Question 1

The nurse is teaching a group of older adults about basic eye examinations. What would the nurse recommend about the frequency for eye examinations for most people over 65 years of age? a. Every 1 to 2 years b. Every 2 to 4 years c. Every 3 to 5 years d. When the primary health care provider recommends

Accepted Answer

a. Every 1 to 2 years Older adults need more frequent basic eye examinations due to the increased risk of glaucoma and cataracts associated with aging. Therefore, every 1 to 2 years for eye examination in the current best practice recommendation.

Question 2

A client with a family history of glaucoma asks the nurse how to prevent glaucoma? What statement by the nurse is appropriate? a. “You should check with your primary health care provider about eye examination.” b. “You should have genetic testing to determine your risk for glaucoma.” c. “You should have your intraocular pressure measured once or twice a year.” d. “You should check with your primary health care provider about preventive drug therapy.”

Accepted Answer

c. “You should have your intraocular pressure measured once or twice a year.” Glaucoma tends to occur more often in clients who have a family history but cannot be prevented. Genetic testing is not the best response because the client’s family history is already known. Therefore, early detection by having intraocular pressure measured frequently.

Question 3

A client presents to the emergency department reporting a foreign body in the eye. For what diagnostic testing would the nurse prepare the client? a. Corneal staining b. Fluorescein angiography c. Ophthalmoscopy d. Tonometry

Accepted Answer

a. Corneal staining Corneal staining is used when the possibility of eye trauma exists, including a foreign body. Fluorescein angiography is used to assess problems of retinal circulation. Ophthalmoscopy looks at both internal and external eye structures. Tonometry tests the intraocular pressure.

Question 4

The nurse enters an examination room to help with an eye assessment. The client is directed toward the chart shown. What is the primary health care provider assessing? a. Color vision b. Depth perception c. Spatial perception d. Visual acuity

Accepted Answer

a. Color vision

Question 5

The nurse assesses a client for factors that place the client at risk for cataracts. Which factor places the client at the highest risk for cataract development? a. Heart disease b. Glaucoma c. Diabetes mellitus d. Advanced age

Accepted Answer

d. Advanced age Advanced age is the major risk factor for developing cataracts because the lens loses water and lens fibers become more compact.

Question 6

The nurse is teaching about signs and symptoms of cataracts. Which change would the nurse emphasize as possibly indicating beginning cataract formation? a. Diplopia b. Cloudy pupil c. Loss of peripheral vision d. Blurred vision

Accepted Answer

c. Loss of peripheral vision A cloudy pupil is a sign of late cataracts and loss of peripheral vision is more common in clients who have glaucoma. Diplopia occurs with a number of neurologic diseases. Blurred vision is the earliest sign that the lens of the eye is undergoing changes.

Question 7

. The nurse is teaching a client about cataract surgery. Which statement would the nurse include as part of preoperative preparation? a. “You will receive general anesthesia for the surgical procedure.” b. “You will be in the hospital for only 1 to 2 days if everything goes as expected.” c. “You will need to put several types of eyedrops in your eyes before and after surgery.” d. “You will be on bedrest for about a week after the surgical procedure.”

Accepted Answer

c. “You will need to put several types of eyedrops in your eyes before and after surgery.”

Question 8

A client had a retinal detachment and has undergone surgical correction. What discharge health teaching is most important for the nurse to include? a. “Avoid reading, writing, or close work such as sewing.” b. “Report immediate loss of vision of pain in the affected eye.” c. “Keep the follow-up appointment with the ophthalmologist.” d. “Remove your eye patch every hour for eyedrops.”

Accepted Answer

b. “Report immediate loss of vision of pain in the affected eye.” After surgery for retinal detachment, the client is advised to avoid reading, writing, and close work because these activities cause rapid eye movements. However, more importantly is the need for the client or family to report loss of vision or pain in the surgical eye. Keeping a postoperative appointment is important for any surgical patient. The eye patch is not removed for eyedrops after retinal detachment repair.

Question 9

A client has a foreign body in one eye. What action by the nurse is appropriate for the client’s care? a. Administering ordered antibiotics b. Assessing the patient’s visual acuity c. Obtaining consent for enucleation d. Removing the object immediately

Accepted Answer

a. Administering ordered antibiotics To prevent infection, antibiotics are provided. Visual acuity in the affected eye cannot be assessed. The client may or may not need enucleation. The object is only removed by the ophthalmologist.

Question 10

A client who is nearly blind is admitted to the hospital. What action by the nurse is most important? a. Allow the client to feel his or her way around. b. Let the client arrange objects on the bedside table. c. Orient the client to the room using a focal point. d. Speak loudly and slowing when talking to the client.

Accepted Answer

c. Orient the client to the room using a focal point. Using a focal point, orient the client to the room by giving descriptions of items as they relate to the focal point. Letting the client arrange the bedside table is appropriate, but not as important as orienting the client to the room for safety. Allowing the client to just feel around may cause injury. Unless the client is also hearing impaired, use a normal tone of voice.

Question 11

A client is brought to the emergency department after a car crash. The client has a large piece of glass in the left eye. What action by the nurse takes priority? a. Administer a tetanus booster shot. b. Ensure that the client has a patent airway. c. Prepare to irrigate the client’s eye. d. Turn the client on the unaffected side.

Accepted Answer

b. Ensure that the client has a patent airway. Airway always comes first. After ensuring a patent airway and providing cervical spine precautions (do not turn the client to the side), the nurse provides other care that may include administering a tetanus shot. The client’s eye may or may not be irrigated.

Question 12

A nurse is seeing clients in the ophthalmology clinic. Which client would the nurse see first? a. Client with intraocular pressure reading of 24 mm Hg b. Client with a tearing, reddened eye with exudate c. Client whose red reflex is absent on ophthalmologic examination d. Client who has had cataract surgery and has worsening vision

Accepted Answer

d. Client who has had cataract surgery and has worsening vision After cataract surgery, worsening vision indicates a postoperative infection or other complication. The nurse would see this client first. The intraocular pressure is slightly elevated. An absent red reflex may indicate cataracts. The client who has the tearing eye may have an infection.

Question 13

The nurse teaches assistive personnel about age-related changes that affect the eyes and vision. Which changes would the nurse include? (Select all that apply.) a. Decreased eye muscle tone b. Development of arcus senilis c. Increase in far point of near vision d. Decrease in general color perception e. Increase in point of near vision

Accepted Answer

a. Decreased eye muscle tone b. Development of arcus senilis d. Decrease in general color perception e. Increase in point of near vision Normal age-related changes include decreased eye muscle tone, development of arcus senilis, decreased color perception, and increased point of near vision. The far point of near vision typically decreases.

Question 14

The nurse is assessing a client admitted to the emergency department with possible retinal detachment. What assessment findings would the nurse expect? (Select all that apply.) a. Presence of bright light flashes b. Decreased visual field in affected eye c. Feeling like a curtain is over one eye d. Gradual changes in visual acuity e. Painful throbbing in the affected eye

Accepted Answer

a. Presence of bright light flashes b. Decreased visual field in affected eye c. Feeling like a curtain is over one eye

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Chapter 42 Practice Questions - Assessment and Care of Patients With Eye and Vision Problems Flashcards

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