Medical Surg Answer Key

Question 1 When assessing the pressure of the anterior chamber of the eye, a nurse normally expects to find a pressure of: Correct response: 10 to 20 mm Hg. Question 2 Which surgical procedure involves flattening the anterior curvature of the cornea by removing a stromal lamella? Correct response: Laser-assisted in situ keratomileusis (LASIK) Question 3 The nurse asks a client to follow the movement of a pencil up, down, right, left, and both ways diagonally. The nurse is assessing which of the following? Correct response: Extraocular muscle function Question 4 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? Correct response: Myopia Question 5 Which of the following is the role of the nurse toward a patient who is to undergo eye examinations and tests? Correct response: Ensuring that the patient receives eye care to preserve his or her eye function and prevent further visual loss Question 6 Which of the following medications needs to be withheld for 5 to 7 days prior to cataract surgery? Correct response: Coumadin Question 7 The nurse is assisting the eye surgeon in completing an examination of the eye. Which piece of equipment would the nurse provide to the physician to examine the optic disc under magnification? Correct response: Ophthalmoscope Question 8 Following an ophthalmologic exam, an anxious client asks the nurse, “How serious is a refraction error?” Which of the following is the best response from the nurse? Correct response: “It means corrective lenses are required.” Question 9 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? Correct response: A mucopurulent ocular discharge Question 10 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? Correct response: Adhere to the medication regimen. Question 1 Which feature should a nurse observe during an ophthalmic assessment? Correct response: Appearance of the external eye Question 2 Which term refers to swelling of the optic disc due to increased intracranial pressure? Correct response: Papilledema Question 3 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? Correct response: Scleral buckle Question 4 A client has noticed needing to hold printed material at arms length to make the print readable. What is the term used to describe this visual condition? Correct response: presbyopia Question 5 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? Correct response: eyelids Question 6 A nurse is performing an eye examination. Which question would not be included in the examination? Correct response: "Are you able to raise both eyebrows?" Question 7 A nurse notices that a client's left upper eyelid is drooping. The nurse has observed: Correct response: ptosis Question 8 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? Correct response: Retinal Angiography Question 9 A client presents to the ED reporting a chemical burn to both eyes. Which is the priority nursing intervention? Correct response: Irrigate both eyes. Question 10 A patient has been diagnosed with bacterial conjunctivitis that was sexually transmitted. The nurse informs the patient that the isolated organism is which of the following? Correct response: Chlamydia trachomatis Question 1 A client accidentally splashes chemicals into one eye. The nurse knows that eye irrigation with plain tap water should begin immediately and continue for 15 to 20 minutes. What is the primary purpose of this first aid treatment? Correct response: To prevent vision loss Question 2 Which term refers to the absence of the natural lens? Correct response: Aphakia Question 3 A client has undergone tonometry to evaluate for possible glaucoma. Which result would the nurse record as abnormal? Correct response: 25 mm Hg Question 4 A client with AIDS develops cytomegalovirus (CMV) retinitis. Which of the following would the nurse expect as the drug least likely to be prescribed? Correct response: Abacavir Question 5 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? Correct response:To ensure correct application of antibiotic ointment, gently drag tip of tube along lower lid while squeezing ointment on to lid. Question 6 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? Correct response: retinal detachment Question 7 Following cataract removal, discharge instructions will be provided to the client. Which of the following instructions is most important? Correct response: Avoid any activity that can increase intraocular pressure. Question 8 Which surgical procedure involves flattening the anterior curvature of the cornea by removing a stromal lamella layer? Correct response: Laser-assisted stromal in situ keratomileusis (LASIK) Question 9 A nurse conducted a history and physical for a newly admitted patient who states, “My arms are too short. I have to hold my book at a distance to read.” The nurse knows that the patient is most likely experiencing: Correct response: Loss of accommodative power in the lens. Question 10 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: Correct response: >21 mm Hg. Question 1 The nurse should monitor for which manifestation in a client who has undergone LASIK? Correct response: Halos and glare Question 2 To avoid the side effects of corticosteroids, which medication classification is used as an alternative to treat inflammatory conditions of the eyes? Correct response: NSAIDs Question 3 A 52-year-old comes to the clinic for a follow-up examination after being diagnosed with glaucoma. The client states, "I'm hoping that I don't have to use these drops for very long." Which response by the nurse would be most appropriate? Correct response: "You'll need to use the drops for the rest of your life to control the glaucoma." Question 4 Which of the following is the role of the nurse toward a patient who is to undergo eye examinations and tests? Correct response: Ensuring that the patient receives eye care to preserve his or her eye function and prevent further visual loss Question 5 A patient has been diagnosed with hyphema. Which of the following medication classifications stabilizes clot formation at the site of hemorrhage? You Selected: Correct response:Antifibrinolytics Question 6 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: Correct response: perimetry test Question 7 A client with chronic open-angle glaucoma is now presenting with eye pain and intraocular pressure of 50 mm Hg. An immediate iridotomy is scheduled. Which of the following describes the desired effects of this procedure? Correct response: Improve outflow drainage Question 8 To avoid the side effects of corticosteroids, which medication classification is used as an alternative in treating inflammatory conditions of the eyes? Correct response: Nonsteroidal anti-inflammatory drugs (NSAIDs) Question 9 A client is diagnosed with a corneal abrasion and the nurse has administered proparacaine hydrochloride per orders to assess visual acuity. The client requests a prescription for this medication because it completely took away the pain. What is the best response by the nurse? Correct response: “Prescriptions of this medication are generally not given because it can cause corneal problems.” Question 10 The nurse recognizes the following as marker(s) of medication effectiveness in glaucoma control except: Correct response: Opacity of the lens Question 1 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? Correct response: Myopia Question 2 After surgery for removal of cataract, a client is being discharged, and the nurse has completed discharge instruction. Which client statement indicates that the outcome of the teaching plan has been met? Correct response: "I should avoid pulling or pushing any object that weighs more than 15 lbs." Question 3 An aging client is brought to the eye clinic by the son. The son states he has seen his parent holding reading materials at an increasing distance to focus properly. What age-related changes does this indicate? Correct response: Presbyopia Question 4 A client comes to the eye clinic for a routine check-up. The client tells the nurse he thinks he is color blind. What screening test does the nurse know will be performed on this client to assess for color blindness? Correct response: Ishihara Question 5 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? Correct response: “This test measures peripheral vision and detects gaps in the visual field. Question 6 Which of the following occurs when there is deviation from perfect ocular alignment? Correct response: Strabismus Question 7 Which of the following medication classifications increases aqueous fluid outflow in the patient with glaucoma? Correct response: Cholinergics Question 8 A client has noticed recently having clearer vision at a distance than up close. What is the term used to describe this client's visual condition? Correct response: hyperopia Question 9 A client is examined due to recent vision changes and is diagnosed with myopia. What is the cause of this client's vision change? Correct response: elongated eyeballs Question 10 The nurse is demonstrating how to perform punctal occlusion. Which activities does the nurse perform? Correct response Applies gentle pressure bilaterally on the bridge of the nose to the inner canthus of each eye Question 1 The nurse is providing care to a client who has been admitted to the hospital for treatment of an infection. The client is visually impaired. Which of the following would be most appropriate for the nurse to do when interacting with the client? Correct response: Face the client when speaking directly to him. Question 2 A client is scheduled to have a cataract removed and an artificial lens implanted. What test would the nurse know would be useful in measuring for an intraocular lens implant in this client? Correct response: Ultrasonography Question 3 Which of the following is the main refracting surface of the eye? Correct response: Cornea Question 4 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? Correct response: optic nerve Question 5 A client is having a routine eye examination. The procedure being performed is done by using an instrument to indent or flatten the surface of the eye. This is known as ________ and it is routinely done to test for ________. Correct response: tonometry; intraocular pressure Question 6 During a routine eye examination, a patient complains that she is unable to read road signs at a distance when driving her car. What should the patient be assessed for? Correct response: Myopia Question 7 What type of medication would the nurse use in combination with mydriatics to dilate the patient’s pupil? Correct response: Cycloplegics Question 8 When conducting an eye exam, the nurse practitioner is aware that a diagnostic clinical manifestation of glaucoma is: Correct response: The presence of halos around lights. Question 9 During a routine physical examination, the nurse practitioner notes that a 72-year-old patient has a significant loss of ability to discriminate words. The patient also states that he has noticed that he has trouble hearing high-frequency sounds. The nurse suspects that the patient has an age-related change in his ears known as: Correct response: Degeneration of the organ of Corti. Question 10 A nurse is teaching a client about medications for glaucoma. What is the main marker of glaucoma control with medication? Correct response: Lowering intraocular pressure to target pressure Question 1 Which term refers to the absence of the natural lens? Correct response: Aphakia Question 2 Which action should the nurse recommend to a client with blepharitis? Correct response:Keep lid margins clean Question 3 The nures is assessing a client using an Amsler Grid. The nurse is assessing for which of the following? Correct response: Macular problems Question 4 The upper eyelid normally covers the uppermost portion of the iris and is innervated by which cranial nerve? Correct response: III Question 5 The nurse is obtaining a visual history from a client who has noted an increase in glare and changes in color perception. Which assessment would the nurse anticipate to confirm a definitive diagnosis? Correct response: Identification of opacities on the lens Question 6 Which medication classification increases aqueous fluid outflow in the client with glaucoma? Correct response: Cholinergics Question 7 The nurse practitioner conducts a vision test on a 78-year-old woman. Based on the findings, the nurse concludes that the patient has age-related macular degeneration (AMD). What are the signs/symptoms consistent with this diagnosis? Select all that apply. Correct response: When reading, words are missing letters. Straight lines on a paper appear wavy. Faded areas appear on the page. Question 8 During assessment of a patient with a hearing loss, the nurse notes a defect in the tympanic membrane. The nurse documents this disturbance as a loss known as: Correct response: Conductive. Question 9 An ophthalmologist diagnoses a patient with myopia. The nurse explains that this type of impaired vision is a refractive error characterized by: Correct response: Blurred distance vision. Question 10 A patient visits a clinic for an eye examination. He describes his visual changes and mentions a specific diagnostic clinical sign of glaucoma. What is that clinical sign? Correct response: The presence of halos around lights Question 1 A client with an inflammatory ophthalmic disorder has been receiving repeated courses of a corticosteroid ointment, one-half inch in the lower conjunctival sac four times a day as directed. The client reports a headache and blurred vision. The nurse suspects that these symptoms represent: Correct response: increased intraocular pressure (IOP) Question 2 Which is the most common cause of visual loss in people older than 60 years of age? Correct response: Macular degeneration Question 3 Which nursing intervention should be included during the assessment of a client with an eye disorder? Correct response:Check the extraocular muscles by instructing the client to keep his or her head still when following an object. Question 4 Which part of the retina is responsible for central vision? Correct response: Macula Question 5 Which of the following is the role of the nurse toward a patient who is to undergo eye examinations and tests? Correct response: Ensuring that the patient receives eye care to preserve his or her eye function and prevent further visual loss Question 6 Which of the following is the correct advice regarding food for a patient who underwent a cataract surgery? Correct response: Eat soft, easily chewed foods. Question 7 A patient has been diagnosed with hyphema. Which of the following medication classifications stabilizes clot formation at the site of hemorrhage? Correct response: Antifibrinolytics Question 8 Which is the most common cause of visual loss in people older than 65 years of age? Correct response: Macular degeneration Question 9 A nurse is caring for a client scheduled to have angiography of the right eye in 1 hour. What is the highest priority nursing intervention? Correct response: Assess blood urea nitrogen (BUN) and creatinine levels. Question 10 There are four major types of ophthalmic procedures to complete a glaucoma examination. If the health care provider wants to inspect the optic nerve, the nurse would prepare the patient for: Correct response: Ophthalmoscopy. Question 1 Which group of medications causes pupillary constriction? Correct response: Miotics Question 2 A client comes to the clinic for a routine examination. After obtaining the ocular history, which of the following would the nurse do next? Correct response: Test the client's visual acuity. Question 3 A client is prescribed pilocarpine. When preparing the client's teaching plan about this drug, which of the following would the nurse integrate? Correct response: The client may experience difficulty seeing in the dark. Question 4 A client comes to the eye clinic for a routine check-up. The client tells the nurse he thinks he is color blind. What screening test does the nurse know will be performed on this client to assess for color blindness? Correct response: Ishihara Question 5 An 8th grade boy comes to the school nurse and tells the nurse that he had an eye exam the day before. He says the eye doctor told him he had astigmatism and that meant his eyeball wasn't shaped right. The boy is concerned because he says he went home and looked in the mirror and both eyes looked just alike. What is the school nurse's best response? Correct response: “Astigmatism means that the cornea of the eye is shaped differently than the cornea in most eyes.” Question 6 Viewed through the pupil, the landmarks of the retina are which of the following? Select all that apply. Correct response: Optic disk Retinal vessels Macula Question 7 Which type of cataract is caused by central opacity of the lens? Correct response: Nuclear Question 8 The nurse is evaluating the client while taking the color vision test. Which response would the nurse anticipate when caring for a client with normal color vision? Correct response: The nurse would anticipate the client identifying numbers and shapes. Question 9 When conducting an eye exam, the nurse practitioner is aware that a diagnostic clinical manifestation of glaucoma is: Correct response: The presence of halos around lights. Question 10 A patient was recently diagnosed with a cortical cataract in his left eye. His wife asks the nurse for information about his diagnosis. The nurse explains that: Correct response: The cataract should have little or no effect on his vision. Question 1 Retinoblastoma is the most common eye tumor of childhood. It is hereditary in which percentage of cases? Correct response: 30 to 40 Question 2 The most common site of metastasis in clients diagnosed with rhabdomyosarcoma is the Correct response: lungs. Question 3 A patient is suspected of having retinal detachment. The nurse would expect to prepare the patient for which of the following? Select all that apply. Correct response: Visual acuity testing Indirect ophthalmoscopy Slit lamp biomicroscopy Fluorescein angiography Question 4 The red reflex occurs when a normal orange glow is observed as light is applied to which of the following? Correct response: Pupil Question 5 Edema of the conjunctiva is termed which of the following? Correct response: Chemosis Question 6 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. Correct response: There is a decrease in pupil size. There is slowing of accommodation. There is an increase in lens opaqueness. Question 7 The nurse screens a middle-aged client’s vision and notes that the client has difficulty reading print when it is placed at arm’s length. The client tells the nurse that the same problem happened to his father. The nurse is aware that the health care practitioner will refer this client to an ophthalmologist for correction of what vision problem? Correct response: Presbyopia Question 8 The nurse is giving instructions to a client who has been diagnosed with viral conjunctivitis. The nurse will teach the client which aspects of self-care related to this disorder? Select all that apply. Correct response: Do not wear contact lenses until there is no more inflammation. Wash hands before touching eyes and frequently during the day. Do not use the same towels or washcloths as other members of the family. Question 9 A client in the emergency room was involved in a motor vehicle accident which caused blunt facial trauma, especially to the orbit of the skull. Which bones are in danger of fracture in this type of injury? Select all that apply. Correct response: Lacrimal Ethmoid Frontal Question 10 The nurse recognizes the following as marker(s) of medication effectiveness in glaucoma control except: Correct response: Opacity of the lens Question 1 Students are reviewing information about orbital and ocular tumors. They demonstrate understanding of the material when they identify which of the following as the most common malginant tumor of the eyelid? Correct response: Basal cell carcinoma Question 2 The nurse is precepting a nursing student when a new client comes to the eye clinic. The client explains that she thinks she may have a corneal abrasion. The nurse should explain what to the student nurse? Correct response: “To detect corneal abrasions, a slit lamp is used.” Question 3 A client is examined due to recent vision changes and is diagnosed with myopia. What is the cause of this client's vision change? Correct response: elongated eyeballs Question 4 A client has received a diagnosis of hyperopia and is wondering if there is a physical condition that has caused these vision changes. In explaining hyperopia, what does the nurse indicate is the cause of this client's vision changes? Correct response: eyeballs that are shorter than normal Question 5 A client is having a routine eye examination. The procedure being performed is done by using an instrument to indent or flatten the surface of the eye. This is known as ________ and it is routinely done to test for ________. Correct response: tonometry; intraocular pressure Question 6 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? Correct response: Retinal Angiography Question 7 An ophthalmologist tells a patient that he has a cataract. The nurse explains to the patient that this means there is: Correct response: Interference with focusing of a sharp image. Question 8 A nurse practitioner examines the fundus of the eye using direct ophthalmoscopy and notes a yellow lipid in the retina. What is this indicative of? Correct response: Diabetes Question 9 A patient with low-tension glaucoma and an IOP of 22 mm Hg will be started on a medication regimen. The initial target score for a lowered IOP reading would be: Correct response: 15. Question 10 Which is not a clinical manifestation of a retinal detachment? Correct response: Pain Question 1 Edema of the conjunctiva is termed Correct response: chemosis. Question 2 Nursing students are reviewing information about the causes associated with low vision and blindness. The students demonstrate a need for additional review when they identify which of the following as a common cause in older adults? Correct response: Presbyopia Question 3 A client who had a corneal transplant a few months ago arrives at the emergency department reporting eye discomfort. When assessing the client, which of the following would lead the nurse to suspect graft failure? Correct response: Blurred vision Question 4 `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? Correct response: Macular degeneration Question 5 Which of the following is the role of the nurse toward a patient who is to undergo eye examinations and tests? Correct response: Ensuring that the patient receives eye care to preserve his or her eye function and prevent further visual loss Question 6 What should the nurse recommend to a client with blepharitis? Correct response: frequent washing of the face and hair Question 7 Which would be an advanced stage finding in a client with wet macular degeneration? Correct response: inability to see images by looking at them directly Question 8 A client is scheduled to undergo surgery to remove a cataract in the left eye using phacoemulsification. When phacoemulsification is used, a: Correct response: small portion of the anterior capsule is removed. Ultrasound is emitted through a probe, and suction is used to extract the lens. Question 9 The nurse is assessing a client's visual acuity using a Snellen chart. The client states he cannot read the letter at the top of the chart. What action should the nurse do next? Correct response: Determine whether the client can count fingers. Question 10 A diabetic patient is scheduled for surgery for repair of a detached retina that was caused by proliferative retinopathy. The nurse prepared the patient for surgery, aware that the type of detachment is most likely classified as which of the following? Correct response: Rhegmatogenous Question 1 The most common site of metastasis in clients diagnosed with rhabdomyosarcoma is the Correct response: lungs. Question 2 The initial target for intraocular pressure (IOP) among patient with elevated IOP and those with low-vision glaucoma with progressive visual field loss is typically set at what percentage? Correct response: 30% lower than the current pressure Question 3 When an impaled object is in the eye, which of the following steps should be taken to ensure that no further damage occurs? Select all that apply. Correct response: No attempt should be made to remove the object Protect object from jarring Use metal shield Question 4 A client is being discharged after successful same-day cataract surgery. The nurse instructs the client about permitted activities and which activities to avoid. Which of the following activities would be permitted in the postoperative instructions by the client? Correct response: Cooking. Question 5 Which medication is used to treat glaucoma by pulling the iris away from the drainage channels so that aqueous fluid can escape? Correct response: carbachol Question 6 A client was hit in the eye with a stick. The nurse notes edema to the conjunctiva. What documentation by the nurse describes the assessment findings? Correct response: Chemosis Question 7 The nurse is preparing a presentation for a group of older adults on the topic of open-angle glaucoma. Which symptoms would be included as indications of open-angle glaucoma? Select all that apply. Correct response:Difficulty adjusting eyes in low lighting Halos around lights Blurred vision Decreasing peripheral vision Question 8 A patient is being seen in the ophthalmology clinic for a suspected detached retina. What clinical manifestations does the nurse recognize as significant for a retinal detachment? Select all that apply. Correct response: A visual field of floating particles A definite area of blank vision Momentary flashes of light Question 9 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? Correct response: A mucopurulent ocular discharge Question 10 A nurse conducted a history and physical for a newly admitted patient who states, “My arms are too short. I have to hold my book at a distance to read.” The nurse knows that the patient is most likely experiencing: Correct response: Loss of accommodative power in the lens. Question 1 A client who wears soft contact lenses opts for laser correction surgery. The nurse would instruct the client to discontinue using the contact lenses for which time period before surgery? Correct response: 2 to 3 weeks Question 2 A client complains to the nurse about having difficulty seeing to read, but reports no difficulty with driving. What test would the nurse prepare for the physician to administer to this client? Correct response: Rosenbaum Question 3 The accompanying illustration depicts the neural pathway for vision. Which of the numbered areas is responsible for receiving the stimulus from the retina? Correct response: 4 Question 4 A legally blind client is in pre-op area prior to an appendectomy. What steps does the nurse take to effectively communicate with this client ? Correct response: Notify the client prior to touching the client. Question 5 A patient has been brought to the emergency room after being hit in the head with a baseball. The nurse should be alert to which of the following clinical manifestations of a detached retina? Select all that apply. Correct response: Bright flashing lights Sudden onset of floaters Cobwebs Sensation of a curtain coming across vision of one eye Question 6 Which category of drugs is contraindicated in clients with glaucoma? Correct response: mydriatics Question 7 Which features should a nurse observe during an ophthalmic assessment? Select all that apply. Correct response: external eye appearance pupil responses Question 8 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? Correct response: Marked blurring of vision Question 9 The nurse is giving instructions to a client who has been diagnosed with viral conjunctivitis. The nurse will teach the client which aspects of self-care related to this disorder? Select all that apply. Correct response: Do not wear contact lenses until there is no more inflammation. Wash hands before touching eyes and frequently during the day. Do not use the same towels or washcloths as other members of the family. Question 10 The nurse recognizes the following as marker(s) of medication effectiveness in glaucoma control except: Correct response: Opacity of the lens Question 1 Which statement is accurate regarding refractive surgery? Correct response: Refractive surgery is an elective, cosmetic surgery performed to reshape the cornea. Question 2 A client diagnosed with a cataract comes into the clinic. What assessments should the nurse observe in this client? Correct response: Blurred or cloudy visual image Question 3 You are the clinic nurse in an ophthalmic clinic. When assessing clients, which client has an abnormal intraocular pressure (IOP)? Correct response: A client with an IOP of 8 mm Hg Question 4 Viewed through the pupil, the landmarks of the retina are which of the following? Select all that apply. Correct response: Optic disk Retinal vessels Macula Question 5 The nurse is instructing a nursing student when a new client comes to the eye clinic. The client explains that he thinks he has a corneal abrasion. The nurse should explain what to the student nurse? Correct response: “To detect corneal abrasions, a slit lamp is used.” Question 6 The nurse is evaluating the client while taking the color vision test. Which response would the nurse anticipate when caring for a client with normal color vision? Correct response The nurse would anticipate the client identifying numbers and shapes. Question 7 An eight-grade boy tells the school nurse that the eye doctor told him he had astigmatism and that meant his eyeball wasn’t shaped right. The boy says he went home and looked in the mirror and both eyes looked just alike. What is the school nurse’s best response? Correct response: “Astigmatism means that the cornea of the eye is shaped differently than the cornea in most eyes.” Question 8 An elderly client with macular degeneration has received injections of angiogenesis inhibitors. Which assessment finding would indicate the condition is worsening? Correct response: Central vision impairment Question 9 An elderly client is scheduled for cataract surgery and asks the nurse, “Will I need to wear popbottle lenses after surgery?” Which is the most appropriate response from the nurse? Correct response: “An implanted lens has replaced the need for corrective glasses.” Question 10 A nurse practitioner examines the fundus of the eye using direct ophthalmoscopy and notes a yellow lipid in the retina. What is this indicative of? Correct response: Diabetes Question 1 Which feature should a nurse observe during an ophthalmic assessment? Correct response: Appearance of the external eye Question 2 A client comes to the clinic for a routine examination. After obtaining the ocular history, which of the following would the nurse do next? Correct response: Test the client's visual acuity. Question 3 The nurse is preparing a presentation for a local community group comparing photorefractive keratectomy and LASIK refractive surgeries. Which of the following would the nurse include? Correct response: LASIK involves working with the cornea on a deeper level. Question 4 The nurse admits a client to the emergency department who has been referred by the eye clinic. Which condition is an emergency where the nurse should refer the client for medical treatment immediately? Correct response: Acute angle-closure glaucoma Question 5 Which of the following medications decreases the production of aqueous humor? Correct response: Beta blockers Question 6 Which type of cataract is caused by central opacity of the lens? Correct response: Nuclear Question 7 A patient has been diagnosed with hyphema. Which of the following medication classifications stabilizes clot formation at the site of hemorrhage? Correct response: Antifibrinolytics Question 8 A client has noticed needing to hold printed material at arms length to make the print readable. What is the term used to describe this visual condition? Correct response: presbyopia Question 9 The nurse is caring for geriatric clients who state that they are prescribed reading glasses. Some individuals state needing assistance with seeing writing far away, and others need assistance with closer vision. The nurse is correct to understand that the aging visual changes relate to which of the following? Correct response: Changes in accommodation Question 10 The nurse screens a middle-aged client’s vision and notes that the client has difficulty reading print when it is placed at arm’s length. The client tells the nurse that the same problem happened to his father. The nurse is aware that the health care practitioner will refer this client to an ophthalmologist for correction of what vision problem? Correct response: Presbyopia Question 1 A colleague has been splashed in the eye with cleaning solution. Which of the following would be the priority? Correct response: Irrigating the eye immediately with tap water Question 2 Students are reviewing information about orbital and ocular tumors. They demonstrate understanding of the material when they identify which of the following as the most common malginant tumor of the eyelid? Correct response: Basal cell carcinoma Question 3 Which of the following is the overall aim of glaucoma treatment? Correct response: Prevent optic nerve damage Question 4 What should the nurse recommend to a client with blepharitis? Correct response: frequent washing of the face and hair Question 5 Which category of drugs is contraindicated in clients with glaucoma? Correct response: mydriatics Question 6 The nurse is caring for a client with increased fluid accumulation in the eye. When assessing the client, which structure within the eye is noted to drain fluid from the anterior chamber? Correct response: Canal of Schlemm Question 7 Postoperative health teaching for a patient who has had an intraocular lens implant is a vital nursing responsibility. Which of the following statements applies to this situation? Select all that apply. Correct response: Do not lift, pull, or push objects heavier than 15 pounds. Wipe the closed eye from the inner canthus outward. Avoid bending the head forward for an extended time. Question 8 A diabetic patient is scheduled for surgery for repair of a detached retina that was caused by proliferative retinopathy. The nurse prepared the patient for surgery, aware that the type of detachment is most likely classified as which of the following? Correct response: Rhegmatogenous Question 9 The nurse recognizes the following as marker(s) of medication effectiveness in glaucoma control except: Correct response: Opacity of the lens Question 10 Which is not a clinical manifestation of a retinal detachment? Correct response: Pain Question 1 Retinoblastoma is the most common eye tumor of childhood. It is hereditary in which percentage of cases? Correct response: 30 to 40 Question 2 Which group of medications causes pupillary constriction? Correct response: Miotics Question 3 A client is scheduled to have a cataract removed and an artificial lens implanted. What test would the nurse know would be useful in measuring for an intraocular lens implant in this client? Correct response: Ultrasonography Question 4 A client complains to the nurse about having difficulty seeing to read, but reports no difficulty with driving. What test would the nurse prepare for the physician to administer to this client? Correct response: Rosenbaum Question 5 Edema of the conjunctiva is termed which of the following? Correct response: Chemosis Question 6 A client who is blind is awaiting elective surgery. What should the nurse do to promote this client's control over their hospital environment? Correct response: Ask the client where to store his or her self-care items. Question 7 A client is diagnosed with blepharitis. What symptoms should a nurse monitor in this client? Correct response: Patchy flakes clinging to the eyelashes Question 8 An ophthalmologist tells a patient that he has a cataract. The nurse explains to the patient that this means there is: Correct response: Interference with focusing of a sharp image. Question 9 A nurse practitioner examines the fundus of the eye using direct ophthalmoscopy and notes a yellow lipid in the retina. What is this indicative of? Correct response: Diabetes Question 10 The nurse is giving instructions to a client who has been diagnosed with viral conjunctivitis. The nurse will teach the client which aspects of self-care related to this disorder? Select all that apply. Correct response: Do not wear contact lenses until there is no more inflammation. Wash hands before touching eyes and frequently during the day. Do not use the same towels or washcloths as other members of the family. Question 1 A client is prescribed pilocarpine. When preparing the client's teaching plan about this drug, which of the following would the nurse integrate? Correct response: The client may experience difficulty seeing in the dark. Question 2 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? Correct response: Macular degeneration Question 3 A client is receiving phenylephrine eye drops in preparation for ophthalmoscopy. The client receives the final dose of drops at 10:30 a.m. The nurse informs the client that he will begin to notice the effects of the drug beginning to wear off around what time? Correct response: 1:30 p.m. Question 4 A client diagnosed with a cataract comes into the clinic. What assessments should the nurse observe in this client? Correct response: Blurred or cloudy visual image Question 5 Which of the following is a surgical procedure that removes the eyelids, eye, and various amounts of orbital contents? Correct response: Exenteration Question 6 When an impaled object is in the eye, which of the following steps should be taken to ensure that no further damage occurs? Select all that apply. Correct response: No attempt should be made to remove the object Protect object from jarring Use metal shield Question 7 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? Correct response: retinal detachment Question 8 Which features should a nurse observe during an ophthalmic assessment? Select all that apply. Correct response: external eye appearance pupil responses Question 9 The nurse is assessing a client's visual acuity using a Snellen chart. The client states he cannot read the letter at the top of the chart. What action should the nurse do next? Correct response: Determine whether the client can count fingers. Question 10 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? Correct response: Brimonidine (Alphagan-P)