NSG223 Exam Four Blueprint 2026 Latest Updated Questions With Answers Success Guide.
Glaucoma nursing assessment - (ANSWER)-establish the diagnostic category
-assess the optic nerve damage
-formulate a treatment plan.
-The patient's ocular and medical history must be detailed to investigate the history of predisposing
factors.
Exams: tonometry to measure the IOP, ophthalmoscopy to inspect the optic nerve, and central visual
field testing
Changes in optic nerve are pallor (lack of blood supply) and cupping (exaggerated bending of the blood
vessel as they cross the optic disk) progression caused by the gradual loss of retinal nerve fibers and loss
of blood supply
As optic nerve damage increases, visual perception decreases
Glaucoma medical treatment - (ANSWER)Treatment is prevention of optic nerve damage
Lifelong treatment-no cure
Treatment aimed at pharmacology (systemic and topical ocular medications), laser, surgery, and a
combination to control further damage
Initial target is 30% lower than current pressure
Glaucoma pharm treatment - (ANSWER)Started on low doses and then advanced to increased
concentrations until the desired IOP level is reached
Beta blockers are the preferred innitial topical medication
One eye treated first, with the other eye used as a control to determine the efficiency of the medication,
once established then the other eye treated
,NSG223 Exam Four Blueprint 2026 Latest Updated Questions With Answers Success Guide.
When results are not satisfactory, a new medication is substituted. The main markers of the efficacy of
the medication in glaucoma control are lowering of the IOP to the target pressure, stable appearance of
the optic nerve head, and the visual field.
Cholinergics (miotics) (pilocarpine, carbachol) {Increased aqueous fluid outflow by contracting the ciliary
muscles and causing meiosis (constriction of the pupil) and opening the trabecular meshwork}
Beta-blockers (FIRST LINE)
(timolol) {Decrease aqueous humor production}
Alpha-adrenergic agonists (apraclonidine, bromonidine) {Decrease aqueous humor production}
Carbonia anhydrase inhibitors (acetazolamide, dorzolamide) {Decrease aqueous humor production}
Prostaglandin analogs (latanoprost, bimatoprost) {Increase uveoscleral outflow}
Glaucoma nursing management - (ANSWER)NO CURE-slows progression of the disease but does not cure
it
Assess for knowledge level and adherence to their prescribed medication.
The lifelong therapeutic regimen mandates patient education. The nature of the disease and the
importance of strict adherence to the medication regimen must be included in an individualized
education plan
REASSURANCE AND EMOTIONAL SUPPORT, IN HOME CARE IF BLINDNESS OCCURS, has a familial
tendency, educate family on getting tested
Medication administration - (ANSWER)When multiple eyedrops are required, there should be an interval
of 5 to 10 minutes between drops
, NSG223 Exam Four Blueprint 2026 Latest Updated Questions With Answers Success Guide.
Apply pressure to the tear duct to discourage systemic absorption for 3-5 minutes after instillation to
decrease systemic absorption
Eye drops and ointments: Ointments are administered less frequently and higher concentration but
cause blurred vision
Do not use after expiration date, cloudy, discolored solution should be discarded
Some eyedrops contain benzalkonium hydrochloride, a preservative, which is absorbed by soft contact
lenses. The medications should not be applied while wearing soft contacts and should be instilled 15
minutes or longer before inserting soft contacts.
Cataracts nursing assessment - (ANSWER)Leading cause of blindness in the world
One or both eyes
Painless blurry vision- percieves surroundings as dimmer, reduced contrast sensitivity, sensitivity to
glare, reduced visual acuity, myopic shift, astigmatism, monocular diplopia, color changes
Decreased visual acuity is directly proportionate to cataract density. The Snellen visual acuity test,
ophthalmoscopy, and slit-lamp biomicroscopic examination are used to establish the degree of cataract
formation. The degree of lens opacity does not always correlate with the patient's functional status.
Some patients can perform normal activities despite clinically significant cataracts. Others with less lens
opacification have a disproportionate decrease in visual acuity; hence, visual acuity is an imperfect
measure of visual impairment
Surgical nursing management- Cataracts - (ANSWER)No non-surgical treatment cures cataracts or
prevents age related cataracts-optical management is prevention (Smoking cessation, weight reduction,
optimal blood glucose control, sunglasses outdoors.)
Only does if cataract interferes with normal activities
Cataract removal
Glaucoma nursing assessment - (ANSWER)-establish the diagnostic category
-assess the optic nerve damage
-formulate a treatment plan.
-The patient's ocular and medical history must be detailed to investigate the history of predisposing
factors.
Exams: tonometry to measure the IOP, ophthalmoscopy to inspect the optic nerve, and central visual
field testing
Changes in optic nerve are pallor (lack of blood supply) and cupping (exaggerated bending of the blood
vessel as they cross the optic disk) progression caused by the gradual loss of retinal nerve fibers and loss
of blood supply
As optic nerve damage increases, visual perception decreases
Glaucoma medical treatment - (ANSWER)Treatment is prevention of optic nerve damage
Lifelong treatment-no cure
Treatment aimed at pharmacology (systemic and topical ocular medications), laser, surgery, and a
combination to control further damage
Initial target is 30% lower than current pressure
Glaucoma pharm treatment - (ANSWER)Started on low doses and then advanced to increased
concentrations until the desired IOP level is reached
Beta blockers are the preferred innitial topical medication
One eye treated first, with the other eye used as a control to determine the efficiency of the medication,
once established then the other eye treated
,NSG223 Exam Four Blueprint 2026 Latest Updated Questions With Answers Success Guide.
When results are not satisfactory, a new medication is substituted. The main markers of the efficacy of
the medication in glaucoma control are lowering of the IOP to the target pressure, stable appearance of
the optic nerve head, and the visual field.
Cholinergics (miotics) (pilocarpine, carbachol) {Increased aqueous fluid outflow by contracting the ciliary
muscles and causing meiosis (constriction of the pupil) and opening the trabecular meshwork}
Beta-blockers (FIRST LINE)
(timolol) {Decrease aqueous humor production}
Alpha-adrenergic agonists (apraclonidine, bromonidine) {Decrease aqueous humor production}
Carbonia anhydrase inhibitors (acetazolamide, dorzolamide) {Decrease aqueous humor production}
Prostaglandin analogs (latanoprost, bimatoprost) {Increase uveoscleral outflow}
Glaucoma nursing management - (ANSWER)NO CURE-slows progression of the disease but does not cure
it
Assess for knowledge level and adherence to their prescribed medication.
The lifelong therapeutic regimen mandates patient education. The nature of the disease and the
importance of strict adherence to the medication regimen must be included in an individualized
education plan
REASSURANCE AND EMOTIONAL SUPPORT, IN HOME CARE IF BLINDNESS OCCURS, has a familial
tendency, educate family on getting tested
Medication administration - (ANSWER)When multiple eyedrops are required, there should be an interval
of 5 to 10 minutes between drops
, NSG223 Exam Four Blueprint 2026 Latest Updated Questions With Answers Success Guide.
Apply pressure to the tear duct to discourage systemic absorption for 3-5 minutes after instillation to
decrease systemic absorption
Eye drops and ointments: Ointments are administered less frequently and higher concentration but
cause blurred vision
Do not use after expiration date, cloudy, discolored solution should be discarded
Some eyedrops contain benzalkonium hydrochloride, a preservative, which is absorbed by soft contact
lenses. The medications should not be applied while wearing soft contacts and should be instilled 15
minutes or longer before inserting soft contacts.
Cataracts nursing assessment - (ANSWER)Leading cause of blindness in the world
One or both eyes
Painless blurry vision- percieves surroundings as dimmer, reduced contrast sensitivity, sensitivity to
glare, reduced visual acuity, myopic shift, astigmatism, monocular diplopia, color changes
Decreased visual acuity is directly proportionate to cataract density. The Snellen visual acuity test,
ophthalmoscopy, and slit-lamp biomicroscopic examination are used to establish the degree of cataract
formation. The degree of lens opacity does not always correlate with the patient's functional status.
Some patients can perform normal activities despite clinically significant cataracts. Others with less lens
opacification have a disproportionate decrease in visual acuity; hence, visual acuity is an imperfect
measure of visual impairment
Surgical nursing management- Cataracts - (ANSWER)No non-surgical treatment cures cataracts or
prevents age related cataracts-optical management is prevention (Smoking cessation, weight reduction,
optimal blood glucose control, sunglasses outdoors.)
Only does if cataract interferes with normal activities
Cataract removal
