigeminal nerve

- optic nerve

A client with multiple sclerosis is being seen by a neuroophthalmologist for a routine eye exam. The nurse explains to the client that during the examination, the client will be asked to maintain a fixed gaze on a stationary point while an object is moved from a point on the side, where it can't be seen, toward the center. The client will indicate when the object becomes visible The nurse further explains that the test being performed is called a: - color vision test - retinal angiography - slit-lamp examination - perimetry test

- perimetry test

The nurse realizes that a client understands how to correctly instill ophthalmic medications when the client: - wipes the lids and lashes prior to instillation in a direction toward the nose with moistened, soft gauze. - pulls the tissue near the cheek downward to instill medication. - rubs the eye after administering medication. - allows the tip of the container to touch the eyelid while administering the medication.

- pulls the tissue near the cheek downward to instill medication.

After a fall at home, a client hits their head on the corner of a table. Shortly after the accident, the client arrives at the ED, unable to see out of their left eye. The client tells the nurse that symptoms began with seeing spots or moving particles in the field of vision but that there was no pain in the eye. The client is very upset that the vision will not return. What is the most likely cause of this client's symptoms? - eye trauma - angle-closure glaucoma - chalazion - retinal detachment

- retinal detachment

When the client tells the nurse that his vision is 20/200 and then asks what that means, the nurse informs the client that a person with 20/200 vision - sees an object from 200 feet away that a person with normal vision sees from 20 feet away. - sees an object from 20 feet away that a person with normal vision sees from 200 feet away. - sees an object from 20 feet away just like a person with normal vision. - sees an object from 200 feet away just like a person with normal vision.

- sees an object from 20 feet away that a person with normal vision sees from 200 feet away.

The ophthalmologist tells a patient that he has increased intraocular pressure (IOP). The nurse understands that increased pressure resulting from optic nerve damage is indicated by a reading of: - 6 to 10 mm Hg. - 11 to 20 mm Hg. - 0 to 5 mm Hg. - >21 mm Hg.

- >21 mm Hg.

The nurse is establishing a visual test using the Snellen chart for a client experiencing visual changes. At which distance should the nurse instruct the client to stand? - A 30-feet distance - A 10-feet distance - A 20-feet distance - A 40-feet distance

- A 20-feet distance

A patient comes to the clinic with a suspected eye infection. The nurse recognizes that the patient most likely has conjunctivitis, as evidenced by what symptom? - Blurred vision - Elevated IOP - Severe pain - A mucopurulent ocular discharge

- A mucopurulent ocular discharge

Which type of glaucoma presents an ocular emergency? - Normal tension glaucoma - Ocular hypertension - Acute angle-closure glaucoma - Chronic open-angle glaucoma

- Acute angle-closure glaucoma

Which type of glaucoma presents an ocular emergency? - Ocular hypertension - Acute angle-closure glaucoma - Chronic open-angle glaucoma - Normal tension glaucoma

- Acute angle-closure glaucoma

A client's vision is assessed at 20/200. The client asks what that means. Which is the most appropriate response by the nurse? - "You see an object from 20 feet away just like a person with normal vision." - "You see an object from 200 feet away that a person with normal vision sees from 20 feet away." - "You see an object from 200 feet away just like a person with normal vision." - "You see an object from 20 feet away that a person with normal vision sees from 200 feet away."

- "You see an object from 20 feet away that a person with normal vision sees from 200 feet away."

It is determined that a patient is legally blind and will be unable to drive any longer. Legal blindness refers to a best-corrected visual acuity (BCVA) that does not exceed what reading in the better eye? - 20/100 - 20/200 - 20/50 - 20/150

- 20/200

A client has undergone tonometry to evaluate for possible glaucoma. Which result would the nurse record as abnormal? - 20 mm Hg - 25 mm Hg - 15 mm Hg - 10 mm Hg

- 25 mm Hg

On ocular examination, the health care provider notes severely elevated IOP, corneal edema, and a pupil that is fixed in a semi-dilated position. The nurse knows that these clinical signs are diagnostic of the type of glaucoma known as: - Chronic open-angle. - Normal tension. - Acute angle-closure. - Chronic angle-closure.

- Acute angle-closure.

A major role for nursing in the management of glaucoma is health education. Which of the following is the most important teaching point that the nurse should advise the patient of? - Keep all follow-up appointments. - Adhere to the medication regimen. - Participate in the decision-making process. - Keep a record of eye pressure measurements.

- Adhere to the medication regimen.

Which surgical procedure involves flattening the anterior curvature of the cornea by removing a stromal lamella layer? - Keratoplasty - Laser-assisted stromal in situ keratomileusis (LASIK) - Photorefractive keratectomy (PRK) - Keratoconus

- Laser-assisted stromal in situ keratomileusis (LASIK)

A client is diagnosed with an exudative retinal detachment. When reviewing the client's history, the nurse would identify which of the following as a possible underlying cause? - Diabetes - Trauma - Macular degeneration - Hypertension

- Macular degeneration

The nurse is performing an assessment of the visual fields for a patient with glaucoma. When assessing the visual fields in acute glaucoma, what would the nurse expect to find? - Constricted pupil - Marked blurring of vision - Clear cornea - Watery ocular discharge

- Marked blurring of vision

During an initial assessment, the nurse notes a symptom of a mild case of bacterial conjunctivitis and documents in the electronic medical record that the client is displaying which of the following ? - Blurred vision - Elevated intraocular pressure - Severe pain - Mucopurulent ocular discharge

- Mucopurulent ocular discharge

A nurse notices that a client's left upper eyelid is drooping. The nurse has observed: - ptolemy - ptosis - proptosis - nystagmus

- ptosis