Chapter 15: Eyes
Physical Examination and Health Assessment, 8th Edition by
Carolyn Jarvis
MULTIPLE CHOICE
1. When examining the eye, the nurse notices that the patients 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)
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)
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)
MSC: Client Needs: Physiologic Integrity: Physiologic Adaptation
4. When examining a patients 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)
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)
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 righteye.
Physical Examination and Health Assessment, 8th Edition by
Carolyn Jarvis
MULTIPLE CHOICE
1. When examining the eye, the nurse notices that the patients 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)
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)
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)
MSC: Client Needs: Physiologic Integrity: Physiologic Adaptation
4. When examining a patients 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)
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)
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 righteye.
