Chapter 53: Eye and Vision Disorders
Linton: Introduction to Medical-Surgical Nursing, 6th Edition
MULTIPLE CHOICE
1. A 60-year-old patient who has had an enucleation asks when he can get his prosthesis fitted.
In approximately how many weeks should this patient expect to be fitted?
a.
2
b.
4
c.
8
d.
12
2. A patient who has been taking opioid medication for postoperative pain exhibits pinpoint
pupils. Which anatomic portion of the eye has been affected by the medication?
a.
Sclera
b.
Retina
c.
Choroid
d.
Bulbar conjunctiva
3. Which portion of the eye makes it possible for a person to see in a darkened environment?
a.
Macula
b.
Rods
c.
Cones
d.
Optic nerve
4. When being interviewed, a 50-year-old patient says that he cannot see the newspaper as well
as he used to. What is the reason this patient vision has changed from near to far?
a.
The ciliary muscle changes the pupil size.
b.
The lens of the eye changes shape as the ciliary muscle contracts and relaxes.
c.
Nearsightedness has set in.
d.
Clouding of the vitreous humor has occurred.
5. During the initial assessment of a very thin patient at the eye clinic, a nurse notes that the
patient has very prominent eyes. What medical diagnosis might the nurse find in this patient’s
history?
a.
Diabetes
b.
Glomerulonephritis
c.
Graves disease
d.
Hypertension
6. When asked about his vision, a patient says that the last time he had it tested, his vision was
recorded as 20/50. What does this mean?
a.
He can read at 20 feet what a person with normal vision can read at 50 feet.
b.
He can read at 50 feet what a person with normal vision can read at 20 feet.
c.
He needs to be 50 feet from objects to see them.
d.
He can see objects the best between 20 and 50 feet.
7. Which intraocular pressure reading obtained by tonometry indicates a patient being evaluated
for a visual impairment does not have glaucoma?
a.
18 mm Hg
b.
28 mm Hg
c.
45 mm Hg
d.
52 mm Hg
8. What does a pneumatonometric study of the eye require?
a.
Regional anesthesia
b.
A pneumotonometer to be placed into the eye
c.
A puff of air directed at the surface of the eye
d.
An applanation performed with a slit-lamp microscope
9. What is an appropriate nursing action to implement when performing eye irrigation?
a.
Ask the patient to tip up her head and run the irrigation fluid over her open eye.
b.
Direct the irrigating fluid from the inner canthus to the outer canthus.
c.
Not allow the patient to blink.
d.
Place the irrigating syringe directly onto the corner of the eye and allow the fluid
to move across the eye.
10. What information should a nurse include when providing information to a patient using
topical eye medications?
a.
Look upward and drop the medication into the inner canthus.
b.
Pull the lower eyelid down and drop the medication into the conjunctival sac.
c.
Hold both eyelids open and drop the medication onto the sclera.
d.
Tilt the head to the side and drop the medication into the outer canthus.
11. What does electroretinography measure?
a.
A fluorescein dye is injected intravenously (IV) into a vein in the arm, and the
retina is observed as the dye circulates.
b.
Electrodes are placed on the scalp, each eye is stimulated, and retinal activity is
assessed.
c.
A small plunger is used to apply pressure on the sclera while the retinal vessels are
evaluated.
d.
A contact lens electrode is placed on the eye and exposed to flashes of light to
evaluate the retinal response.
12. What information should a nurse relay to a patient when providing education about protecting
vision?
a.
After 40 years of age, eye examinations should be performed every 2 years.
b.
Crusted eyelids on awakening are caused by decreased tear production.
c.
Floaters are a sign of eye infection.
d.
Blurred vision without pain is temporary eye strain.
13. How should a nurse assist a visually impaired patient to ambulate?
a.
Hold the visually impaired person by his or her nondominant arm and walk side by
side.
b.
Hold the nondominant hand, wrap the arm around his or her waist, and walk side
by side.
c.
Allow the visually impaired person to hold the helper’s arm, with the helper
slightly ahead.
d.
Allow the visually impaired person to hold the shoulder of the helper and walk
slightly behind the helper.
14. A newly diagnosed patient with macular degeneration flings her book at the television set and
furiously says, “I can’t read this blasted book, and I can’t see what is on the stupid TV!” How
should the nurse define this behavior?
a.
Anger stage of grieving
b.
Poor impulse control
c.
Ineffective management of a therapeutic regimen
d.
Psychotic reaction to loss
15. What is the correct term to use for a patient with a vision disorder?
a.
Blind
b.
Handicapped
c.
Partially blind
d.
Visually impaired
16. Which nursing diagnosis is not appropriate for a visually impaired patient?
a.
Impaired sensory perception
b.
Risk for delayed development
c.
Self-care deficit
d.
Ineffective coping
17. Which implementation is appropriate in the care plan for a visually impaired person?
a.
Leaving the bed in the highest position
b.
Keeping the door closed
c.
Announcing your presence when you enter and leave the room
d.
Leaving the radio on all the time to help the patient know the time of day
18. A patient with glaucoma is taking a beta-adrenergic blocking agent, timolol (Timoptic). For
which potential side effect should the nurse assess the patient?
a.
Wheezing
b.
Hypertension
c.
Sudden eye pain
d.
Blurred vision
19. A 52-year-old patient reports that he must hold his paper farther and farther away from his
face to read it. What is the nurse’s most informative response?
a.
“You are describing myopia. Glasses will help you read.”
b.
“You may have astigmatism, but your eyes will finally adjust.”
c.
“You have presbyopia. Nonprescription reading glasses will help you.”
d.
“An eye infection may be the problem. Check with your physician for
medication.”
20. A nurse explains that laser-assisted in situ keratomileusis (Lasik) and photorefractive
keratectomy (PRK) are methods to correct refractive errors surgically. What do these
procedures reshape?
a.
Cornea
b.
Lens
c.
Iris
d.
Pupil
21. A patient reports to a home health care nurse of having cloudy vision and seeing spots and
halos around lights. What should the nurse suspect based on these patient symptoms?
a.
Cataracts
b.
Glaucoma
c.
Detached retina
d.
Macular degeneration
22. How does closed-angle glaucoma differ from open-angle glaucoma?
a.
The onset is acute.
b.
Trabeculectomy is the initial treatment.
c.
Treatment can be conservative.
d.
Intraocular pressure drops suddenly.
23. What is the cause of glaucoma?
a.
Cloudiness in the lens
b.
Increase in intraocular pressure
c.
Failed eye surgery
d.
Retinal tears
24. A patient in the emergency department complains of severe pain in his eye and is seeing halos
around lights and feeling nauseous. Which diagnosis should the nurse suspect?
a.
Open-angle glaucoma
b.
Angle-closure glaucoma
c.
Cataracts
d.
Retinal detachment
25. Which surgical implementation is most effective with retinal detachment?
a.
Removing the lens
b.
Macular bonding
c.
Lasik surgery
d.
Scleral buckling
MULTIPLE RESPONSE
26. A nurse assesses an 80-year-old patient for age-related changes to the eye. What potential
changes should the nurse anticipate? (Select all that apply.)
a.
Decreased tear production
b.
Eyeball sunk deep in orbit
c.
Hyperopia
d.
Eye lashes diminished
e.
Arcus senilis
27. What makes up the refractive media of the eye? (Select all that apply.)
a.
Aqueous humor
b.
Retina
c.
Vitreous humor
d.
Cornea
e.
Lens
28. What actions should a nurse implement when assessing a patient’s accommodation? (Select
all that apply.)
a.
Hold his or her finger approximately 20 inches in front of the patient’s eyes.
b.
Observe for pupillary constriction.
c.
Assess for convergence.
d.
Note blinking.
e.
Move his or her finger slowly toward the patient’s nose.
29. A patient who has had surgery this morning for cataracts is now going home. What should the
nurse include when providing discharge instructions? (Select all that apply.)
a.
Sleep on the affected side.
b.
Use stool softeners.
c.
Avoid bending over.
d.
Avoid lifting anything heavier than 5 lb.
e.
Do not wear an eye shield at night.