Chapter 13- Eye Assessment

the eye

what is the sensory organ of sight?

the orbital socket of the cranium

what protects the complex internal structures of the eye?

the anterior portion of the eyeball.

what portion of the eye is vision?

it takes in information in the form of light, then the internal structures will analyze and interpret to produce shape, colors, and objects

what is the function of the eye?

loose mobile folds of skin that covers the eye, protects it from foreign bodies, regulates light entrance, and distribute tears.

what are eyelids?

palpebral fissure

what is the almond-shape open space between the eyelid?

when the palpebral fissure is closed

when do the lid margins normally approximate completely?

the upper portion of the iris

what does the upper eyelid cover?

at the limbus, which is the border between the sclera and cornea

where are the lower eyelid margins?

conjuctiva

what is the thin mucous membrane that lines the inner eyelid?

the lacrimal gland, punctum, lacrimal sac, and nasolacrimal duct

what is composed in the lacrimal apparatus?

it protects and lubricates the cornea and conjunctiva by producing and draining tears.

what is the job of the lacrimal apparatus?

they control eye movement and hold the eye in place in the socket. These muscles coordinate their actions to produce vision in both eyes

what is the job of the six extraocular muscles?

it elevates the eye upward and adducts (toward the nose) and rotates the eye medially (inward)

what is the function of the superior rectus?

it rotates the eye downward and adducts and rotates the eye medially

what is the function of the inferior rectus?

it moves the eye laterally (toward the temple)

what is the function of the lateral rectus?

it moves the eye medially

what is the function of the medial rectus?

it turns the eye downward and abducts (toward the temple) and rotates the eye laterally

what is the function of the superior oblique ?

it turns the eye upward and abducts and turns the eye laterally

what is the function of the inferior oblique?

CN III- oculomotor
CN IV- trochlear
CN VI- abducens

what nerves innervate and control the motor nerve activities of the eye?

the white sclera

what helps to maintain the size and shape of the eye?

the transparent and avascular cornea

what allows light rays to enter the eye?

the iris

what regulates the amount of light that enters the pupil?

the type and amount of pigment in the smooth muscles of the iris

what does the color of the eye depend on?

the lens

what sits directly behind the pupil, and refracts and focuses light on to the retina?

the ciliary body

what produces aqueous humor and contains the muscles that controls the shape of the lens?

the choroids

what covers the recessed portion of the eye, and is a network of blood vessels in the eye?

the anterior chamber

the space between the cornea in the front and the iris/lens in the back that contains aqueous humor

the posterior chamber

starts behind the iris and goes to the lens. it is the largest vitreous chamber and is adjacent to the inner retinal layer and lens.

it is gelatinous, and it holds the retina in place, and maintains the shape of the eyeball

what is the vitreous humor

the retina

what receives and transmits visual stimuli to the brain for processing?

to view the retinal structure

what is the ophthalmoscope used for?

superior, inferior, and medial rectus, as well as the inferior oblique

what eye muscles does CN III deal with?

lateral rectus

what eye muscle does CN VI deal with?

superior oblique

What eye muscles does CN IV deal with?

*eyelids may droop and become wrinkled from loss of skin elasticity.
*the eye sits deeper in the orbits from loss of subcutaneous fats
*eyebrows become thinner
*conjunctivae are thinner and may appear yellow
*irregular iris pigmentation
*tear formation de

what are the changes in eye structure in older adults?

first you identify the problem and then determine whether the situation requires immediate medical attention. In the case of trauma or injury, time delay can threaten eye function

what is involved in an acute assessment of the eye?

assessing for foreign bodies, lacerations, or hyphema (blood in the anterior chamber of the eye), and testing extraocular movement

what is involved in a rapid assessment?

an acute blockage of the fluid at the base between the iris and cornea. this is an emergency

what is acute glaucoma caused by?

it beings with the health history, continues with questions about specific eye conditions, and ends with detailed collection of information involving areas of concern

how do you collect subjective data on the eye?

age related eye diseases such as macular degeneration, cataract, diabetic retinopathy, and glaucoma

what is the leading cause of blindness and impaired vision in patients in the U.S?

deep water fish
fruits
vegetables

what are foods that promote eye health?

pain
trauma or surgery
visual changes
blind spots, floaters, halos
discharge
change in ADL

what are common symptoms of eye problems?

optic atrophy
glaucoma
vitamin A deficiency

what is associated with loss of night vision?

translucent specks that drift across the visual field. they are common in people older than 40 years of age, and near sighted people

what are floaters?

tunnel vision of your visual field

what is a symptom of macular degeneration?

assessment of visual acuity, the external eye, eye muscle function, external ocular structures (pupil reflex included), and internal ocular structure

what is involved in a comprehensive physical examination of the eye?

through inspection and palpation

how do you examine the external and external ocular structure?

a penetrating injury or suspected fracture of the orbital bone

what types of trauma requires a referral on an emergency basis?

through excessive formation of tears, allergic conjunctivitis, and itching

how does the body's response to allergens effect the eyes?

insect stings or bites to the eye

what often leads to periorbital edema and erythema?

congenital eye problems in the fetus

maternal exposure to rubella can lead to what?

neonatal blindness secondary to cataracts

fetal exposure to rubella can cause what?

congenital syphilis

what can cause neonatal blindness?

tunneling of your visual eye field

what is a main symptom of macular degeneration?

to evaluate for symmetry, redness, and obvious deformities

why do you inspect the external eye?

to test the ability to see far and drive

why do you test distance vision?

to evaluate the ability

why do you test near vision?

to assess for movement of the eye in several planes of movement . it allows you to detect muscle defects that cause misalignment or uncoordinated eye movement.

why do you test cardinal fields of gaze?

to evaluate swelling and tenderness

why do you inspect and palpate the lacrimal apparatus and conjunctiva?

to evaluate the pupil's response to direct and consensual light source

why do you test pupillary reflexes?

to screen for differences in the visual field from side to side and inferior and superior

why do you test static confrontation?

to assess the gross peripheral boundaries

why do you test kinetic confrontation?

to test for strabismus

why do you test corneal light reflexes?

to assess the presence and amount of ocular deviation

why do you perform the cover test?

to assess for glaucoma and cataracts

why do you inspect the cornea and lens?

to evaluate disc, vessels, macula, and periphery

why do you inspect the posterior eye
?

wash hands
don gloves
clean all equipment before examination
always examine the infected eye last

what measures do you use to avoid cross-contamination?

visual acuity
visual fields
funduscopic exam

CN II (optic nerve) tests for what?

cardinal field of gaze
eyelid inspection
pupil reaction

CN III (occulomotor nerve) tests for what?

cardinal fields of gaze

CN IV (trochlear nerve) and VI (abducens nerve) tests for what?

have the patient read the Snellen test

what is used to assess the distance visual acuity?

leaning forward
squinting
hesitation
misidentification of 3 object
more than a 2 line diff between eyes

unexpected findings during the Snellen chart include?

the top number represents the distance in feet the patient was from the chart. the bottom number marks the number under the smallest line of letters the patient correctly identifies. The larger the bottom number, the worse the visual acuity

what do the two numbers indicate in the Snellen test?

near vision. it is a pocket screener used to allow the patient to see if they could read using one eye at a time

what is the Jaeger chart used for?

ishihara cards or by having the patient identify the color bars on the Snellen chart

what is used for color vision?

it refers to what in the environment is visible when the eye fixates on a stationary object

what is the visual field?

used to screen for visual field defects

what is the confrontation test?

it can help you detect gross differences in all four quadrants of the visual field.

describe the static test.

differences from side to side (hemianopias) and inferior to superior (attitudinal)

the static test effectively screens for what?

the gross peripheral boundaries of the patient's visual field. When using the test, you move an object or your fingers from the periphery toward fixation at the point that the patient first becomes aware of the target

what does the kinetic test assess?

the corneal light reflex (Hirschberg test)
the cover test
the cardinal field of gaze test

what are the tests examiners use to assess the movement of the extraocular muscles?

improper alignment and appear as asymmetric reflection.

what is an unexpected finding during the Hirschberg test?

instruct the patient to stare ahead at the bridge of your nose
shine a penlight at the bridge of the patient's nose
note where the light reflects on the cornea of each eye

describe the corneal light reflex (Hirschberg) test

cover one eye
inspect for refixation of the uncovered eye, and then inspect the covered eye. any refixation is from muscle weakness in the covered eye

describe the cover test

sharply defined bright red blood in the eye

what indicates a subconjunctival hemorrhage

an abnormal thickening of the conjunctiva from the limbus over the cornea.

what is pterygium?

a jerking movement of the eye that can be quick and fluttering or slow and rolling, similar to a tremor.

what is nystagmus?

ask the patient to focus on your finger as you move it towards the patients nose. Constricted pupils are accommodation and eye crossing is convergence

how do you test for accommodation (CN III)?

it allows easy identification of foreign bodies

why is it important to test for eversion of the eyelids?

shape (round or oval)
color (creamy, yellow-orange, or pink)
disc margin (distinct and sharply demarcated)

what should you assess when looking at the optic disc

cataracts and age related macular degeneration

what are the two leading causes of loss of vision and blindness in the United States?

people who cannot read or speak english

what is the Snellen E chart used for?

A)
The palpebral fissure

1.
The open space between the eyelids is called what?
A)
The palpebral fissure
B)
The limbus
C)
The lacrimal fissure
D)
The eyeball

A)
Punctum
C)
Lacrimal gland
E)
Nasolacrimal duct

2.
The anatomy and physiology instructor is discussing the eye with the prenursing students. What would the instructor cite as part of the lacrimal apparatus? (Select all that apply.)
A)
Punctum
B)
Palpebral fissure
C)
Lacrimal gland
D)
Limbus
E)
Nasolacr

C)
The choroids

3.
During an anatomy class on the eye, a student asks the instructor what blood vessels go to the eye. What would be the instructor's best answer?
A)
The optic vein
B)
The optic plexus
C)
The choroids
D)
The coronal vein

D)
Vitreous

4.
The nurse is caring for a 15-year-old boy with an eye injury. The patient asks about the eye, and the nurse explains its structures and functions. What would the nurse tell the patient is the largest chamber of the eye?
A)
Anterior
B)
Posterior
C)
Corn

B)
Mydriatic drops may precipitate acute angle-closure glaucoma

5.
The nursing instructor is discussing glaucoma with clinical students. What would be important to tell the students about mydriatic drops in regard to glaucoma?
A)
Mydriatic drops do not affect patients with glaucoma
B)
Mydriatic drops may precipitate a

C)
Kinetic confrontation

6.
The nurse is assessing the peripheral vision of a 55-year-old patient. What test would the nurse use to assess the boundaries of the patient's peripheral vision?
A)
Static confrontation
B)
Allen
C)
Kinetic confrontation
D)
Cover

D)
Glaucoma

7.
When assessing risk factors for eye and vision problems, the nurse knows that genetics can play a role. What major eye problem are patients most likely at increased risk for if a first-degree relative has it?
A)
Retinoblastoma
B)
Strabismus
C)
Retiniti

A)
Use of safety equipment

8.
A 13-year-old girl is brought to the clinic for a sports physical examination. The patient states that she is going to play goalie on the community soccer team. What is the most important teaching opportunity presented for this patient?
A)
Use of safet

C)
Cardinal fields

9.
A patient tells the nurse that his eyes "aren't working right." When the nurse asks what the patient means, the patient states, "It is like one eye is moving faster than the other." What test would be most appropriate for the nurse to use to assess thi

C)
It is genetically determined
D)
It is equal in both eyes

10.
The cup-disc ratio is assessed by the use of the ophthalmoscope. What would the APRN know about the cup-disc ratio? (Select all that apply.)
A)
It should be 1:1
B)
It occurs only in females
C)
It is genetically determined
D)
It is equal in both eyes
E

A)
AV nicking

11.
The APRN is assessing the eyes of a patient with long-standing uncontrolled hypertension. What might the APRN visualize during an assessment with an ophthalmoscope?
A)
AV nicking
B)
Dilated veins
C)
Dilated arteries
D)
Brass wiring

B)
"It is called a pterygium.

12.
A 45-year-old professional fisherman presents at the ophthalmologist's office after being referred by his family physician. The referral was made after a benign growth of the conjunctiva was found growing from the nasal side of the sclera to the limbu

D)
20/200 bilaterally

13.
When assessing visual acuity in children, what would be the expected normal vision in a toddler?
A)
20/50 bilaterally
B)
20/100 bilaterally
C)
20/150 bilaterally
D)
20/200 bilaterally

A)
Hearing problems

14.
What puts a child at increased risk for visual impairments?
A)
Hearing problems
B)
Hispanic ethnicity
C)
Down's syndrome
D)
Motor problems

A)
Corneal light reflex

15.
A mother brings her 2-year-old child to the clinic stating that the child is cross-eyed. What test would the nurse perform to test for strabismus?
A)
Corneal light reflex
B)
Cover
C)
Allen
D)
Static

B)
Asthenopia

16.
A patient presents at the clinic with painful eyes, blurred vision, and headaches from using the computer all day at work. After a generalized assessment with no abnormal findings, the nurse would note what in reference to the eyes?
A)
Presbyopia
B)
A

A)
II
B)
III
C)
IV
E)
VI

17.
Normal movement of the eye involves what cranial nerves? (Mark all that apply.)
A)
II
B)
III
C)
IV
D)
V
E)
VI

A)
Arcus senilis
D)
Decreased tear production

18.
The nurse is performing visual acuity testing on a 70-year-old woman who has fallen and fractured her femur. What finding would be considered normal for this older adult? (Select all that apply.)
A)
Arcus senilis
B)
Increased tear production
C)
Catara

c) 10/40

19.
A nursing student is helping to test vision and hearing at the local elementary school. Each child needs to have vision tested and documented. The students are standing with their heels on a line 10 feet from the eye chart. How would the nurse documen

the eye

what is the sensory organ of sight?

the orbital socket of the cranium

what protects the complex internal structures of the eye?

the anterior portion of the eyeball.

what portion of the eye is vision?

it takes in information in the form of light, then the internal structures will analyze and interpret to produce shape, colors, and objects

what is the function of the eye?

loose mobile folds of skin that covers the eye, protects it from foreign bodies, regulates light entrance, and distribute tears.

what are eyelids?

palpebral fissure

what is the almond-shape open space between the eyelid?

when the palpebral fissure is closed

when do the lid margins normally approximate completely?

the upper portion of the iris

what does the upper eyelid cover?

at the limbus, which is the border between the sclera and cornea

where are the lower eyelid margins?

conjuctiva

what is the thin mucous membrane that lines the inner eyelid?

the lacrimal gland, punctum, lacrimal sac, and nasolacrimal duct

what is composed in the lacrimal apparatus?

it protects and lubricates the cornea and conjunctiva by producing and draining tears.

what is the job of the lacrimal apparatus?

they control eye movement and hold the eye in place in the socket. These muscles coordinate their actions to produce vision in both eyes

what is the job of the six extraocular muscles?

it elevates the eye upward and adducts (toward the nose) and rotates the eye medially (inward)

what is the function of the superior rectus?

it rotates the eye downward and adducts and rotates the eye medially

what is the function of the inferior rectus?

it moves the eye laterally (toward the temple)

what is the function of the lateral rectus?

it moves the eye medially

what is the function of the medial rectus?

it turns the eye downward and abducts (toward the temple) and rotates the eye laterally

what is the function of the superior oblique ?

it turns the eye upward and abducts and turns the eye laterally

what is the function of the inferior oblique?

CN III- oculomotor
CN IV- trochlear
CN VI- abducens

what nerves innervate and control the motor nerve activities of the eye?

the white sclera

what helps to maintain the size and shape of the eye?

the transparent and avascular cornea

what allows light rays to enter the eye?

the iris

what regulates the amount of light that enters the pupil?

the type and amount of pigment in the smooth muscles of the iris

what does the color of the eye depend on?

the lens

what sits directly behind the pupil, and refracts and focuses light on to the retina?

the ciliary body

what produces aqueous humor and contains the muscles that controls the shape of the lens?

the choroids

what covers the recessed portion of the eye, and is a network of blood vessels in the eye?

the anterior chamber

the space between the cornea in the front and the iris/lens in the back that contains aqueous humor

the posterior chamber

starts behind the iris and goes to the lens. it is the largest vitreous chamber and is adjacent to the inner retinal layer and lens.

it is gelatinous, and it holds the retina in place, and maintains the shape of the eyeball

what is the vitreous humor

the retina

what receives and transmits visual stimuli to the brain for processing?

to view the retinal structure

what is the ophthalmoscope used for?

superior, inferior, and medial rectus, as well as the inferior oblique

what eye muscles does CN III deal with?

lateral rectus

what eye muscle does CN VI deal with?

superior oblique

What eye muscles does CN IV deal with?

*eyelids may droop and become wrinkled from loss of skin elasticity.
*the eye sits deeper in the orbits from loss of subcutaneous fats
*eyebrows become thinner
*conjunctivae are thinner and may appear yellow
*irregular iris pigmentation
*tear formation de

what are the changes in eye structure in older adults?

first you identify the problem and then determine whether the situation requires immediate medical attention. In the case of trauma or injury, time delay can threaten eye function

what is involved in an acute assessment of the eye?

assessing for foreign bodies, lacerations, or hyphema (blood in the anterior chamber of the eye), and testing extraocular movement

what is involved in a rapid assessment?

an acute blockage of the fluid at the base between the iris and cornea. this is an emergency

what is acute glaucoma caused by?

it beings with the health history, continues with questions about specific eye conditions, and ends with detailed collection of information involving areas of concern

how do you collect subjective data on the eye?

age related eye diseases such as macular degeneration, cataract, diabetic retinopathy, and glaucoma

what is the leading cause of blindness and impaired vision in patients in the U.S?

deep water fish
fruits
vegetables

what are foods that promote eye health?

pain
trauma or surgery
visual changes
blind spots, floaters, halos
discharge
change in ADL

what are common symptoms of eye problems?

optic atrophy
glaucoma
vitamin A deficiency

what is associated with loss of night vision?

translucent specks that drift across the visual field. they are common in people older than 40 years of age, and near sighted people

what are floaters?

tunnel vision of your visual field

what is a symptom of macular degeneration?

assessment of visual acuity, the external eye, eye muscle function, external ocular structures (pupil reflex included), and internal ocular structure

what is involved in a comprehensive physical examination of the eye?

through inspection and palpation

how do you examine the external and external ocular structure?

a penetrating injury or suspected fracture of the orbital bone

what types of trauma requires a referral on an emergency basis?

through excessive formation of tears, allergic conjunctivitis, and itching

how does the body's response to allergens effect the eyes?

insect stings or bites to the eye

what often leads to periorbital edema and erythema?

congenital eye problems in the fetus

maternal exposure to rubella can lead to what?

neonatal blindness secondary to cataracts

fetal exposure to rubella can cause what?

congenital syphilis

what can cause neonatal blindness?

tunneling of your visual eye field

what is a main symptom of macular degeneration?

to evaluate for symmetry, redness, and obvious deformities

why do you inspect the external eye?

to test the ability to see far and drive

why do you test distance vision?

to evaluate the ability

why do you test near vision?

to assess for movement of the eye in several planes of movement . it allows you to detect muscle defects that cause misalignment or uncoordinated eye movement.

why do you test cardinal fields of gaze?

to evaluate swelling and tenderness

why do you inspect and palpate the lacrimal apparatus and conjunctiva?

to evaluate the pupil's response to direct and consensual light source

why do you test pupillary reflexes?

to screen for differences in the visual field from side to side and inferior and superior

why do you test static confrontation?

to assess the gross peripheral boundaries

why do you test kinetic confrontation?

to test for strabismus

why do you test corneal light reflexes?

to assess the presence and amount of ocular deviation

why do you perform the cover test?

to assess for glaucoma and cataracts

why do you inspect the cornea and lens?

to evaluate disc, vessels, macula, and periphery

why do you inspect the posterior eye
?

wash hands
don gloves
clean all equipment before examination
always examine the infected eye last

what measures do you use to avoid cross-contamination?

visual acuity
visual fields
funduscopic exam

CN II (optic nerve) tests for what?

cardinal field of gaze
eyelid inspection
pupil reaction

CN III (occulomotor nerve) tests for what?

cardinal fields of gaze

CN IV (trochlear nerve) and VI (abducens nerve) tests for what?

have the patient read the Snellen test

what is used to assess the distance visual acuity?

leaning forward
squinting
hesitation
misidentification of 3 object
more than a 2 line diff between eyes

unexpected findings during the Snellen chart include?

the top number represents the distance in feet the patient was from the chart. the bottom number marks the number under the smallest line of letters the patient correctly identifies. The larger the bottom number, the worse the visual acuity

what do the two numbers indicate in the Snellen test?

near vision. it is a pocket screener used to allow the patient to see if they could read using one eye at a time

what is the Jaeger chart used for?

ishihara cards or by having the patient identify the color bars on the Snellen chart

what is used for color vision?

it refers to what in the environment is visible when the eye fixates on a stationary object

what is the visual field?

used to screen for visual field defects

what is the confrontation test?

it can help you detect gross differences in all four quadrants of the visual field.

describe the static test.

differences from side to side (hemianopias) and inferior to superior (attitudinal)

the static test effectively screens for what?

the gross peripheral boundaries of the patient's visual field. When using the test, you move an object or your fingers from the periphery toward fixation at the point that the patient first becomes aware of the target

what does the kinetic test assess?

the corneal light reflex (Hirschberg test)
the cover test
the cardinal field of gaze test

what are the tests examiners use to assess the movement of the extraocular muscles?

improper alignment and appear as asymmetric reflection.

what is an unexpected finding during the Hirschberg test?

instruct the patient to stare ahead at the bridge of your nose
shine a penlight at the bridge of the patient's nose
note where the light reflects on the cornea of each eye

describe the corneal light reflex (Hirschberg) test

cover one eye
inspect for refixation of the uncovered eye, and then inspect the covered eye. any refixation is from muscle weakness in the covered eye

describe the cover test

sharply defined bright red blood in the eye

what indicates a subconjunctival hemorrhage

an abnormal thickening of the conjunctiva from the limbus over the cornea.

what is pterygium?

a jerking movement of the eye that can be quick and fluttering or slow and rolling, similar to a tremor.

what is nystagmus?

ask the patient to focus on your finger as you move it towards the patients nose. Constricted pupils are accommodation and eye crossing is convergence

how do you test for accommodation (CN III)?

it allows easy identification of foreign bodies

why is it important to test for eversion of the eyelids?

shape (round or oval)
color (creamy, yellow-orange, or pink)
disc margin (distinct and sharply demarcated)

what should you assess when looking at the optic disc

cataracts and age related macular degeneration

what are the two leading causes of loss of vision and blindness in the United States?

people who cannot read or speak english

what is the Snellen E chart used for?

A)
The palpebral fissure

1.
The open space between the eyelids is called what?
A)
The palpebral fissure
B)
The limbus
C)
The lacrimal fissure
D)
The eyeball

A)
Punctum
C)
Lacrimal gland
E)
Nasolacrimal duct

2.
The anatomy and physiology instructor is discussing the eye with the prenursing students. What would the instructor cite as part of the lacrimal apparatus? (Select all that apply.)
A)
Punctum
B)
Palpebral fissure
C)
Lacrimal gland
D)
Limbus
E)
Nasolacr

C)
The choroids

3.
During an anatomy class on the eye, a student asks the instructor what blood vessels go to the eye. What would be the instructor's best answer?
A)
The optic vein
B)
The optic plexus
C)
The choroids
D)
The coronal vein

D)
Vitreous

4.
The nurse is caring for a 15-year-old boy with an eye injury. The patient asks about the eye, and the nurse explains its structures and functions. What would the nurse tell the patient is the largest chamber of the eye?
A)
Anterior
B)
Posterior
C)
Corn

B)
Mydriatic drops may precipitate acute angle-closure glaucoma

5.
The nursing instructor is discussing glaucoma with clinical students. What would be important to tell the students about mydriatic drops in regard to glaucoma?
A)
Mydriatic drops do not affect patients with glaucoma
B)
Mydriatic drops may precipitate a

C)
Kinetic confrontation

6.
The nurse is assessing the peripheral vision of a 55-year-old patient. What test would the nurse use to assess the boundaries of the patient's peripheral vision?
A)
Static confrontation
B)
Allen
C)
Kinetic confrontation
D)
Cover

D)
Glaucoma

7.
When assessing risk factors for eye and vision problems, the nurse knows that genetics can play a role. What major eye problem are patients most likely at increased risk for if a first-degree relative has it?
A)
Retinoblastoma
B)
Strabismus
C)
Retiniti

A)
Use of safety equipment

8.
A 13-year-old girl is brought to the clinic for a sports physical examination. The patient states that she is going to play goalie on the community soccer team. What is the most important teaching opportunity presented for this patient?
A)
Use of safet

C)
Cardinal fields

9.
A patient tells the nurse that his eyes "aren't working right." When the nurse asks what the patient means, the patient states, "It is like one eye is moving faster than the other." What test would be most appropriate for the nurse to use to assess thi

C)
It is genetically determined
D)
It is equal in both eyes

10.
The cup-disc ratio is assessed by the use of the ophthalmoscope. What would the APRN know about the cup-disc ratio? (Select all that apply.)
A)
It should be 1:1
B)
It occurs only in females
C)
It is genetically determined
D)
It is equal in both eyes
E

A)
AV nicking

11.
The APRN is assessing the eyes of a patient with long-standing uncontrolled hypertension. What might the APRN visualize during an assessment with an ophthalmoscope?
A)
AV nicking
B)
Dilated veins
C)
Dilated arteries
D)
Brass wiring

B)
"It is called a pterygium.

12.
A 45-year-old professional fisherman presents at the ophthalmologist's office after being referred by his family physician. The referral was made after a benign growth of the conjunctiva was found growing from the nasal side of the sclera to the limbu

D)
20/200 bilaterally

13.
When assessing visual acuity in children, what would be the expected normal vision in a toddler?
A)
20/50 bilaterally
B)
20/100 bilaterally
C)
20/150 bilaterally
D)
20/200 bilaterally

A)
Hearing problems

14.
What puts a child at increased risk for visual impairments?
A)
Hearing problems
B)
Hispanic ethnicity
C)
Down's syndrome
D)
Motor problems

A)
Corneal light reflex

15.
A mother brings her 2-year-old child to the clinic stating that the child is cross-eyed. What test would the nurse perform to test for strabismus?
A)
Corneal light reflex
B)
Cover
C)
Allen
D)
Static

B)
Asthenopia

16.
A patient presents at the clinic with painful eyes, blurred vision, and headaches from using the computer all day at work. After a generalized assessment with no abnormal findings, the nurse would note what in reference to the eyes?
A)
Presbyopia
B)
A

A)
II
B)
III
C)
IV
E)
VI

17.
Normal movement of the eye involves what cranial nerves? (Mark all that apply.)
A)
II
B)
III
C)
IV
D)
V
E)
VI

A)
Arcus senilis
D)
Decreased tear production

18.
The nurse is performing visual acuity testing on a 70-year-old woman who has fallen and fractured her femur. What finding would be considered normal for this older adult? (Select all that apply.)
A)
Arcus senilis
B)
Increased tear production
C)
Catara

c) 10/40

19.
A nursing student is helping to test vision and hearing at the local elementary school. Each child needs to have vision tested and documented. The students are standing with their heels on a line 10 feet from the eye chart. How would the nurse documen