Nurs 224 Chapter 13 CoursePoint

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The nurse uses the Jaeger test on a patient. What is the nurse assessing? a) Near vision b) Distance vision c) Intraocular pressure d) Color discrimination

a) Near vision

You are assessing visual fields on a client newly admitted for eye surgery. The client's left eye repeatedly does not see your fingers until they have crossed the line of gaze. You would document that the client has what? a) A homonymous hemianopsia b) A left temporal hemianopsia c) A bitemporal hemianopsia d) A quadrantic defect

b) A left temporal hemianopsia

A client complains of excessive tearing of the eyes. Which assessment would the nurse do next? a) Inspect the palpebral conjunctiva. b) Assess the nasolacrimal sac. c) Perform the eye positions test. d) Test pupillary reaction to light.

b) Assess the nasolacrimal sac.

A nurse in the emergency department assesses a client's pupillary reaction and observes pinpoint pupils. The nurse interprets this finding as suggesting which of the following? a) Recent eye trauma b) Narcotic use c) Macular degeneration d) Recent peripheral nervous system injury

b) Narcotic use

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? a) Myopia b) Presbyopia c) Cataracts d) Tropia

b) Presbyopia

The nurse is preparing to assess a client's visual fields to evaluate her gross peripheral vision. Which test would the nurse perform? a) Cover test b) Corneal light reflex test c) Confrontation test d) Eye position test

c) Confrontation test

A nurse is preparing to assess the distant visual acuity of a client who wears reading glasses. Which of the following would be most appropriate? a) Ask the client to remove the glasses before testing. b) Have the client keep the glasses on but occlude one eye. c) Test the client's near visual acuity instead. d) Use the E chart rather than the Snellen chart for testing.

a) Ask the client to remove the glasses before testing.

A nurse inspects the eyes of a young child and notices the inward turning of the eyes. What test should the nurse perform to assess whether this finding is normal or abnormal? a) Corneal light reflex b) Cover test c) Confrontation d) Pupillary reaction to light

a) Corneal light reflex

The nurse selects the tumbling E's chart to assess a client's vision. Which client characteristic caused the nurse to select this chart? a) Does not speak English. b) Being treated for glaucoma. c) Has blue-green color blindness. d) Recovering from cataract surgery.

a) Does not speak English.

While assessing the eye of an adult client, the nurse observes an inward turning of the client's left eye. The nurse should document the client's a) Esotropia b) Strabismus c) Phoria d) Exotropia

a) Esotropia

When performing the cover test, a nurse notices that the client's left eye turns outward. How should the nurse document this finding in the client's record? a) Exotropia b) Esotropia c) Strabismus d) Presbyopia

a) Exotropia

The nurse is preparing to test a client's eyes for accommodation. The nurse would have the client focus on an object in which sequence for this test? a) Far, then near. b) Lateral, then near. c) Near, then far. d) Lateral, then far.

a) Far, then near.

A nurse begins the eye examination on a client who presents to the health care clinic for a routine examination. What is the correct action by the nurse to perform the test for near visual acuity? a) Have the client hold the Jaeger card 14 inches from the face and read with one eye at a time. b) Sit the client in front of the examiner, extend one arm, and slowly move one finger upward. c) Tell the client to remove glasses, if present, and read the Snellen card using both eyes. d) Place the client 20 feet from the Snellen chart and record the smallest line the client can read.

a) Have the client hold the Jaeger card 14 inches from the face and read with one eye at a time.

During adolescence, what vision change is common? a) Nearsightedness b) Color blindness c) Amblyopia d) Presbyopia

a) Nearsightedness

The optic nerves from each eyeball cross at the a) Optic chiasma b) Vitreous humor c) Optic disc d) Visual cortex

a) Optic chiasma

The nurse is preparing to examine an adult client's eyes, using a Snellen chart. The nurse should a) Position the client 609.6 cm (20 ft) away from the chart. b) Ask the client to remove his glasses. c) Ask the client to read each line with both eyes open. d) Instruct the client to begin reading from the bottom of the chart.

a) Position the client 609.6 cm (20 ft) away from the chart.

Which of the following assessment findings suggests a problem with the client's cranial nerves? a) A client states that he has recently begun seeing lights flashing in his field of vision. b) A client's extraocular movements are asymmetrical and she complains of diplopia. c) Fundoscopic examination reveals intraocular bleeding. d) A client's lens appears cloudy and she claims that her visual acuity has recently declined.

b) A client's extraocular movements are asymmetrical and she complains of diplopia.

The functional reflex that allows the eyes to focus on near objects is termed a) Pupillary reflex b) Accommodation c) Refraction d) Indirect reflex

b) Accommodation

The nurse has tested the near visual acuity of a 45-year-old client. The nurse explains to the client that the client has impaired near vision and discusses a possible reason for the condition. The nurse determines that the client has understood the instructions when the client says that presbyopia is usually due to a) Congenital cataracts b) Decreased accommodation c) Muscle weakness d) Constant misalignment of the eyes

b) Decreased accommodation

What eye function is the nurse preparing to assess when the client is asked to stand 20 feet from a specific chart that is mounted on the examination room wall? a) Near vision b) Distant vision c) Peripheral vision d) External eye structures

b) Distant vision

A 29-year-old physical therapist presents for evaluation of an eyelid problem. On observation, the right eyeball appears to be protruding forward. Based on this description, what is the most likely diagnosis? a) Ptosis b) Exophthalmos c) Ectropion d) Epicanthus

b) Exophthalmos

A client's history suggests a need to assess eye muscle strength and cranial nerve function. What assessment should the nurse consequently perform? a) Corneal light reflex test b) Eye positions test c) Cover test d) Visual fields test

b) Eye positions test

A nurse shines a light into one of the client's eyes during an ocular exam and the pupil of the other eye constricts. The nurse interprets this as which of the following? a) Direct reflex b) Optic chiasm c) Consensual response d) Accommodation

c) Consensual response

A client has been diagnosed with astigmatism. The nurse should be prepared to teach the client about which treatment for this condition? a) Surgery b) Daily use of eye drops c) Corrective lenses d) No night driving

c) Corrective lenses

Which of the following would a nurse expect to assess in a client with esotropia? a) Eye turning outward. b) Eye malalignment. c) Eye turning inward. d) Eye oscillating.

c) Eye turning inward.

A client presents to the emergency department after being hit in the head with a baseball bat during a game. The nurse should assess for which condition? a) Blepharitis b) Chalazion c) Hyphema d) Iris nevus

c) Hyphema

A middle-aged client reports difficulty in reading. Which action by the nurse is appropriate to test the near visual acuity using a Jaeger reading card? a) Place the chart 20 feet away from the client on the wall. b) Instruct the client to hold the chart away from the body at arm's length. c) Instruct the client hold the chart 14 inches from the eyes. d) Place the chart on a table 17 inches away from the client.

c) Instruct the client hold the chart 14 inches from the eyes.

A client frequently experiences dry, irritated eyes. These findings are consistent with a problem in what part of the eye? a) Vitreous chamber b) Aqueous chamber c) Lacrimal apparatus d) Sinus

c) Lacrimal apparatus

When testing the near reaction, an expected finding includes which of the following? a) Pupillary dilation on near gaze; dilation on distant gaze. b) Pupillary dilation on near gaze; constriction on distant gaze. c) Pupillary constriction on near gaze; dilation on distant gaze. d) Pupillary constriction on near gaze; constriction on distant gaze.

c) Pupillary constriction on near gaze; dilation on distant gaze.

Photoreceptors of the eye are located in the eye's a) Ciliary body b) Lens c) Retina d) Pupil

c) Retina

A 6-year-old boy has come to the clinic with his mother because of recent eye redness and discharge. The nurse's assessment has suggested a diagnosis of conjunctivitis. What should the nurse tell the mother about her son's eye? a) "In children, this problem is usually caused by an increase in pressure within the eye." b) "I'll prescribe some analgesics because your son is likely to have quite severe pain while his eye heals." c) "Antibiotics will clear this up, but you need to make sure he gets them as ordered to avoid vision damage." d) "This might have been the result of an allergy, but most likely it was caused by a bacteria or virus."

d) "This might have been the result of an allergy, but most likely it was caused by a bacteria or virus."

Which vision acuity reading indicates blindness? a) 20/20 b) 20/40 c) 20/100 d) 20/200

d) 20/200

Which of the following statements most accurately describes the maintenance of normal intraocular pressure? a) The lacrimal gland produces increased fluid when intraocular pressure is low and ceases production when pressure is high. b) The eye is a closed system whose contents of aqueous humor provide consistent internal pressure. c) The muscles of the ciliary body adjust the volume of the eye in response to increased or decreased pressure. d) Aqueous humor is continuously circulating through the eye with production equaling drainage.

d) Aqueous humor is continuously circulating through the eye with production equaling drainage.

Which technique by the nurse demonstrates proper use of the ophthalmoscope? a) Uses right eye to examine the client's left eye. b) Moves the scope around so the entire optic disk may be seen. c) Approaches the client directly in front of the pupil. d) Asks the client to fix the gaze upon an object and look straight ahead.

d) Asks the client to fix the gaze upon an object and look straight ahead.

A client performs the test for distant visual acuity and scores 20/50. How should the nurse most accurately interpret this finding? a) Client did not wear his glasses for this test and therefore it is not accurate. b) When 50 feet from the chart, the client can see better than a person standing at 20 feet. c) Client can read the 20/50 line correctly and two other letters on the line above. d) At 20 feet from the chart, the client sees what a person with good vision can see at 50 feet.

d) At 20 feet from the chart, the client sees what a person with good vision can see at 50 feet.

The chambers of the eye contain aqueous humor, which helps to maintain intraocular pressure and a) Transmit light rays. b) Maintain the retinal vessels. c) Change refractory of the lens. d) Cleanse the cornea and the lens.

d) Cleanse the cornea and the lens.

A client complains of feeling like he is slowly losing his central vision. The nurse knows this symptom could represent a) Open-angle glaucoma b) Hemianopsia c) Retinal detachment d) Macular degeneration

d) Macular degeneration

A nurse notices a middle-aged client in the waiting room pick up a magazine to read while she waits to be seen. She opens the magazine and then extends her arms to move it further from her eyes. Which condition does the nurse most suspect in this client? a) Exotropia b) Esotropia c) Strabismus d) Presbyopia

d) Presbyopia

A client presents to the health care clinic and reports pain in the eyes when working on the computer for long periods of time. The client states that he almost ran into a parked car yesterday because he misjudged the distance from the bumper of his own car. He works for a computer software company and has noticed he is experiencing difficulty reading the manuals that accompany the software he installs for companies. What nursing diagnosis can the nurse confirm based on this data? a) Ineffective Individual Coping b) Disturbed Self Concept c) Self-Care Deficit d) Risk for Injury

d) Risk for Injury

What information should the nurse include when documenting the data associated with the physical examination of a client's eyes? (Select all that apply.) a) Presence of double vision. b) Trauma to the eye. c) Diagnosis of diabetes. d) Shape and size of the pupils. e) Appearance of the optic disc.

d) Shape and size of the pupils. e) Appearance of the optic disc.

A 15-year-old high school student presents to the emergency department with his mother for evaluation of an area of blood in the left eye. He denies trauma or injury but has been coughing forcefully with a recent cold. He denies visual disturbances, eye pain, or discharge from the eye. On physical examination, the pupils are equal, round, and reactive to light with a visual acuity of 20/20 in each eye and 20/20 bilaterally. There is a homogeneous, sharply demarcated area at the lateral aspect of the base of the left eye. The cornea is clear. Based on this description, what is the most likely diagnosis? a) Conjunctivitis b) Acute iritis c) Corneal abrasion d) Subconjunctival hemorrhage

d) Subconjunctival hemorrhage

As part of a physical assessment, the nurse performs the confrontation test to assess the client's peripheral vision. Which test result should a nurse recognize as indicating normal peripheral vision for a client using the confrontation test? a) Client's consensual pupil constricts in response to indirect light. b) Eyes converge on an object as it is moved towards the nose. c) Direct light shown into the client's pupils results in constriction. d) The client and the examiner see the examiner's finger at the same time.

d) The client and the examiner see the examiner's finger at the same time.


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