WGU D444 ADULT HEALTH I EXAM
STUDY GUIDE 2026 UPDATE
Visual
Subjective Data "says" -Correct Answer ✔-Health History:
-ocular history(direct eye)
-visual acuity/ sharpness
-h/o strabissmus (misalignment of the eyes causing the eye to deviate while the
other is fixated, crosseyed), retinal detachment, refractive surgery, glaucoma
- non-ocular history (non-eye related but is a disease/ condition that can lead to
eye problems)
VISION ASSESSMENTS -Correct Answer ✔-*BEFORE ASSESSMENT OF VISION,
SNELLEN EYE CHART IS NEEDED FIRST. Assess visual acuity of the right then the left
eye (t reads fro the chart at 20 ft for distance vision, then Jaguar chart at 14 in
which is for near vision)
-assessing eye movement using 6 positions of gaze cn assess any weakness or
paralysis in the extra ocular muscles and cranial nerves (CNN II, CN IV, CN VI)
-Pupil function and IOP: PERRLA(A-focus on a distant object, causes dilation)
-IOP- uses tonometry. Normal IOPP is 10-21 mmHG.
Glaucoma
ETIOLOGY, S/S, PT TEACHING -Correct Answer ✔-group of disorders resulting from
elevated intraocular pressure leading to decreased peripheral vision and damage
of the trabecular meshwork of the eye
-2nd leading cause of blindness in US
-LEADING CAUSE IN AA
-incidence increases w age
ETIOLOGY:
, -outflow of the eye is called angle bc it is the angle where the iris meets the
cornea. If the inflow rate is greater than the outflow it increases IOP (intraocular
pressure). If it continues= vison loss
-Primary open angle glaucoma (PAOG)
- most common type
--s/s slow onset, but can develop tunnel vision, no peripheral vision
-treatment PAOG: prostaglandin analogs, they treat NOT cure
-Angle closure glaucoma is caused by the decrease in outflow of the aquaeous
humor which causes angle closure. Angle closure can also happen bc of pupil
dilation
-Acute angle-closure (AACG): MEDICAL EMERGENCY. caused by prolonged dilation
of the EYE which is prolonged increase IOP induced mydrasis from topical eye
meds, emotional excitement, etc. S/S are definite severe pain, nausea vomiting,
seeing halos, eye redness
Treatment of AACG: IV Hyperosmostics (get water, aqueous humor out of eye
channels and into the outflow channels)--Mannitol, glycerin, isosorbide
PT teaching:
-teach patient not to take mydratic medications (drugs that dilate pupil)
-Miotics are helpful bc they help to decrease IOP and increase the outflow of the
aqueous humor
-drainage surgery is an option (trabeculectomy, trabeculoplasty)
-eye drops: put pressure in the inner canthus after applying the eye drops to help
prevent systemic absorption of the meds and increase effectiveness to the eyes
GLAUCOMA
-Nursing Management -Correct Answer ✔-Diagnosis assessment:
-history and physical assessment
-visual acuity-- Snellen eye chart for distance vision acuity 20 ft, Jaeger
chart/newsprint container level fi you dont have chart for near sight vision acuity
(14 ft)
-visual field
-medication history
STUDY GUIDE 2026 UPDATE
Visual
Subjective Data "says" -Correct Answer ✔-Health History:
-ocular history(direct eye)
-visual acuity/ sharpness
-h/o strabissmus (misalignment of the eyes causing the eye to deviate while the
other is fixated, crosseyed), retinal detachment, refractive surgery, glaucoma
- non-ocular history (non-eye related but is a disease/ condition that can lead to
eye problems)
VISION ASSESSMENTS -Correct Answer ✔-*BEFORE ASSESSMENT OF VISION,
SNELLEN EYE CHART IS NEEDED FIRST. Assess visual acuity of the right then the left
eye (t reads fro the chart at 20 ft for distance vision, then Jaguar chart at 14 in
which is for near vision)
-assessing eye movement using 6 positions of gaze cn assess any weakness or
paralysis in the extra ocular muscles and cranial nerves (CNN II, CN IV, CN VI)
-Pupil function and IOP: PERRLA(A-focus on a distant object, causes dilation)
-IOP- uses tonometry. Normal IOPP is 10-21 mmHG.
Glaucoma
ETIOLOGY, S/S, PT TEACHING -Correct Answer ✔-group of disorders resulting from
elevated intraocular pressure leading to decreased peripheral vision and damage
of the trabecular meshwork of the eye
-2nd leading cause of blindness in US
-LEADING CAUSE IN AA
-incidence increases w age
ETIOLOGY:
, -outflow of the eye is called angle bc it is the angle where the iris meets the
cornea. If the inflow rate is greater than the outflow it increases IOP (intraocular
pressure). If it continues= vison loss
-Primary open angle glaucoma (PAOG)
- most common type
--s/s slow onset, but can develop tunnel vision, no peripheral vision
-treatment PAOG: prostaglandin analogs, they treat NOT cure
-Angle closure glaucoma is caused by the decrease in outflow of the aquaeous
humor which causes angle closure. Angle closure can also happen bc of pupil
dilation
-Acute angle-closure (AACG): MEDICAL EMERGENCY. caused by prolonged dilation
of the EYE which is prolonged increase IOP induced mydrasis from topical eye
meds, emotional excitement, etc. S/S are definite severe pain, nausea vomiting,
seeing halos, eye redness
Treatment of AACG: IV Hyperosmostics (get water, aqueous humor out of eye
channels and into the outflow channels)--Mannitol, glycerin, isosorbide
PT teaching:
-teach patient not to take mydratic medications (drugs that dilate pupil)
-Miotics are helpful bc they help to decrease IOP and increase the outflow of the
aqueous humor
-drainage surgery is an option (trabeculectomy, trabeculoplasty)
-eye drops: put pressure in the inner canthus after applying the eye drops to help
prevent systemic absorption of the meds and increase effectiveness to the eyes
GLAUCOMA
-Nursing Management -Correct Answer ✔-Diagnosis assessment:
-history and physical assessment
-visual acuity-- Snellen eye chart for distance vision acuity 20 ft, Jaeger
chart/newsprint container level fi you dont have chart for near sight vision acuity
(14 ft)
-visual field
-medication history
