Lewis Chapter 20: Assessment of Visual and Auditory Systems Exam Questions
and Answers With Verified Solutions 2025
The nurse is providing health promotion teaching to a group of *older adults*. Which information will
the nurse include when teaching about routine *glaucoma testing*?
a. A Tono-Pen will be applied to the surface of the eye.
b. The test involves reading a Snellen chart from 20 feet.
c. Medications will be used to dilate the pupils for the test.
d. The examination involves checking the pupil's reaction to light. - a. A Tono-Pen will be applied to the
surface of the eye
Glaucoma is caused by an *increase in intraocular pressure*, which would be measured using the
*Tono-Pen*. The other techniques are used in testing for other eye disorders.
The nurse is performing an eye examination on a *76-yr-old* patient. The nurse should refer the patient
for a more extensive assessment based on which finding?
a. The patient's sclerae are light yellow.
b. The patient reports persistent photophobia.
c. The pupil recovers slowly after responding to a bright light.
d. There is a whitish gray ring encircling the periphery of the iris. - b. The patient reports persistent
photophobia.
*Photophobia* is *not a normally occurring change* with aging and would require further assessment.
The other assessment data are common gerontologic differences in assessment and would not be
unusual in a 76-yr-old patien
The nurse performing an eye examination will document normal findings for accommodation when
a. shining a light into the patient's eye causes pupil constriction in the opposite eye.
b. a blink reaction follows touching the patient's pupil with a piece of sterile cotton.
c. covering one eye for 1 minute and noting pupil constriction as the cover is
removed.
d. the pupils constrict while fixating on an object being moved toward the patient's
,eyes. - d. the pupils constrict while fixating on an object being moved toward the patient's
eyes.
Which assessment finding alerts the nurse to provide patient teaching about *cataract development*?
a. History of hyperthyroidism
b. Unequal pupil size and shape
c. Blurred vision and light sensitivity
d. Loss of peripheral vision in both eyes - c. Blurred vision and light sensitivity
Classic signs of cataracts include blurred vision and light sensitivity. Thyroid problems are a major cause
of exophthalmos. Unequal pupil is not indicative of cataracts. Loss of peripheral vision is a sign of
glaucoma.
Assessment of a patient's visual acuity reveals that the left eye can see at 20 feet what a person with
normal vision can see at 50 feet and the right eye can see at 20 feet what a person with normal vision
can see at 40 feet. The nurse records which finding?
a. OS 20/50; OD 20/40
c. OD 20/40; OS 20/50
b. OU 20/40; OS 50/20
d. OU 40/20; OD 50/20 - a. OS 20/50; OD 20/40
When assessing a patient's consensual pupil response, the nurse should
a. have the patient cover one eye while facing the nurse.
b. observe for a light reflection in the center of both pupils.
c. shine a light into one eye and observe responses of both pupils.
d. instruct the patient to follow a moving object using only the eyes. - c. shine a light into one eye and
observe responses of both pupils.
The nurse is observing a student who is preparing to perform an ear examination for a 30-yr-old patient.
The nurse will need to intervene if the student
a. pulls the auricle of the ear up and posterior.
, b. chooses a speculum larger than the ear canal.
c. stabilizes the hand holding the otoscope on the patient's head.
d. stops inserting the otoscope after observing impacted cerumen. - b. chooses a speculum larger than
the ear canal.
When obtaining a health history from a 49-yr-old patient, which patient statement is most important to
communicate to the primary health care provider?
a. "My eyes are dry now."
b. "It is hard for me to see at night."
c. "My vision is blurry when I read."
d. "I can't see as far over to the side." - d. "I can't see as far over to the side."
The *decrease in peripheral vision* may *indicate glaucoma*, which is not a normal visual change
associated with aging and requires rapid treatment.
A 65-yr-old patient is being evaluated for glaucoma. Which information given by the patient has
implications for the patient's treatment plan?
a. "I take metoprolol (Lopressor) for angina."
b. "I take aspirin when I have a sinus headache."
c. "I have had frequent episodes of conjunctivitis."
d. "I have not had an eye examination for 10 years." - a. "I take metoprolol (Lopressor) for angina."
It is important to note whether the patient takes any *b-adrenergic blockers* because this classification
of medications is *also used to treat glaucoma*, and there may be an *increase in adverse effects*. The
use of aspirin does not increase intraocular pressure and is safe for patients with glaucoma. Although
older patients should have yearly eye examinations, the treatment for this patient will not be affected
by the 10-year gap in eye care. Conjunctivitis does not increase the risk for glaucoma.
The nurse is testing the visual acuity of a patient in the outpatient clinic. The nurse's instructions for this
test include asking the patient to
a. stand 20 feet away from the wall chart.
b. follow the examiner's finger with the eyes only.
and Answers With Verified Solutions 2025
The nurse is providing health promotion teaching to a group of *older adults*. Which information will
the nurse include when teaching about routine *glaucoma testing*?
a. A Tono-Pen will be applied to the surface of the eye.
b. The test involves reading a Snellen chart from 20 feet.
c. Medications will be used to dilate the pupils for the test.
d. The examination involves checking the pupil's reaction to light. - a. A Tono-Pen will be applied to the
surface of the eye
Glaucoma is caused by an *increase in intraocular pressure*, which would be measured using the
*Tono-Pen*. The other techniques are used in testing for other eye disorders.
The nurse is performing an eye examination on a *76-yr-old* patient. The nurse should refer the patient
for a more extensive assessment based on which finding?
a. The patient's sclerae are light yellow.
b. The patient reports persistent photophobia.
c. The pupil recovers slowly after responding to a bright light.
d. There is a whitish gray ring encircling the periphery of the iris. - b. The patient reports persistent
photophobia.
*Photophobia* is *not a normally occurring change* with aging and would require further assessment.
The other assessment data are common gerontologic differences in assessment and would not be
unusual in a 76-yr-old patien
The nurse performing an eye examination will document normal findings for accommodation when
a. shining a light into the patient's eye causes pupil constriction in the opposite eye.
b. a blink reaction follows touching the patient's pupil with a piece of sterile cotton.
c. covering one eye for 1 minute and noting pupil constriction as the cover is
removed.
d. the pupils constrict while fixating on an object being moved toward the patient's
,eyes. - d. the pupils constrict while fixating on an object being moved toward the patient's
eyes.
Which assessment finding alerts the nurse to provide patient teaching about *cataract development*?
a. History of hyperthyroidism
b. Unequal pupil size and shape
c. Blurred vision and light sensitivity
d. Loss of peripheral vision in both eyes - c. Blurred vision and light sensitivity
Classic signs of cataracts include blurred vision and light sensitivity. Thyroid problems are a major cause
of exophthalmos. Unequal pupil is not indicative of cataracts. Loss of peripheral vision is a sign of
glaucoma.
Assessment of a patient's visual acuity reveals that the left eye can see at 20 feet what a person with
normal vision can see at 50 feet and the right eye can see at 20 feet what a person with normal vision
can see at 40 feet. The nurse records which finding?
a. OS 20/50; OD 20/40
c. OD 20/40; OS 20/50
b. OU 20/40; OS 50/20
d. OU 40/20; OD 50/20 - a. OS 20/50; OD 20/40
When assessing a patient's consensual pupil response, the nurse should
a. have the patient cover one eye while facing the nurse.
b. observe for a light reflection in the center of both pupils.
c. shine a light into one eye and observe responses of both pupils.
d. instruct the patient to follow a moving object using only the eyes. - c. shine a light into one eye and
observe responses of both pupils.
The nurse is observing a student who is preparing to perform an ear examination for a 30-yr-old patient.
The nurse will need to intervene if the student
a. pulls the auricle of the ear up and posterior.
, b. chooses a speculum larger than the ear canal.
c. stabilizes the hand holding the otoscope on the patient's head.
d. stops inserting the otoscope after observing impacted cerumen. - b. chooses a speculum larger than
the ear canal.
When obtaining a health history from a 49-yr-old patient, which patient statement is most important to
communicate to the primary health care provider?
a. "My eyes are dry now."
b. "It is hard for me to see at night."
c. "My vision is blurry when I read."
d. "I can't see as far over to the side." - d. "I can't see as far over to the side."
The *decrease in peripheral vision* may *indicate glaucoma*, which is not a normal visual change
associated with aging and requires rapid treatment.
A 65-yr-old patient is being evaluated for glaucoma. Which information given by the patient has
implications for the patient's treatment plan?
a. "I take metoprolol (Lopressor) for angina."
b. "I take aspirin when I have a sinus headache."
c. "I have had frequent episodes of conjunctivitis."
d. "I have not had an eye examination for 10 years." - a. "I take metoprolol (Lopressor) for angina."
It is important to note whether the patient takes any *b-adrenergic blockers* because this classification
of medications is *also used to treat glaucoma*, and there may be an *increase in adverse effects*. The
use of aspirin does not increase intraocular pressure and is safe for patients with glaucoma. Although
older patients should have yearly eye examinations, the treatment for this patient will not be affected
by the 10-year gap in eye care. Conjunctivitis does not increase the risk for glaucoma.
The nurse is testing the visual acuity of a patient in the outpatient clinic. The nurse's instructions for this
test include asking the patient to
a. stand 20 feet away from the wall chart.
b. follow the examiner's finger with the eyes only.
