Question 1

The nurse is reviewing causes of increased intraocular pressure. Which of these factors determines intraocular pressure?

Accepted Answer

A)  Thickness or bulging of the lens 
B)  Posterior chamber as it accommodates increased fluid 
C)  Contraction of the ciliary body in response to the aqueous within the eye 
D)  Amount of aqueous produced and resistance to its outflow at the angle of the anterior chamber

Question 2

A 60-year-old man is at the clinic for an eye examination. The nurse suspects that he has ptosis of one eye. How should the nurse check for this?

Accepted Answer

A)  Perform the confrontation test. 
B)  Assess the individual's near vision. 
C)  Observe the distance between the palpebral fissures. 
D)  Perform the corneal light test, and look for symmetry of the light reflex.

Question 3

The nurse is testing a patient's visual accommodation. How is accommodation assessed?

Accepted Answer

A)  Pupillary dilation when looking at a distant object 
B)  Involuntary blinking in the presence of bright light 
C)  Pupillary constriction when looking at a near object 
D)  Changes in peripheral vision in response to bright light

Question 4

The nurse notices the presence of periorbital edema when performing an eye assessment on a 70-year-old patient. What should the nurse do next?

Accepted Answer

A)  Check for the presence of exophthalmos. 
B)  Suspect that the patient has hyperthyroidism. 
C)  Ask the patient if he or she has a history of heart failure. 
D)  Assess for blepharitis, which is often associated with periorbital edema.

Question 5

A patient comes to the emergency department after a boxing match, and his O.S. is almost swollen shut. He has bruises on his face and neck. He says he is worried because he "can't see well" from his O.S. The physician suspects retinal detachment. What finding would support this suspicion?

Accepted Answer

A)  Loss of central vision 
B)  Loss of peripheral vision 
C)  Sudden loss of pupillary constriction and accommodation 
D)  Shadow or diminished vision in one quadrant or one half of the visual field

Question 6

When assessing the pupillary light reflex, the nurse should use which technique?

Accepted Answer

A)  Shine a penlight from directly in front of the patient, and inspect for pupillary constriction. 
B)  Ask the patient to follow the penlight in eight directions, and observe for bilateral pupil constriction. 
C)  Shine a light across the pupil from the side, and observe for direct and consensual pupillary constriction. 
D)  Ask the patient to focus on a distant object. Then ask the patient to follow the penlight to approximately 7 cm from the nose.

Question 7

A patient's vision is recorded as 20/30 when the Snellen eye chart is used. How should the nurse interpret these results?

Accepted Answer

A)  At 30 feet the patient can read the entire chart. 
B)  The patient can read at 20 feet what a person with normal vision can read at 30 feet. 
C)  The patient can read the chart from 20 feet in the O.S. and 30 feet in the O.D. 
D)  The patient can read from 30 feet what a person with normal vision can read from 20 feet.

Question 8

In using the ophthalmoscope to assess a patient's eyes, the nurse notices a red glow in the patient's pupils. Based on this finding, what should the nurse do?

Accepted Answer

A)  Suspect that an opacity is present in the lens or cornea. 
B)  Check the light source of the ophthalmoscope to verify that it is functioning. 
C)  Consider the red glow a normal reflection of the ophthalmoscope light off the inner retina. 
D)  Continue with the ophthalmoscopic examination, and refer the patient for further evaluation.

Question 9

The nurse is performing an external eye examination. Which statement regarding the outer layer of the eye is true?

Accepted Answer

A)  The outer layer of the eye is very sensitive to touch. 
B)  The outer layer of the eye is darkly pigmented to prevent light from reflecting internally. 
C)  The trigeminal nerve (CN V) and the trochlear nerve (CN IV) are stimulated when the outer surface of the eye is stimulated. 
D)  The visual receptive layer of the eye in which light waves are changed into nerve impulses is located in the outer layer of the eye.

Question 10

The nurse is assessing a patient's eyes for the accommodation response and would expect to see which normal finding?

Accepted Answer

A)  Dilation of the pupils 
B)  Consensual light reflex 
C)  Disconjugate movement of the eyes 
D)  Convergence of the axes of the eyes

Question 11

The nurse is examining a patient's retina with an ophthalmoscope. Which finding is considered normal?

Accepted Answer

A)  Optic disc that is a yellow-orange color. 
B)  Presence of pigmented crescents in the macular area. 
C)  Optic disc margins that are blurred around the edges. 
D)  Presence of the macula located on the nasal side of the retina.

Question 12

During a physical education class, a student is hit in the eye with the end of a baseball bat. When examined in the emergency department, the nurse notices the presence of blood in the anterior chamber of the eye. What does this finding indicate?

Accepted Answer

A)  Hypopyon 
B)  Hyphema 
C)  Pterygium 
D)  A corneal abrasion

Question 13

The nurse is performing an eye assessment on an 80-year-old patient. Which of these findings is considered abnormal?

Accepted Answer

A)  Decrease in tear production 
B)  Unequal pupillary constriction in response to light 
C)  Presence of arcus senilis observed around the cornea 
D)  Loss of the outer hair on the eyebrows attributable to a decrease in hair follicles

Question 14

A patient comes into the emergency department after an accident at work. A machine blew dust into his eyes, and he was not wearing safety glasses. The nurse examines his corneas by shining a light from the side across the cornea. What findings would suggest that he has suffered a corneal abrasion?

Accepted Answer

A)  Smooth and clear corneas 
B)  Opacity of the lens behind the cornea 
C)  Bleeding from the areas across the cornea 
D)  Shattered look to the light rays reflecting off the cornea

Question 15

A 52-year-old patient describes the presence of occasional floaters or spots moving in front of his eyes. How should the nurse proceed?

Accepted Answer

A)  Examine the retina to determine the number of floaters. 
B)  Presume the patient has glaucoma and refer him for further testing. 
C)  Consider these to be abnormal findings, and refer him to an ophthalmologist. 
D)  Understand that floaters are usually insignificant and are caused by condensed vitreous fibers.

Question 16

A 2-week-old infant can fixate on an object but cannot follow a light or bright toy. What should the nurse do?

Accepted Answer

A)  Consider this a normal finding. 
B)  Continue with the examination, and assess visual fields. 
C)  Assess the pupillary light reflex for possible blindness. 
D)  Expect that a 2-week-old infant should be able to fixate and follow an object.

Question 17

An ophthalmic examination reveals papilledema. What does this finding indicate?

Accepted Answer

A)  Retinal detachment 
B)  Diabetic retinopathy 
C)  Acute-angle glaucoma 
D)  Increased intracranial pressure

Question 18

During an examination, a patient states that she was diagnosed with open-angle glaucoma 2 years ago. The nurse assesses for characteristics of open-angle glaucoma. Which of these are characteristics of open-angle glaucoma? (Select all that apply.)

Accepted Answer

A)  Immediate treatment is needed. 
B)  Virtually no symptoms are exhibited. 
C)  Vision loss begins with peripheral vision. 
D)  Patient may experience sensitivity to light, nausea, and halos around lights. 
E)  Patient experiences tunnel vision in the late stages.
F) Open-angle glaucoma causes sudden attacks of increased pressure that cause blurred vision.

Question 19

A patient is unable to read even the largest letters on the Snellen chart. The nurse should take which action next?

Accepted Answer

A)  Refer the patient to an ophthalmologist or optometrist for further evaluation. 
B)  Assess whether the patient can count the nurse's fingers when they are placed in front of his or her eyes. 
C)  Ask the patient to put on his or her reading glasses and attempt to read the Snellen chart again. 
D)  Shorten the distance between the patient and the chart until the letters are seen, and record that distance.

Exam 15: Eyes