Unit 5 Chapter 19 Path Flashcards
A client reports sudden, acute left eye pain with blurred vision and a headache on the affected side. The client is most likely experiencing:
A) Primary open-angle glaucoma
B) Acute-onset wide-angle glaucoma
C) Acute angle-closure glaucoma
D) Subacute angle-closure glaucoma
C) Acute angle-closure glaucoma
Rationale:The sudden onset of eye pain, blurred vision, and a headache on the affected side indicate acute angle-closure glaucoma, which is an ophthalmic emergency. Subacute angle-closure glaucoma manifests as recurrent short episodes of unilateral pain, conjunctival redness, and blurring of vision associated with halos around lights. Open-angle glaucoma is usually asymptomatic and chronic.
The nurse is teaching a client about the treatment of open-angle glaucoma. The most appropriate information for the nurse to give the client would be:
A) oral diuretics should be administered immediately.
B) laser peripheral iridotomy is performed immediately.
C) administration of topical beta-adrenergic antagonists to lower the pressure.
D) to monitor vision for signs of closed-angle vision
C) administration of topical beta-adrenergic antagonists to lower the pressure.
Rationale:The elevation in intraocular pressure in persons with open-angle glaucoma is usually treated pharmacologically or, in cases where pharmacologic treatment fails, by increasing aqueous outflow through a surgically created pathway. Medication is generally administered topically.
The nurse discusses Botox injections as a treatment of which eye disorder?
A) Eye tremor
B) Strabismus
C) Amblyopia
D) Ptosis
B) Strabismus
Rationale:One treatment for strabismus involves the injection of botulinum toxin type A (Botox) into the extraocular muscle to produce a dose-dependent paralysis of that extraocular muscle. None of the other options are treated with Botox injections.
A 42-year-old client reports increasing difficulty reading the labels on packages. He states that he has to continually hold it further and further away from his face in order to see the type clearly. Which eye disorder is this client most likely experiencing?
A) The normal decline in retinal function that occurs in adulthood.
B) The accumulated effects of ultraviolet light exposure.
C) Undiagnosed diabetic retinopathy.
D) An age-related change in accommodation.
D) An age-related change in accommodation.
Rationale:The term presbyopia refers to a decrease in accommodation that occurs because of aging. This is unrelated to UV light exposure and diabetes does not normally cause a specific decline in accommodation. Presbyopia is not the result of changes in retinal function.
A client who experiences constant cloudiness of vision, sees floaters, and has an opaque lens is diagnosed with a cataract. The most appropriate treatment would be:
A) daily application of pilocarpine eye drops.
B) wearing bifocal lenses to strengthen vision.
C) surgical lens replacement to correct vision.
D) patching the affected eye until vision returns.
C) surgical lens replacement to correct vision.
Rationale:Although strong bifocal lenses, magnification, appropriate lighting, and visual aids may help, surgery is the only treatment for cataract.
The conjunctiva is extremely sensitive to irritation and inflammation. What are the common manifestations of a client with conjunctivitis? Select all that apply.
A) Scratching or burning sensation
B) Foreign body sensation
C) Blurred vision
D) Itching
A) Scratching or burning sensation
B) Foreign body sensation
D) Itching
Rationale:Clinical manifestations of conjunctivitis include a foreign body sensation, a scratching or burning sensation, itching, and photophobia, not blurred vision.
A clent has damage to the epithelial layer of the cornea. Which are clinical manifestations that can occur with damage to the epithelial layer of the cornea? Select all that apply.
A) Reflex lacrimation
B) Foreign body sensation
C) No pain
D) Burning of the eyes
A) Reflex lacrimation
B) Foreign body sensation
D) Burning of the eyes
Rationale:Epithelial damage causes discomfort that ranges from a foreign body sensation and burning of the eyes to severe, incapacitating pain. Reflex lacrimation is common.
An older adult client comes to the clinic complaining of seeing flashing lights and small spots. The client tells the nurse that this has been going on for over 24 hours but now it is as if there is a dark curtain whenever the client opens the eyes. The client asks the nurse if this means that blindness is imminent. What diagnosis should the nurse suspect?
A) Glaucoma
B) Conjunctivitis
C) Retinal detachment
D) Cataracts
C) Retinal detachment
Rationale:The primary symptom of retinal detachment consists of painless changes in vision. Commonly, flashing lights or sparks followed by small floaters or spots in the field of vision occur. As the detachment progresses the person perceives a shadow or dark curtain across the visual field.
A client presents to the clinic complaining, “I have something in my eye.” When questioned, the client admits to a scratching and burning sensation and light sensitivity. The health care provider suspects the client has developed:
A( Corneal edema
B) Conjunctivitis
C) Acute glaucoma
D) Retinal detachment
B) Conjunctivitis
Rationale:Conjunctivitis causes bilateral tearing, itching, burning, foreign body sensation, and morning eyelash crusting and eye redness. The primary symptom of retinal detachment is painless changes in vision. Commonly, flashing lights or sparks, followed by small floaters or spots in the field of vision, are early symptoms. Attacks of glaucoma (increased intraocular pressure) are manifested by ocular pain, excruciating headache, blurred or iridescent vision, and corneal edema with hazy cornea, dilated (mydriasis), and fixed pupil; with repeated or prolonged attacks, the eye becomes reddened. With corneal edema, the cornea appears dull, uneven, and hazy; visual acuity decreases; and iridescent vision (i.e., rainbows around lights) occurs.
A client presents with varicella predominately occuring from the top of the nose to the eyelid margins. Which further assessments correlate to the development of varicella-zoster ophthalmicus? Select all that apply.
A) tearing of the eye and photophobia
B) bruising around the eyes, bilaterally
C) uveitis with elevated intraocular pressure of
32 mm Hg
D) eye pain and vesicular rash
E) bulging of the eye orbit and drying of the cornea
A) tearing of the eye and photophobia
C) uveitis with elevated intraocular pressure of
32 mm Hg
D) eye pain and vesicular rash
Rationale:Herpes zoster ophthalmicus usually presents with malaise, fever, headache, and burning and itching of the periorbital area. These symptoms commonly precede the ocular eruption by a day or so. The rash is initally vesicular, becomes pustular and then crusts. Involvement of the tip of the nose and lid margins indicates a high likelihood of ocular involvement. Ocular signs include conjunctivitis, keratitis (irritation tearing and photophobia), and anterior uveitis, often with elevated intraoccular pressure. Bruising is not common with this diagosis. Bulging of the eye orbit (exophthalmos) is usually associated with thyroid problems (hyperthyroidism).
The nurse is assessing a client who has been diagnosed with esotropia. The nurse would expect the assessment findings to include:
A) Downward deviation
B) Medial deviation
C) Upward deviation
D) Lateral deviation
B) Medial deviation
Rationale:Disorders of eye movement are described according to the direction of movement. Esotropia refers to medial deviation, exotropia to lateral deviation, hypertropia to upward deviation, hypotropia to downward deviation, and cyclotropia to torsional deviation.
The nursing instructor is teaching a class on diabetes and discusses complications of the disease. The instructor further states that diabetic retinopathy is one of the leading causes of blindness. What does the instructor tell the students are major risk factors for developing diabetic retinopathy? Select all that apply.
A) Hypertension
B) Smoking
C) Chronic hypoglycemia
D) Chronic hyperglycemia
E) Hypotension
A) Hypertension
B) Smoking
D) Chronic hyperglycemia
Rationale:Diabetic retinopathy is one of the leading causes of blindness. Chronic hyperglycemia, hypertension, hypercholesterolemia, and smoking are risk factors for the development and progression of the disorder
A parent brings the child to the clinic reporting inflammed eyes. Upon examination, the entire uveal tract is inflammed. The child recently was playing at the family barn and exposed to bird/bat droppings along with cat feces in the soil. Which parasite may be responsible for the child’s assessment findings? Select all that apply.
A) Acanthamoeba keratitis
B) Herpes zoster
C) Staphylococcus aureus
D) Toxoplasmosis
E) Histoplasmosis
D) Toxoplasmosis
E) Histoplasmosis
Rationale:Uveitis in an inflammation of the entire uveal tract. It is caused by infectious (virus, bacteria, fungi, or parasite) or noninfectious agents. Parasitic invasion of the choroid can result in local atrophic changes that usually involve the retina: examples invlude toxophasmosis (found in cat feces) and histoplasmosis (found in bird and bat droppings). Herpes zoster is infection that results when varicella-zoster virus reactivates from its latent state in a posterior dorsal root ganglion. Acanthamoeba keratitis is when it infects the transparent outer covering of the eye called the cornea. Acanthamoeba amebas are very common in nature and can be found in bodies of water like lakes. Staphylococcus aureus is the most dangerous of all of the many common staphylococcal bacteria. These bacteria are spread by having direct contact with an infected person, by using a contaminated object, or by inhaling infected droplets dispersed by sneezing or coughing.
A client tells the health care provider he has noticed a recent change in his vision: he can bring distant images into focus, but near images become blurred. The client has most likely developed:
A) astigmatism.
B) nearsightedness.
C) hyperopia.
D) myopia.
C) hyperopia.
Rationale:Hyperopia or farsightedness occurs when the accommodative changes of the lens can bring distant images into focus, but near images become blurred. Persons with myopia or nearsightedness can see close objects without a problem because accommodative changes in their lens bring near objects into focus, but distant objects are blurred. Astigmatism is a refractive defect of the corneal surface.
The ophthalmologist is performing a client’s annual eye exam and notes an increase in intraocular pressure. The condition most likely is the result of:
A) imbalance between aqueous production and outflow.
B) the development of degenerative cataracts.
C) damage to the retina leading to vision changes.
D) a breakdown of cells in the macula lutea.
A) imbalance between aqueous production and outflow.
Rationale:Increases in intraocular pressure occur when there is an imbalance between aqueous production and outflow. A cell breakdown in the macula lutea results in macular degeneration. Cataracts may cause blurring of vision but do not alter pressure.
