Ocular Assessment Quiz

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| By Catherine Halcomb
Catherine Halcomb
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1. 2. During ocular examinations, the nurse keeps in mind that movement of the extraocular muscles is:

Explanation

Movement of the extraocular muscles is stimulated by three CNs: III, IV, and VI.

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About This Quiz
Nursing Quizzes & Trivia

This Ocular Assessment Quiz assesses essential nursing skills in ocular health assessment, focusing on critical areas such as eyelid margins, extraocular muscle movement, and eye sensitivity. It also covers autonomic eye responses, intraocular pressure measurement, and evaluation of visual fields. Designed to enhance practical knowledge, this quiz helps nursing professionals... see moredevelop competence in conducting thorough eye examinations.

Understanding these components is vital for early detection of eye disorders and effective patient care. By testing knowledge in these specific areas, the quiz prepares learners to confidently perform ocular assessments and interpret findings accurately. This focused evaluation supports improved clinical decision-making and promotes comprehensive eye health management, ensuring nurses are well-equipped to meet the needs of patients requiring ocular care.
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2. 8. A patient has a normal pupillary light reflex. The nurse recognizes that this reflex indicates that:

Explanation

The pupillary light reflex is the normal constriction of the pupils when bright light shines on the retina. The other responses are not correct.

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3. 13. The nurse is preparing to assess the visual acuity of a 16-year-old patient. How should the nurse proceed?

Explanation

The Snellen alphabet chart is the most commonly used and most accurate measure of visual acuity. The confrontation test is a gross measure of peripheral vision. The Jaeger card or newspaper tests are used to test near vision.

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4. 17. When performing the corneal light reflex assessment, the nurse notes that the light is reflected at 2 o'clock in each eye. The nurse should:

Explanation

Reflection of the light on the corneas should be in exactly the same spot on each eye, or symmetric. If asymmetry is noted, then the nurse should administer the cover test.

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5. 16. A patient's vision is recorded as 20/80 in each eye. The nurse interprets this finding to mean that the patient:

Explanation

Normal visual acuity is 20/20 in each eye; the larger the denominator, the poorer the vision.

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6. 11. Which of these assessment findings would the nurse expect to see when examining the eyes of a black patient?

Explanation

An ethnically based variability in the color of the iris and in retinal pigmentation exists, with darker irides having darker retinas behind them.

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7. 1. When examining the eye, the nurse notices that the patient's eyelid margins approximate completely. The nurse recognizes that this assessment finding:

Explanation

The palpebral fissure is the elliptical open space between the eyelids, and, when closed, the lid margins approximate completely, which is a normal finding.

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

Explanation

The cornea and the sclera make up the outer layer of the eye. The cornea is very sensitive to touch. The middle layer, the choroid, has dark pigmentation to prevent light from reflecting internally. The trigeminal nerve (CN V) and the facial nerve (CN VII) are stimulated when the outer surface of the eye is stimulated. The retina, in the inner layer of the eye, is where light waves are changed into nerve impulses.

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9. 34. A patient comes into the clinic complaining of pain in her right eye. On examination, the nurse sees a pustule at the lid margin that is painful to touch, red, and swollen. The nurse recognizes that this is a:

Explanation

A hordeolum, or stye, is a painful, red, and swollen pustule at the lid margin. A chalazion is a nodule protruding on the lid, toward the inside, and is nontender, firm, with discrete swelling. Dacryocystitis is an inflammation of the lacrimal sac. Blepharitis is inflammation of the eyelids (see Table 14-3).

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10. 24. In using the ophthalmoscope to assess a patient's eyes, the nurse notices a red glow in the patient's pupils. On the basis of this finding, the nurse would:

Explanation

The red glow filling the person’s pupil is the red reflex and is a normal finding caused by the reflection of the ophthalmoscope light off the inner retina. The other responses are not correct.

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11. 7. The nurse is testing a patient's visual accommodation, which refers to which action?

Explanation

The muscle fibers of the iris contract the pupil in bright light and accommodate for near vision, which also results in pupil constriction. The other responses are not correct.

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12. 19. During an assessment of the sclera of a black patient, the nurse would consider which of these an expected finding?

Explanation

Normally in dark-skinned people, small brown macules may be observed in the sclera.

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13. 38. 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. This finding indicates the presence of:

Explanation

Hyphema is the term for blood in the anterior chamber and is a serious result of blunt trauma (a fist or a baseball) or spontaneous hemorrhage and may indicate scleral rupture or major intraocular trauma. (See Table 14-7 for descriptions of the other terms.)

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14. 6. The nurse is conducting a visual examination. Which of these statements regarding visual pathways and visual fields is true?

Explanation

The image formed on the retina is upside down and reversed from its actual appearance in the outside world. The light rays are refracted through the transparent media of the eye before striking the retina, and the nerve impulses are conducted through the optic nerve tract to the visual cortex of the occipital lobe of the brain. The left side of the brain interprets vision for the right eye.

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

Explanation

If the person is unable to see even the largest letters when standing 20 feet from the chart, then the nurse should shorten the distance to the chart until the letters are seen, and record that distance (e.g., “10/200”). If visual acuity is even lower, then the nurse should assess whether the person can count fingers when they are spread in front of the eyes or can distinguish light perception from a penlight. If vision is poorer than 20/30, then a referral to an ophthalmologist or optometrist is necessary, but the nurse must first assess the visual acuity.

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16. 21. During an examination of the eye, the nurse would expect what normal finding when assessing the lacrimal apparatus?

Explanation

No swelling, redness, or drainage from the puncta should be observed when it is pressed. Regurgitation of fluid from the puncta, when pressed, indicates duct blockage. The lacrimal glands are not functional at birth.

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17. 35. A 68-year-old woman is in the eye clinic for a checkup. She tells the nurse that she has been having trouble reading the paper, sewing, and even seeing the faces of her grandchildren. On examination, the nurse notes that she has some loss of central vision but her peripheral vision is normal. These findings suggest that she may have:

Explanation

Macular degeneration is the most common cause of blindness. It is characterized by the loss of central vision. Cataracts would show lens opacity. Chronic open-angle glaucoma, the most common type of glaucoma, involves a gradual loss of peripheral vision. These findings are not consistent with vision that is considered normal at any age.

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18. 10. The nurse is reviewing in age-related changes in the eye for a class. Which of these physiologic changes is responsible for presbyopia?

Explanation

The lens loses elasticity and decreases its ability to change shape to accommodate for near vision. This condition is called presbyopia.

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

Explanation

To test the pupillary light reflex, the nurse should advance a light in from the side and note the direct and consensual pupillary constriction.

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20. 4. When examining a patient's eyes, the nurse recalls that stimulation of the sympathetic branch of the autonomic nervous system:

Explanation

Stimulation of the sympathetic branch of the autonomic nervous system dilates the pupil and elevates the eyelid. Parasympathetic nervous system stimulation causes the pupil to constrict. The muscle fibers of the iris contract the pupil in bright light to accommodate for near vision. The ciliary body controls the thickness of the lens.

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

Explanation

The optic disc is located on the nasal side of the retina. Its color is a creamy yellow-orange to a pink, and the edges are distinct and sharply demarcated, not blurred. A pigmented crescent is black and is due to the accumulation of pigment in the choroid.

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22. 36. 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?

Explanation

A corneal abrasion causes irregular ridges in reflected light, which produce a shattered appearance to light rays. No opacities should be observed in the cornea. The other responses are not correct.

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

Explanation

Pupils are small in the older adult, and the pupillary light reflex may be slowed, but pupillary constriction should be symmetric. The assessment findings in the other responses are considered normal in older persons.

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24. 39. During an assessment, the nurse notices that an older adult patient has tears rolling down his face from his left eye. Closer examination shows that the lower lid is loose and rolling outward. The patient complains of his eye feeling "dry and itchy." Which action by the nurse is correct?

Explanation

The condition described is known as ectropion, and it occurs in older adults and is attributable to atrophy of the elastic and fibrous tissues. The lower lid does not approximate to the eyeball, and, as a result, the puncta cannot effectively siphon tears; excessive tearing results. Ptosis is a drooping of the upper eyelid. These signs do not suggest the presence of a foreign body in the eye or basal cell carcinoma.

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25. 28. The nurse is performing an eye-screening clinic at a daycare center. When examining a 2-year-old child, the nurse suspects that the child has a "lazy eye" and should:

Explanation

Testing for strabismus is done by performing the corneal light reflex test and the cover test. The Snellen eye chart and confrontation test are not used to test for strabismus.

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26. 9. A mother asks when her newborn infant's eyesight will be developed. The nurse should reply:

Explanation

Eye movements may be poorly coordinated at birth, but by 3 to 4 months of age, the infant should establish binocularity and should be able to fixate simultaneously on a single image with both eyes.

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27. 26. A 2-week-old infant can fixate on an object but cannot follow a light or bright toy. The nurse would:

Explanation

By 2 to 4 weeks an infant can fixate on an object. By the age of 1 month, the infant should fixate and follow a bright light or toy.

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28. 32. In a patient who has anisocoria, the nurse would expect to observe:

Explanation

Unequal pupil size is termed anisocoria. It normally exists in 5% of the population but may also be indicative of central nervous system disease.

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29. 33. A patient comes to the emergency department after a boxing match, and his left eye is swollen almost shut. He has bruises on his face and neck. He says he is worried because he "can't see well" from his left eye. The physician suspects retinal damage. The nurse recognizes that signs of retinal detachment include:

Explanation

With retinal detachment, the person has shadows or diminished vision in one quadrant or one half of the visual field. The other responses are not signs of retinal detachment.

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30. 18. The nurse is performing the diagnostic positions test. Normal findings would be which of these results?

Explanation

A normal response for the diagnostic positions test is parallel tracking of the object with both eyes. Eye movement that is not parallel indicates a weakness of an extraocular muscle or dysfunction of the CN that innervates it.

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31. 14. A patient's vision is recorded as 20/30 when the Snellen eye chart is used. The nurse interprets these results to indicate that:

Explanation

The top number indicates the distance the person is standing from the chart; the denominator gives the distance at which a normal eye can see.

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32. 27. The nurse is assessing color vision of a male child. Which statement is correct? The nurse should:

Explanation

Test boys only once for color vision between the ages of 4 and 8 years. Color vision is not tested in girls because it is rare in girls. Testing is performed with the Ishihara test, which is a series of polychromatic cards.

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33. 30. The nurse notices the presence of periorbital edema when performing an eye assessment on a 70-year-old patient. The nurse should:

Explanation

Periorbital edema occurs with local infections, crying, and systemic conditions such as heart failure, renal failure, allergy, and hypothyroidism. Periorbital edema is not associated with blepharitis.

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34. 12. A 52-year-old patient describes the presence of occasional floaters or spots moving in front of his eyes. The nurse should:

Explanation

Floaters are a common sensation with myopia or after middle age and are attributable to condensed vitreous fibers. Floaters or spots are not usually significant, but the acute onset of floaters may occur with retinal detachment.

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35. 37. An ophthalmic examination reveals papilledema. The nurse is aware that this finding indicates:

Explanation

Papilledema, or choked disk, is a serious sign of increased intracranial pressure, which is caused by a space-occupying mass such as a brain tumor or hematoma. This pressure causes venous stasis in the globe, showing redness, congestion, and elevation of the optic disc, blurred margins, hemorrhages, and absent venous pulsations. Papilledema is not associated with the conditions in the other responses.

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

Explanation

Intraocular pressure is determined by a balance between the amount of aqueous produced and the resistance to its outflow at the angle of the anterior chamber. The other responses are incorrect.

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37. 20. 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?

Explanation

Ptosis is a drooping of the upper eyelid that would be apparent by observing the distance between the upper and lower eyelids. The confrontation test measures peripheral vision. Measuring near vision or the corneal light test does not check for ptosis.

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

Explanation

The accommodation reaction includes pupillary constriction and convergence of the axes of the eyes. The other responses are not correct.

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39. 31. When a light is directed across the iris of a patient's eye from the temporal side, the nurse is assessing for:

Explanation

The presence of shadows in the anterior chamber may be a sign of acute angle-closure glaucoma. The normal iris is flat and creates no shadows. This method is not correct for the assessment of dacryocystitis, conjunctivitis, or cataracts.

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40. 1. 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.

Explanation

Open-angle glaucoma is the most common type of glaucoma; virtually no symptoms are exhibited. Vision loss begins with the peripheral vision, which often goes unnoticed because individuals learn to compensate intuitively by turning their heads. The other characteristics are those of closed-angle glaucoma.

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2. During ocular examinations, the nurse keeps in mind that...
8. A patient has a normal pupillary light reflex. The nurse...
13. The nurse is preparing to assess the visual acuity of a...
17. When performing the corneal light reflex assessment, the...
16. A patient's vision is recorded as 20/80 in each eye. The...
11. Which of these assessment findings would the nurse expect to...
1. When examining the eye, the nurse notices that the patient's...
3. The nurse is performing an external eye examination. Which...
34. A patient comes into the clinic complaining of pain in her...
24. In using the ophthalmoscope to assess a patient's eyes, the...
7. The nurse is testing a patient's visual accommodation, which...
19. During an assessment of the sclera of a black patient, the...
38. During a physical education class, a student is hit in the...
6. The nurse is conducting a visual examination. Which of these...
15. A patient is unable to read even the largest letters on the...
21. During an examination of the eye, the nurse would expect what...
35. A 68-year-old woman is in the eye clinic for a checkup. She...
10. The nurse is reviewing in age-related changes in the eye for...
22. When assessing the pupillary light reflex, the nurse should...
4. When examining a patient's eyes, the nurse recalls that...
25. The nurse is examining a patient's retina with an...
36. A patient comes into the emergency department after an...
29. The nurse is performing an eye assessment on an 80-year-old...
39. During an assessment, the nurse notices that an older adult...
28. The nurse is performing an eye-screening clinic at a daycare...
9. A mother asks when her newborn infant's eyesight will be...
26. A 2-week-old infant can fixate on an object but cannot follow...
32. In a patient who has anisocoria, the nurse would expect to...
33. A patient comes to the emergency department after a boxing...
18. The nurse is performing the diagnostic positions test. Normal...
14. A patient's vision is recorded as 20/30 when the Snellen eye...
27. The nurse is assessing color vision of a male child. Which...
30. The nurse notices the presence of periorbital edema when...
12. A 52-year-old patient describes the presence of...
37. An ophthalmic examination reveals papilledema. The nurse is...
5. The nurse is reviewing causes of increased intraocular...
20. A 60-year-old man is at the clinic for an eye examination....
23. The nurse is assessing a patient's eyes for the accommodation...
31. When a light is directed across the iris of a patient's eye...
1. During an examination, a patient states that she was diagnosed...
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