NSG 4067: VISION
1. A nurse develops a plan of care for an older adult recently diagnosed with Lewy body
dementia. Which functional consequence would be most important to monitor in this older adult?
A) Development of visual hallucinations
B) A visual acuity score of 20/30
C) Improved visual acuity after medications for dementia
D) Growth of cataracts
Ans: A
Feedback:
Persons with Lewy body dementia are at risk for visual hallucinations. Low vision is 20/70
visual acuity to 20/200 visual acuity. Visual acuity will not improve with dementia medications,
as anticholinergics also impair vision. Cataracts are unrelated to Lewy body dementia, although
they are common in all older adults.
2. A nurse is providing an educational program about age-related macular degeneration (AMD)
to a group of older adults. Which of the following statements by an older adult indicates the need
for further teaching?
A) "Smoking is a risk factor for AMD."
B) "Macular degeneration causes a loss of central vision."
C) "People with macular degeneration should have any sudden changes evaluated."
D) "The dry type of macular degeneration occurs rapidly."
Ans: D
Feedback:
The dry type of AMD progresses slowly and does not cause total blindness. The wet type of
macular degeneration develops rapidly and causes visual loss. Smoking is a risk factor for
macular degeneration. As AMD progresses, it affects central vision. People with AMD should
have any sudden changes evaluated.
3. Which of the following methods can be used to informally assess an older adult's visual skills?
(Select all that apply.)
A) Ask the person to look out a window and describe certain details.
B) Perform a standard confrontation test to assess central vision.
C) Place good illumination and ask the person to read printed material with various type
sizes.
, D) Perform a standard vision test, testing each eye separately and allowing the person to
cover the other eye with a hand.
Ans: A, C
Feedback:
Nurses informally assess vision by asking the older adult to read printed material with various
type sizes and describing details of a scene at a distance. A standard confrontation test is a gross
measurement of peripheral vision fields. With standard vision tests, each eye is tested separately,
and one should avoid using the hand as a cover.
4. Which of the following are crucial when assessing visual function in an older adult? (Select all
that apply.)
A) Asking the older adult to read the fine print on a medicine bottle without a magnifying
aid
B) Asking the older adult whether he or she can drive without difficulties at night
C) Observing the older adult functioning in his or her normal environment
D) Observing the older adult while he or she is reading a newspaper without glasses
Ans: B, C
Feedback:
The nurse should observe the older adult's usual pattern of activities. These observations are best
made in the person's usual environment and address the person's ability to carry out activities.
Older adults who report difficulty driving at night may have cataracts or other visual
impairments.
5. A nurse knows teaching has been effective when the client states the following:
A) "If my sensitivity to glare decreases and my contrast sensitivity increases, I will be
evaluated for cataracts."
B) "I wear sunglasses and a wide-brimmed hat when I am in the sun to protect my eyes and
prevent the development of cataracts."
C) "Having Alzheimer disease increases one's risk of developing macular degeneration."
D) "If I take ototoxic medications, this will increase my risk for developing cataracts."
Ans: B
Feedback:
Protecting one's eyes from sunlight is a health promotion intervention for preventing cataracts.
Cataract symptoms include increased sensitivity to glare and decreased contrast sensitivity.
Individuals with Alzheimer disease may have impaired contrast sensitivity and other visual
1. A nurse develops a plan of care for an older adult recently diagnosed with Lewy body
dementia. Which functional consequence would be most important to monitor in this older adult?
A) Development of visual hallucinations
B) A visual acuity score of 20/30
C) Improved visual acuity after medications for dementia
D) Growth of cataracts
Ans: A
Feedback:
Persons with Lewy body dementia are at risk for visual hallucinations. Low vision is 20/70
visual acuity to 20/200 visual acuity. Visual acuity will not improve with dementia medications,
as anticholinergics also impair vision. Cataracts are unrelated to Lewy body dementia, although
they are common in all older adults.
2. A nurse is providing an educational program about age-related macular degeneration (AMD)
to a group of older adults. Which of the following statements by an older adult indicates the need
for further teaching?
A) "Smoking is a risk factor for AMD."
B) "Macular degeneration causes a loss of central vision."
C) "People with macular degeneration should have any sudden changes evaluated."
D) "The dry type of macular degeneration occurs rapidly."
Ans: D
Feedback:
The dry type of AMD progresses slowly and does not cause total blindness. The wet type of
macular degeneration develops rapidly and causes visual loss. Smoking is a risk factor for
macular degeneration. As AMD progresses, it affects central vision. People with AMD should
have any sudden changes evaluated.
3. Which of the following methods can be used to informally assess an older adult's visual skills?
(Select all that apply.)
A) Ask the person to look out a window and describe certain details.
B) Perform a standard confrontation test to assess central vision.
C) Place good illumination and ask the person to read printed material with various type
sizes.
, D) Perform a standard vision test, testing each eye separately and allowing the person to
cover the other eye with a hand.
Ans: A, C
Feedback:
Nurses informally assess vision by asking the older adult to read printed material with various
type sizes and describing details of a scene at a distance. A standard confrontation test is a gross
measurement of peripheral vision fields. With standard vision tests, each eye is tested separately,
and one should avoid using the hand as a cover.
4. Which of the following are crucial when assessing visual function in an older adult? (Select all
that apply.)
A) Asking the older adult to read the fine print on a medicine bottle without a magnifying
aid
B) Asking the older adult whether he or she can drive without difficulties at night
C) Observing the older adult functioning in his or her normal environment
D) Observing the older adult while he or she is reading a newspaper without glasses
Ans: B, C
Feedback:
The nurse should observe the older adult's usual pattern of activities. These observations are best
made in the person's usual environment and address the person's ability to carry out activities.
Older adults who report difficulty driving at night may have cataracts or other visual
impairments.
5. A nurse knows teaching has been effective when the client states the following:
A) "If my sensitivity to glare decreases and my contrast sensitivity increases, I will be
evaluated for cataracts."
B) "I wear sunglasses and a wide-brimmed hat when I am in the sun to protect my eyes and
prevent the development of cataracts."
C) "Having Alzheimer disease increases one's risk of developing macular degeneration."
D) "If I take ototoxic medications, this will increase my risk for developing cataracts."
Ans: B
Feedback:
Protecting one's eyes from sunlight is a health promotion intervention for preventing cataracts.
Cataract symptoms include increased sensitivity to glare and decreased contrast sensitivity.
Individuals with Alzheimer disease may have impaired contrast sensitivity and other visual
