Chapter 12: Eyes
Ball: Seidel’s Guide to Physical Examination, 9th Edition
MULTIPLE CHOICE
1. Mrs. Alden is a 29-year-old pregnant patient in her third trimester. She tells you that her vision
has been a little blurred, and she thinks she needs to get new contact lenses. You should advise
her to:
a. get new lenses as soon as possible to avoid complications.
b. wait until several weeks after delivery to get new lenses.
c. go to the nearest emergency department for evaluation.
d. change her diet to include more yellow vegetables.
ANS: B
Because of the increased level of lysozyme in the tears during pregnancy, a blurred sensation
may occur but will subside several weeks after pregnancy. The blurred vision is a normal
occurrence during pregnancy. It is not an emergency, nor is it diet-dependent.
DIF: Cognitive Level: Applying (Application)
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
2. A condition that typically develops by the age of 45 years is:
a. presbyopia.
b. hyperopia.
c. myopia.
d. astigmatism.
ANS: A
By 45 years of age, a condition known as presbyopia develops; presbyopia involves a weakening
of accommodation. Hyperopia occurs in early infancy. Myopia and astigmatism can occur at any
time.
DIF: Cognitive Level: Understanding (Comprehension)
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
3. Which finding, when seen in the infant, is ominous?
a. Difficulty tracking objects with the eyes
b. Appearing to have better peripheral than central vision
c. Blinking when bright light is directed at the face
d. White pupils on photographs
ANS: D
The absence of a red reflex, determined by physical examination or the appearance of white
pupils on a photograph, is indicative of retinoblastoma, a serious retinal tumor.
DIF: Cognitive Level: Analyzing (Analysis)
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
, 4. Mr. C’s visual acuity is 20/50. This means that he:
a. can see 50% of what the average person sees at 20 feet.
b. has perfect vision when tested at 50 feet.
c. can see 20% of the letters on the chart’s 20/50 line.
d. can read letters while standing 20 feet from the chart that the average person could read at 50
feet.
ANS: D
Visual acuity is measured as a fraction, in which the top number is the distance that the patient is
standing from the chart; the bottom number is the distance that an average person can stand and
still read the line.
DIF: Cognitive Level: Analyzing (Analysis)
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
5. The criterion for determining the adequacy of a patient’s visual field is:
a. the ability to discriminate primary colors.
b. the ability to discriminate details.
c. correspondence with the visual field of the examiner.
d. distance vision equal to that of an average person.
ANS: C
The examiner compares his or her own peripheral vision to that of the patient while performing
the confrontation test, so unless the examiner is aware of a problem with his or her own vision,
the examiner could assume that the fields are full if they match.
DIF: Cognitive Level: Understanding (Comprehension)
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
6. Mrs. S. is a 69-year-old woman who presents for a physical examination. On inspection of her
eyes, you note that the left upper
eyelid droops, covering more of the iris than does the right. This is recorded as:
a. exophthalmos on the right.
b. ptosis on the left.
c. nystagmus on the left.
d. astigmatism on the right.
ANS: B
Ptosis is when one of the upper eyelids covers more of the iris than the other lid, possibly
extending over the pupil.
DIF: Cognitive Level: Applying (Application)
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
7. A condition in which the eyelids do not completely meet to cover the globe is called:
a. glaucoma.
b. lagophthalmos.
c. exophthalmos.
d. hordeolum.
ANS: B
Ball: Seidel’s Guide to Physical Examination, 9th Edition
MULTIPLE CHOICE
1. Mrs. Alden is a 29-year-old pregnant patient in her third trimester. She tells you that her vision
has been a little blurred, and she thinks she needs to get new contact lenses. You should advise
her to:
a. get new lenses as soon as possible to avoid complications.
b. wait until several weeks after delivery to get new lenses.
c. go to the nearest emergency department for evaluation.
d. change her diet to include more yellow vegetables.
ANS: B
Because of the increased level of lysozyme in the tears during pregnancy, a blurred sensation
may occur but will subside several weeks after pregnancy. The blurred vision is a normal
occurrence during pregnancy. It is not an emergency, nor is it diet-dependent.
DIF: Cognitive Level: Applying (Application)
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
2. A condition that typically develops by the age of 45 years is:
a. presbyopia.
b. hyperopia.
c. myopia.
d. astigmatism.
ANS: A
By 45 years of age, a condition known as presbyopia develops; presbyopia involves a weakening
of accommodation. Hyperopia occurs in early infancy. Myopia and astigmatism can occur at any
time.
DIF: Cognitive Level: Understanding (Comprehension)
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
3. Which finding, when seen in the infant, is ominous?
a. Difficulty tracking objects with the eyes
b. Appearing to have better peripheral than central vision
c. Blinking when bright light is directed at the face
d. White pupils on photographs
ANS: D
The absence of a red reflex, determined by physical examination or the appearance of white
pupils on a photograph, is indicative of retinoblastoma, a serious retinal tumor.
DIF: Cognitive Level: Analyzing (Analysis)
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
, 4. Mr. C’s visual acuity is 20/50. This means that he:
a. can see 50% of what the average person sees at 20 feet.
b. has perfect vision when tested at 50 feet.
c. can see 20% of the letters on the chart’s 20/50 line.
d. can read letters while standing 20 feet from the chart that the average person could read at 50
feet.
ANS: D
Visual acuity is measured as a fraction, in which the top number is the distance that the patient is
standing from the chart; the bottom number is the distance that an average person can stand and
still read the line.
DIF: Cognitive Level: Analyzing (Analysis)
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
5. The criterion for determining the adequacy of a patient’s visual field is:
a. the ability to discriminate primary colors.
b. the ability to discriminate details.
c. correspondence with the visual field of the examiner.
d. distance vision equal to that of an average person.
ANS: C
The examiner compares his or her own peripheral vision to that of the patient while performing
the confrontation test, so unless the examiner is aware of a problem with his or her own vision,
the examiner could assume that the fields are full if they match.
DIF: Cognitive Level: Understanding (Comprehension)
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
6. Mrs. S. is a 69-year-old woman who presents for a physical examination. On inspection of her
eyes, you note that the left upper
eyelid droops, covering more of the iris than does the right. This is recorded as:
a. exophthalmos on the right.
b. ptosis on the left.
c. nystagmus on the left.
d. astigmatism on the right.
ANS: B
Ptosis is when one of the upper eyelids covers more of the iris than the other lid, possibly
extending over the pupil.
DIF: Cognitive Level: Applying (Application)
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
7. A condition in which the eyelids do not completely meet to cover the globe is called:
a. glaucoma.
b. lagophthalmos.
c. exophthalmos.
d. hordeolum.
ANS: B
