P a g e |1 In preparation for cataract surgery, the nurse is to administer prescribed eye drops. The nurse reviews
the physicians orders, expecting which type of eye drops to be instilled?
The clinic nurse is preparing to test the visual acuity of a client using a Snellen chart. Which of the
following identifies the accurate procedure for this visual acuity test? A. An osmotic diuretic
B. A miotic agent
C. A mydriatic medication
A. Both eyes are assessed together, followed by the assessment of the right and then the left eye.
D. A thiazide diuretic
B. The right eye is tested followed by the left eye, and then both eyes are tested. A mydriatic medication produces mydriasis or dilation of the pupil. Mydriatic medications are used preoperatively in the cataract client. These medication act by dilating the
C. The client is asked to stand at a distance of 40ft. from the chart and is asked to read the largest line on pupils. They also constrict blood vessels. An osmotic diuretic may be used to decrease intraocular pressure. A miotic medication constricts the pupil. A thiazide diuretic is not
likely to be prescribed for a client with a cataract.
the chart.
D. The client is asked to stand at a distance of 40ft from the chart and to read the line than can be read
200 ft away by an individual with unimpaired vision. During the early postoperative period, the client who had a cataract extraction complains of nausea and
B.
Visual acuity is assessed in one eye at a time, and then in both eyes together with the client comfortably standing or sitting. The right eye is tested with the left eye covered;
severe eye pain over the operative site. The initial nursing action is to:
then the left eye is tested with the right eye covered. Both eyes then are tested together. Visual acuity is measured with or without corrective lenses and the client stands at a
distance of 20ft. from the chart.
A. Call the physician
The clinic nurse notes that the following several eye examinations, the physician has documented a B. Administer the ordered main medication and antiemetic
diagnosis of legal blindness in the client's chart. The nurse reviews the results of the Snellen's chart C. Reassure the client that this is normal.
test expecting to note which of the following? D. Turn the client on his or her operative side
Severe pain or pain accompanied by nausea is an indicator of increased intraocular pressure and should be reported to the physician immediately. The other options are
A. 20/20 vision inappropriate .
B. 20/40 vision
C. 20/60 vision
D. 20/200 vision The client is being discharged from the ambulatory care unit following cataract removal. The nurse
Legal blindness is defined as 20/200 or less with corrected vision (glasses or contact lenses) or visual acuity of less than 20 degrees of the visual field in the better eye. provides instructions regarding home care. Which of the following, if stated by the client, indicates an
understanding of the instructions?
The client's vision is tested with a Snellen's chart. The results of the tests are documented as 20/60. The
nurse interprets this as: A. "I will take Aspirin if I have any discomfort."
A. The client can read at a distance of 60 feet what a client with normal vision can read at 20 feet. B. "I will sleep on the side that I was operated on."
B. The client is legally blind. C. "I will wear my eye shield at night and my glasses during the day."
C. The client's vision is normal D. "I will not lift anything if it weighs more that 10 pounds."
D. The client can read only at a distance of 20 feet what a client with normal vision can read at 60 feet. The client is instructed to wear a metal or plastic shield to protect the eye from accidental and is instructed not to rub the eye. Glasses may be worn during the day. Aspirin or
Vision that is 20/20 is normal, that is, the client is able to read from 20 feet what a person with normal vision can read from 20 feet. A client with a visual acuity of 20/60 only can read at a medications containing aspirin are not to be administered or taken by the client and the client is instructed to take acetaminophen as needed for pain. The client is instructed
distance of 20 feet of what a person with normal vision can read at 60 feet. not to sleep on the side of the body on which the operation occurred. The client is not to lift more than 5 pounds.
The nurse is developing a plan of care for the client scheduled for cataract surgery. The nurse The client with glaucoma asks the nurse is complete vision will return. The most appropriate response
documents which more appropriate nursing diagnosis in the plan of care? is:
A. Self-care deficit A. "Although some vision as been lost and cannot be restored, further loss may be prevented by adhering
B. Imbalanced nutrition to the treatment plan."
C. Disturbed sensory perception B. "Your vision will return as soon as the medications begin to work."
D. Anxiety C. "Your vision will never return to normal."
The most appropriate nursing diagnosis for the client scheduled for cataract surgery is Disturbed sensory perception (visual) related to lens extraction and replacement.
Although the other options identify nursing diagnoses that may be appropriate, they are not related specifically to cataract surgery.
D. "Your vision loss is temporary and will return in about 3-4 weeks."
Vision loss to glaucoma is irreparable. The client should be reassured that although some vision has been lost and cannot be restored, further loss may be prevented by
adhering to the treatment plan. Option C does not provide reassurance to the client.
The nurse is performing an assessment in a client with a suspected diagnosis of cataract. The chief
clinical manifestation that the nurse would expect to note in the early stages of cataract formation is: The nurse is developing a teaching plan for the client with glaucoma. Which of the following
instructions would the nurse include in the plan of care?
A. Eye pain
B. Floating spots A. Decrease fluid intake to control the intraocular pressure
C. Blurred vision B. Avoid overuse of the eyes
D. Diplopia C. Decrease the amount of salt in the diet
A gradual, painless blurring of central vision is the chief clinical manifestation of a cataract. Early symptoms include slightly blurred vision and a decrease in color perception. D. Eye medications will need to be administered lifelong.
, P a g e |2 D. Tonometer
A tonometer is a device used in glaucoma screening to record intraocular pressure. A goniometer measures joint movement and angles. An ophthalmoscope examines the
interior of the eye, especially the retina. A slit lamp evaluates structures in the anterior chamber in the eye.
The administration of eye drops is a critical component of the treatment plan for the client with glaucoma. The client needs to be instructed that medi cations will need to be taken for the
rest of his or her life.
After the nurse instills atropine drops into both eyes for a client undergoing ophthalmic examination,
which of the following instructions would be given to the client?
The nurse is performing an admission assessment on a client with a diagnosis of detached retina.
Which of the following is associated with this eye disorder?
A. "Be careful because the blink reflex is paralyzed."
B. "Avoid wearing your regular glasses when driving."
A. Pain in the affected eye
C. "Be aware that the pupils may be unusually small."
B. Total loss of vision
D. "Wear dark glasses in bright light because the pupils are dilated."
C. A sense of a curtain falling across the field of vision Atropine, an anticholinergic drug, has mydriatic effects causing pupil dilation. This allows more light onto the retina and may cause photophobia and blurred vision. Atropine
D. A yellow discoloration of the sclera. doesn't paralyze the blink reflex or cause miosis (pupil constriction). Driving may be contraindicated to blurred vision.
A characteristic manifestation of retinal detachment described by the client is the feeling that a shadow or curtain is falling across the field of vision. No pain is associated with
detachment of the retina. Options B and D are not characteristics of this disorder. A retinal detachment is an ophthalmic emergency and even more so if visual acuity is still
normal.
Cataract surgery results in aphakia. Which of the following statements best describes this term?
The nurse is caring for a client with a diagnosis of detached retina. Which assessment sign would
indicate that bleeding has occurred as a result of the retinal detachment? A. Absence of the crystalline lens
B. A "keyhole" pupil
C. Loss of accommodation
A. Complaints of a burst of black spots or floaters D. Retinal detachment
Aphakia means without lens, a keyhole pupil results from iridectomy. Loss of accommodation is a normal response to aging. A retinal detachment is usually associated with
B. A sudden sharp pain in the eye retinal holes created by vitreous traction.
C. Total loss of vision
D. A reddened conjunctiva
Complaints of a sudden burst of black spots or floaters indicate that bleeding has occurred as a result of the detachment. When developing a teaching session on glaucoma for the community, which of the following statements
would the nurse stress?
The client sustains a contusion of the eyeball following a traumatic injury with a blunt object. Which
intervention is initiated immediately? A. Glaucoma is easily corrected with eyeglasses
B. White and Asian individuals are at the highest risk for glaucoma.
C. Yearly screening for people ages 20-40 years is recommended.
A. Notify the physician
D. Glaucoma can be painless and vision may be lost before the person is aware of a problem.
B. Irrigate the eye with cold water Open-angle glaucoma causes a painless increase in intraocular pressure (IOP) with loss of peripheral vision. A variety of miotics and agents to decrease IOP and occasional
C. Apply ice to the affected eye surgery are used to treat glaucoma. Blacks have a threefold greater chance of developing with an increased chance of blindnes s than other groups. Individuals older than 40
should be screened.
D. Accompany the client to the emergency room
Treatment for contusion begins at the time of injury. Ice is applied immediately. The client then should be seen by a physici an and receive a thorough eye examination to rule
out the presence of other eye injuries.
For a client having an episode of acute narrow-angle glaucoma, a nurse expects to give which of the
following medications?
When using a Snellen alphabet chart, the nurse records the client's vision as 20/40. Which of the
following statements best describes 20/40 vision?
A. Acetazolamide (Diamox)
B. Atropine
A. The client has alterations in near vision and is legally blind. C. Furosemide (Lasix)
B. The client can see at 20 feet what the person with normal vision can see at 40 feet. D. Urokinase (Abbokinase)
C. The client can see at 40 feet what the person with normal vision sees at 20 feet. Acetazolamide, a carbonic anhydrase inhibitor, decreases intraocular pressure (IOP) by decreasing the secretion of aqueous humor. Atropine dilates the pupil and decreases
outflow of aqueous humor, causing further increase in IOP. Lasix is a loop diuretic, and Urokinase is a thrombolytic agent; they aren't used for the treatment of glaucoma.
D. The client has a 20% decrease in acuity in one eye, and a 40% decrease in the other eye.
The numerator refers to the client's vision while comparing the normal vision in the denominator.
Which of the following symptoms would occur in a client with a detached retina?
Which of the following instruments is used to record intraocular pressure?
A. Flashing lights and floaters
A. Goniometer B. Homonymous hemianopia
B. Ophthalmoscope C. Loss of central vision
C. Slit lamp D. Ptosis
Signs and symptoms of retinal detachment include abrupt flashing lights, floaters, loss of peripheral vision, or a sudden shadow or curtain in the vision. Occasionally visual
loss is gradual.
the physicians orders, expecting which type of eye drops to be instilled?
The clinic nurse is preparing to test the visual acuity of a client using a Snellen chart. Which of the
following identifies the accurate procedure for this visual acuity test? A. An osmotic diuretic
B. A miotic agent
C. A mydriatic medication
A. Both eyes are assessed together, followed by the assessment of the right and then the left eye.
D. A thiazide diuretic
B. The right eye is tested followed by the left eye, and then both eyes are tested. A mydriatic medication produces mydriasis or dilation of the pupil. Mydriatic medications are used preoperatively in the cataract client. These medication act by dilating the
C. The client is asked to stand at a distance of 40ft. from the chart and is asked to read the largest line on pupils. They also constrict blood vessels. An osmotic diuretic may be used to decrease intraocular pressure. A miotic medication constricts the pupil. A thiazide diuretic is not
likely to be prescribed for a client with a cataract.
the chart.
D. The client is asked to stand at a distance of 40ft from the chart and to read the line than can be read
200 ft away by an individual with unimpaired vision. During the early postoperative period, the client who had a cataract extraction complains of nausea and
B.
Visual acuity is assessed in one eye at a time, and then in both eyes together with the client comfortably standing or sitting. The right eye is tested with the left eye covered;
severe eye pain over the operative site. The initial nursing action is to:
then the left eye is tested with the right eye covered. Both eyes then are tested together. Visual acuity is measured with or without corrective lenses and the client stands at a
distance of 20ft. from the chart.
A. Call the physician
The clinic nurse notes that the following several eye examinations, the physician has documented a B. Administer the ordered main medication and antiemetic
diagnosis of legal blindness in the client's chart. The nurse reviews the results of the Snellen's chart C. Reassure the client that this is normal.
test expecting to note which of the following? D. Turn the client on his or her operative side
Severe pain or pain accompanied by nausea is an indicator of increased intraocular pressure and should be reported to the physician immediately. The other options are
A. 20/20 vision inappropriate .
B. 20/40 vision
C. 20/60 vision
D. 20/200 vision The client is being discharged from the ambulatory care unit following cataract removal. The nurse
Legal blindness is defined as 20/200 or less with corrected vision (glasses or contact lenses) or visual acuity of less than 20 degrees of the visual field in the better eye. provides instructions regarding home care. Which of the following, if stated by the client, indicates an
understanding of the instructions?
The client's vision is tested with a Snellen's chart. The results of the tests are documented as 20/60. The
nurse interprets this as: A. "I will take Aspirin if I have any discomfort."
A. The client can read at a distance of 60 feet what a client with normal vision can read at 20 feet. B. "I will sleep on the side that I was operated on."
B. The client is legally blind. C. "I will wear my eye shield at night and my glasses during the day."
C. The client's vision is normal D. "I will not lift anything if it weighs more that 10 pounds."
D. The client can read only at a distance of 20 feet what a client with normal vision can read at 60 feet. The client is instructed to wear a metal or plastic shield to protect the eye from accidental and is instructed not to rub the eye. Glasses may be worn during the day. Aspirin or
Vision that is 20/20 is normal, that is, the client is able to read from 20 feet what a person with normal vision can read from 20 feet. A client with a visual acuity of 20/60 only can read at a medications containing aspirin are not to be administered or taken by the client and the client is instructed to take acetaminophen as needed for pain. The client is instructed
distance of 20 feet of what a person with normal vision can read at 60 feet. not to sleep on the side of the body on which the operation occurred. The client is not to lift more than 5 pounds.
The nurse is developing a plan of care for the client scheduled for cataract surgery. The nurse The client with glaucoma asks the nurse is complete vision will return. The most appropriate response
documents which more appropriate nursing diagnosis in the plan of care? is:
A. Self-care deficit A. "Although some vision as been lost and cannot be restored, further loss may be prevented by adhering
B. Imbalanced nutrition to the treatment plan."
C. Disturbed sensory perception B. "Your vision will return as soon as the medications begin to work."
D. Anxiety C. "Your vision will never return to normal."
The most appropriate nursing diagnosis for the client scheduled for cataract surgery is Disturbed sensory perception (visual) related to lens extraction and replacement.
Although the other options identify nursing diagnoses that may be appropriate, they are not related specifically to cataract surgery.
D. "Your vision loss is temporary and will return in about 3-4 weeks."
Vision loss to glaucoma is irreparable. The client should be reassured that although some vision has been lost and cannot be restored, further loss may be prevented by
adhering to the treatment plan. Option C does not provide reassurance to the client.
The nurse is performing an assessment in a client with a suspected diagnosis of cataract. The chief
clinical manifestation that the nurse would expect to note in the early stages of cataract formation is: The nurse is developing a teaching plan for the client with glaucoma. Which of the following
instructions would the nurse include in the plan of care?
A. Eye pain
B. Floating spots A. Decrease fluid intake to control the intraocular pressure
C. Blurred vision B. Avoid overuse of the eyes
D. Diplopia C. Decrease the amount of salt in the diet
A gradual, painless blurring of central vision is the chief clinical manifestation of a cataract. Early symptoms include slightly blurred vision and a decrease in color perception. D. Eye medications will need to be administered lifelong.
, P a g e |2 D. Tonometer
A tonometer is a device used in glaucoma screening to record intraocular pressure. A goniometer measures joint movement and angles. An ophthalmoscope examines the
interior of the eye, especially the retina. A slit lamp evaluates structures in the anterior chamber in the eye.
The administration of eye drops is a critical component of the treatment plan for the client with glaucoma. The client needs to be instructed that medi cations will need to be taken for the
rest of his or her life.
After the nurse instills atropine drops into both eyes for a client undergoing ophthalmic examination,
which of the following instructions would be given to the client?
The nurse is performing an admission assessment on a client with a diagnosis of detached retina.
Which of the following is associated with this eye disorder?
A. "Be careful because the blink reflex is paralyzed."
B. "Avoid wearing your regular glasses when driving."
A. Pain in the affected eye
C. "Be aware that the pupils may be unusually small."
B. Total loss of vision
D. "Wear dark glasses in bright light because the pupils are dilated."
C. A sense of a curtain falling across the field of vision Atropine, an anticholinergic drug, has mydriatic effects causing pupil dilation. This allows more light onto the retina and may cause photophobia and blurred vision. Atropine
D. A yellow discoloration of the sclera. doesn't paralyze the blink reflex or cause miosis (pupil constriction). Driving may be contraindicated to blurred vision.
A characteristic manifestation of retinal detachment described by the client is the feeling that a shadow or curtain is falling across the field of vision. No pain is associated with
detachment of the retina. Options B and D are not characteristics of this disorder. A retinal detachment is an ophthalmic emergency and even more so if visual acuity is still
normal.
Cataract surgery results in aphakia. Which of the following statements best describes this term?
The nurse is caring for a client with a diagnosis of detached retina. Which assessment sign would
indicate that bleeding has occurred as a result of the retinal detachment? A. Absence of the crystalline lens
B. A "keyhole" pupil
C. Loss of accommodation
A. Complaints of a burst of black spots or floaters D. Retinal detachment
Aphakia means without lens, a keyhole pupil results from iridectomy. Loss of accommodation is a normal response to aging. A retinal detachment is usually associated with
B. A sudden sharp pain in the eye retinal holes created by vitreous traction.
C. Total loss of vision
D. A reddened conjunctiva
Complaints of a sudden burst of black spots or floaters indicate that bleeding has occurred as a result of the detachment. When developing a teaching session on glaucoma for the community, which of the following statements
would the nurse stress?
The client sustains a contusion of the eyeball following a traumatic injury with a blunt object. Which
intervention is initiated immediately? A. Glaucoma is easily corrected with eyeglasses
B. White and Asian individuals are at the highest risk for glaucoma.
C. Yearly screening for people ages 20-40 years is recommended.
A. Notify the physician
D. Glaucoma can be painless and vision may be lost before the person is aware of a problem.
B. Irrigate the eye with cold water Open-angle glaucoma causes a painless increase in intraocular pressure (IOP) with loss of peripheral vision. A variety of miotics and agents to decrease IOP and occasional
C. Apply ice to the affected eye surgery are used to treat glaucoma. Blacks have a threefold greater chance of developing with an increased chance of blindnes s than other groups. Individuals older than 40
should be screened.
D. Accompany the client to the emergency room
Treatment for contusion begins at the time of injury. Ice is applied immediately. The client then should be seen by a physici an and receive a thorough eye examination to rule
out the presence of other eye injuries.
For a client having an episode of acute narrow-angle glaucoma, a nurse expects to give which of the
following medications?
When using a Snellen alphabet chart, the nurse records the client's vision as 20/40. Which of the
following statements best describes 20/40 vision?
A. Acetazolamide (Diamox)
B. Atropine
A. The client has alterations in near vision and is legally blind. C. Furosemide (Lasix)
B. The client can see at 20 feet what the person with normal vision can see at 40 feet. D. Urokinase (Abbokinase)
C. The client can see at 40 feet what the person with normal vision sees at 20 feet. Acetazolamide, a carbonic anhydrase inhibitor, decreases intraocular pressure (IOP) by decreasing the secretion of aqueous humor. Atropine dilates the pupil and decreases
outflow of aqueous humor, causing further increase in IOP. Lasix is a loop diuretic, and Urokinase is a thrombolytic agent; they aren't used for the treatment of glaucoma.
D. The client has a 20% decrease in acuity in one eye, and a 40% decrease in the other eye.
The numerator refers to the client's vision while comparing the normal vision in the denominator.
Which of the following symptoms would occur in a client with a detached retina?
Which of the following instruments is used to record intraocular pressure?
A. Flashing lights and floaters
A. Goniometer B. Homonymous hemianopia
B. Ophthalmoscope C. Loss of central vision
C. Slit lamp D. Ptosis
Signs and symptoms of retinal detachment include abrupt flashing lights, floaters, loss of peripheral vision, or a sudden shadow or curtain in the vision. Occasionally visual
loss is gradual.
