Chapter 14: Eyes
Jarvis: Physical Examination & Health Assessment, 7th Edition
MULTIPLE CHOICE
1. When examining the eye, the nurse notices that the patient’s eyelid margins approximate
completely. The nurse recognizes that this assessment finding:
a.Is expected.
b.May indicate a problem with extraocular muscles.
c.May result in problems with tearing.
d.Indicates increased intraocular pressure.
ANS: A
The palpebral fissure is the elliptical open space between the eyelids, and, when closed, the lid
margins approximate completely, which is a normal finding.
DIF: Cognitive Level: Understanding (Comprehension) REF: p. 281
MSC: Client Needs: Physiologic Integrity: Physiologic Adaptation
2. During ocular examinations, the nurse keeps in mind that movement of the extraocular
muscles is:
a. Decreased in the older adult.
b. Impaired in a patient with cataracts.
c. Stimulated by cranial nerves (CNs) I and II.
d. Stimulated by CNs III, IV, and VI.
ANS: D
Movement of the extraocular muscles is stimulated by three CNs: III, IV, and VI.
DIF: Cognitive Level: Remembering (Knowledge) REF: p. 283
MSC: Client Needs: Physiologic Integrity: Physiologic Adaptation
3. The nurse is performing an external eye examination. Which statement regarding the outer
layer of the eye is true?
a. The outer layer of the eye is very sensitive to touch.
b. The outer layer of the eye is darkly pigmented to prevent light from reflecting
internally.
c. The trigeminal nerve (CN V) and the trochlear nerve (CN IV) are stimulated when
the outer surface of the eye is stimulated.
d. The visual receptive layer of the eye in which light waves are changed into nerve
impulses is located in the outer layer of the eye.
ANS: A
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.
, DIF: Cognitive Level: Understanding (Comprehension) REF: p. 283
MSC: Client Needs: Physiologic Integrity: Physiologic Adaptation
4. When examining a patient’s eyes, the nurse recalls that stimulation of the sympathetic branch
of the autonomic nervous system:
a. Causes pupillary constriction.
b. Adjusts the eye for near vision.
c. Elevates the eyelid and dilates the pupil.
d. Causes contraction of the ciliary body.
ANS: C
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.
DIF: Cognitive Level: Understanding (Comprehension) REF: p. 283
MSC: Client Needs: Physiologic Integrity: Physiologic Adaptation
5. The nurse is reviewing causes of increased intraocular pressure. Which of these factors
determines intraocular pressure?
a. Thickness or bulging of the lens
b. Posterior chamber as it accommodates increased fluid
c. Contraction of the ciliary body in response to the aqueous within the eye
d. Amount of aqueous produced and resistance to its outflow at the angle of the
anterior chamber
ANS: D
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.
DIF: Cognitive Level: Remembering (Knowledge) REF: p. 284
MSC: Client Needs: Physiologic Integrity: Physiologic Adaptation
6. The nurse is conducting a visual examination. Which of these statements regarding visual
pathways and visual fields is true?
a. The right side of the brain interprets the vision for the right eye.
b. The image formed on the retina is upside down and reversed from its actual
appearance in the outside world.
c. Light rays are refracted through the transparent media of the eye before striking the
pupil.
d. Light impulses are conducted through the optic nerve to the temporal lobes of the
brain.
ANS: B
Jarvis: Physical Examination & Health Assessment, 7th Edition
MULTIPLE CHOICE
1. When examining the eye, the nurse notices that the patient’s eyelid margins approximate
completely. The nurse recognizes that this assessment finding:
a.Is expected.
b.May indicate a problem with extraocular muscles.
c.May result in problems with tearing.
d.Indicates increased intraocular pressure.
ANS: A
The palpebral fissure is the elliptical open space between the eyelids, and, when closed, the lid
margins approximate completely, which is a normal finding.
DIF: Cognitive Level: Understanding (Comprehension) REF: p. 281
MSC: Client Needs: Physiologic Integrity: Physiologic Adaptation
2. During ocular examinations, the nurse keeps in mind that movement of the extraocular
muscles is:
a. Decreased in the older adult.
b. Impaired in a patient with cataracts.
c. Stimulated by cranial nerves (CNs) I and II.
d. Stimulated by CNs III, IV, and VI.
ANS: D
Movement of the extraocular muscles is stimulated by three CNs: III, IV, and VI.
DIF: Cognitive Level: Remembering (Knowledge) REF: p. 283
MSC: Client Needs: Physiologic Integrity: Physiologic Adaptation
3. The nurse is performing an external eye examination. Which statement regarding the outer
layer of the eye is true?
a. The outer layer of the eye is very sensitive to touch.
b. The outer layer of the eye is darkly pigmented to prevent light from reflecting
internally.
c. The trigeminal nerve (CN V) and the trochlear nerve (CN IV) are stimulated when
the outer surface of the eye is stimulated.
d. The visual receptive layer of the eye in which light waves are changed into nerve
impulses is located in the outer layer of the eye.
ANS: A
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.
, DIF: Cognitive Level: Understanding (Comprehension) REF: p. 283
MSC: Client Needs: Physiologic Integrity: Physiologic Adaptation
4. When examining a patient’s eyes, the nurse recalls that stimulation of the sympathetic branch
of the autonomic nervous system:
a. Causes pupillary constriction.
b. Adjusts the eye for near vision.
c. Elevates the eyelid and dilates the pupil.
d. Causes contraction of the ciliary body.
ANS: C
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.
DIF: Cognitive Level: Understanding (Comprehension) REF: p. 283
MSC: Client Needs: Physiologic Integrity: Physiologic Adaptation
5. The nurse is reviewing causes of increased intraocular pressure. Which of these factors
determines intraocular pressure?
a. Thickness or bulging of the lens
b. Posterior chamber as it accommodates increased fluid
c. Contraction of the ciliary body in response to the aqueous within the eye
d. Amount of aqueous produced and resistance to its outflow at the angle of the
anterior chamber
ANS: D
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.
DIF: Cognitive Level: Remembering (Knowledge) REF: p. 284
MSC: Client Needs: Physiologic Integrity: Physiologic Adaptation
6. The nurse is conducting a visual examination. Which of these statements regarding visual
pathways and visual fields is true?
a. The right side of the brain interprets the vision for the right eye.
b. The image formed on the retina is upside down and reversed from its actual
appearance in the outside world.
c. Light rays are refracted through the transparent media of the eye before striking the
pupil.
d. Light impulses are conducted through the optic nerve to the temporal lobes of the
brain.
ANS: B
