Assessing Eyes

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A nurse examines a client's retina during the ophthalmic examination and notices light-colored spots on the retinal background. The nurse should ask the client about a history of what disease process? 1. Anemia 2. Renal insufficiency 3. Diabetes 4. Retinal detachment

3. Diabetes

A client frequently experiences dry, irritated eyes. These findings are consistent with a problem in what part of the eye? 1. Vitreous chamber 2. Aqueous chamber 3. Lacrimal apparatus 4. Sinus

3. Lacrimal apparatus

When testing the near reaction, an expected finding includes which of the following? 1. Pupillary dilation on near gaze; dilation on distant gaze 2. Pupillary dilation on near gaze; constriction on distant gaze 3. Pupillary constriction on near gaze; dilation on distant gaze 5. Pupillary constriction on near gaze; constriction on distant gaze

3. Pupillary constriction on near gaze; dilation on distant gaze

A client is being assessed for indications of a possible obstructed nasolacrimal duct in the right eye. Under what circumstances should the nurse avoid compressing the lacrimal sac? 1. Mucopurulent fluid is observed near the sac. 2. There is excessive tearing in the right eye. 3. The area around the sac is inflamed. 4. The client reports experiencing floaters.

3. The area around the sac is inflamed.

What notation demonstrates the nurses understanding of effective documentation when the assessment findings identify thick, purulent drainage in both eyes of a client? 1. Thick, purulent drainage is noted at inner corner of OD. 2. Thick, purulent drainage is noted at inner corner of OS. 3. Thick, purulent drainage is noted at inner corner of OU. 4. Thick, purulent drainage is noted at inner corner of both eyes.

4. Thick, purulent drainage is noted at inner corner of both eyes.

The conjunctiva of the eye is divided into the palpebral portion and the 1. canthus portion. 2. intraocular portion. 3. nasolacrimal portion. 4. bulbar portion.

4. bulbar portion.

An adult client visits the clinic and tells the nurse that he has had excessive tearing in his left eye. The nurse should assess the client's eye for 1. viral infection. 2. double vision. 3. allergic reactions. 4. lacrimal obstruction.

4. lacrimal obstruction.

What do retinal abnormalities include? 1. Age-related macular degeneration 2. Mydriasis 3. Argyll Robertson syndrome 4. Horner's syndrome

1. Age-related macular degeneration

A nurse assesses the parallel alignment of a client's eyes by testing the corneal light reflex. Where should the nurse shine the penlight to obtain an accurate result? 1. Focused on the bridge of the nose 2. Directly on the eye being examined 3. Pointed at a fixed object on the wall 4. Shined on the forehead

1. Focused on the bridge of the nose

A teenager is brought to the clinic for a sports physical examination. The client states plans to play goalie on the community soccer team. What is the most important teaching opportunity presented for this client? 1. Use of safety equipment 2. Prevention of knee injuries 3. Prevention of head injuries 4. Use of correct foot gear

1. Use of safety equipment

The nurse should make it a priority to assess which client for papilledema? 1. a 45-year-old suspected of experiencing a subarachnoid hemorrhage 2. an 80-year-old diagnosed with chronic open-angle glaucoma 3. a 12-year-old demonstrating a deviated left eye 4. a 56-year-old reporting double vision

1. a 45-year-old suspected of experiencing a subarachnoid hemorrhage

The optic nerves from each eyeball cross at the 1. optic chiasma. 2. vitreous humor. 3. optic disc. 4. visual cortex.

1. optic chiasma.

A client is diagnosed with a scotoma. What question is appropriate for the nurse to ask to obtain more data about this condition? 1. "Do you see floaters in front of your eyes?" 2. "Are the blind spots constant or intermittent?" 3. "How often do you have redness or tearing?" 4. "Is night blindness a problem for you?"

2. "Are the blind spots constant or intermittent?"

A client presents to a primary care office with a complaint of double vision (diplopia). On questioning, the client claims to have not suffered any head injuries. Which of the following underlying conditions should the nurse most suspect in this client? 1. Vitamin A deficiency 2. Brain tumor 3. Allergies 4. Viral infection

2. Brain tumor

An adult client tells the nurse that his father had cataracts. He asks the nurse about risk factors for cataracts. Which of the following should the nurse mention to the client as potential risk factors? Select all that apply. 1. Lack of vitamin C in the diet. 2. Ultraviolet light exposure. 3. Obesity. 4. Use of antibiotics.

2. Ultraviolet light exposure. 3. Obesity.

A client has an abnormal consensual pupillary reaction to light. A nurse understands that what reaction occurs in the client's eyes? 1. Pupils dilate in response to a light shone in the eyes. 2. Eyes do not converge to focus on a shining light. 3. There is no reaction in the opposite pupil to light. 4. Light reflection appears at different spots on both eyes.

3. There is no reaction in the opposite pupil to light.

The nurse notes that the pupil of a client's left eye constricts when a light is shined into the right eye. How should the nurse document this finding? 1. direct light response present in left eye 2. pupils equal and react to accommodation 3. consensual light response present in left eye 4. consensual light response present in right eye

3. consensual light response present in left eye

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? 1. "In children, this problem is usually caused by an increase in pressure within the eye." 2. "I'll prescribe some analgesics because your son is likely to have quite severe pain while his eye heals." 3. "Antibiotics will clear this up, but you need to make sure he gets them as ordered to avoid vision damage." 4. "This might have been the result of an allergy, but most likely it was caused by a bacteria or virus."

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

What information should the nurse include when documenting the data associated with the physical examination of a client's eyes? (Select all that apply.) 1. Presence of double vision 2. Trauma to the eye 3. Diagnosis of diabetes 4. Shape and size of the pupils 5. Appearance of the optic disc

4. Shape and size of the pupils 5. Appearance of the optic disc

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? 1. Client's consensual pupil constricts in response to indirect light. 2. Eyes converge on an object as it is moved towards the nose. 3. Direct light shown into the client's pupils results in constriction. 4. The client and the examiner see the examiner's finger at the same time.

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


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