CEN OCULAR EXAM (QUESTIONS
AND ANSWERS)
WHY should the nurse triage as most emergent A pt with Central retinal artery
occlusion? - CORRECT ANSWER-Central retinal artery occlusion produces the sudden
onset of unilateral, painless vision loss and is a true ocular emergency.
Retinal circulation must be restored within 60 to 120 minutes (or less) to prevent
permanent vision loss.
To assess the external eye, the nurse should perform which activity?
A. Have the patient identify letters or objects on a chart or card.
B. Inspect and gently palpate the eyelids, lashes, and surrounding bony structures.
C. Have the patient follow the nurse's fingers with his or her eyes.
D. Visualize the external structures with a slit lamp. - CORRECT ANSWER-An external
eye assessment consists of the inspection and gentle palpation of the eyelids, lashes,
and surrounding bony structures.
Visual acuity is assessed by having the patient identify letters or objects on a chart or
card.
Cardinal fields of gaze are assessed by having a patient follow the nurse's fingers with
his or her eyes.
A slit-lamp microscope is used to help visualize the superficial structures and the
anterior chamber.
Retinal detachment requires consultation with an - CORRECT ANSWER-Retinal
detachment requires consultation with an ophthalmologist to determine a definitive
treatment, such as laser repair or scleral buckling.
Herpes zoster ophthalmicus requires - CORRECT ANSWER-Herpes zoster
ophthalmicus requires local wound care, administration of analgesics and antivirals, and
possibly topical steroids and antibiotics.
Hyphema requires consultation with an - CORRECT ANSWER-Hyphema requires
consultation with an ophthalmologist.
In a patient with a globe rupture, which sign or symptom is expected?
A. Altered depth of the posterior chamber
B. Dilated pupil
C. Teardrop-shaped pupil
,D. Decreased pain sensation - CORRECT ANSWER-Signs and symptoms of a globe
rupture include hyphema, a teardrop-shaped pupil, altered depth of the anterior
chamber, altered light perception, vitreous hemorrhage (occasionally), and minimal to
severe pain.
WHAT disorder results in abnormal extraocular movements? - CORRECT ANSWER-
Orbital cellulitis
The nurse evaluates extraocular movements by testing the six cardinal fields of gaze.
This assesses cranial nerves III, IV, and VI (the oculomotor, trochlear, and abducens
nerves).
A PT WITH Orbital cellulitis WHEREIN A NURSE NEEDS TO EVALUATE THEIR
EXTRAOCULAR MOVEMENTS IS TEST HOW? - CORRECT ANSWER-in Orbital
cellulitis, the nurse evaluates extraocular movements by testing the six cardinal fields of
gaze.
six cardinal fields of gaze assesses which cranial nerves: - CORRECT ANSWER-this
assesses cranial nerves
III, IV, and VI (the oculomotor, trochlear, and abducens nerves).
Impaired extraocular movement may result from - CORRECT ANSWER-an entrapped
muscle caused by orbital cellulitis, an orbital blowout fracture, muscular injury, or an
underlying central nervous system problem.
the three ocular dx do not affect extraocular movement. - CORRECT ANSWER-Corneal
ulcer
retinal detachment, and glaucoma do not affect extraocular movement.
For a patient with an alkali burn of the eye, what is the pH that indicates the endpoint for
continuous irrigation?
B - CORRECT ANSWER-Ocular pH of 7.4
For a patient with an alkali burn, continue irrigation until the ocular pH reaches about 7.3
or 7.4.
Normal conjunctival pH is? - CORRECT ANSWER-Normal conjunctival pH is 7.0 to 7.3.
If litmus paper is not available for pH measurement of the conjunctiva then to mark the
end point of irrigation of eye is - CORRECT ANSWER-irrigate for at least 60 minutes
with 2 L of fluid.
A severe chemical burn may require 2 to 4 hours of irrigation. Measure the pH
periodically during and after the initial irrigation.
, A patient with a corneal infection may develop a - CORRECT ANSWER-hypopyon
(collection of pus due to white blood cells in the anterior chamber of the eye).
Which intervention is appropriate for a hypopyon?
A. Apply an eye patch for comfort.
B. Apply cool compresses.
C. Obtain a specimen for culture and sensitivity testing.
D. Irrigate the eye with copious fluids. - CORRECT ANSWER-Obtain a specimen of the
hypopyon for culture and sensitivity testing to determine the specific cause of the
infection. Other interventions include applying warm compresses and administering
broad-spectrum antibiotics and possibly antifungal eye drops.
because of the risk of Pseudomonas infection, DO NOT APPLY ? TO A PATIENT WITH
HYPOPYN - CORRECT ANSWER-Do not patch the eye because of the risk of
Pseudomonas infection, which is a particular concern with contact lens wearers.
Irrigation with copious fluids is an intervention for a chemical burn, not a hypopyon.
When caring for a multisystem trauma patient, what should you expect to assess after
airway, breathing, circulation and disability: - CORRECT ANSWER-Ocular injuries
commonly occur with head and facial injuries, so carefully evaluate patients with these
injuries for coexisting ocular injuries after evaluating and stabilizing airway, breathing,
circulation, and disability.
When caring for a multisystem trauma patient with a suspected ocular injury, what step
should you take after the primary survey?
A. Instill saline eye drops.
B. Forcibly open the eyelids, if needed, to assess ocular structures.
C. Remove the patient's contact lenses.
D. Apply a topical anesthetic. - CORRECT ANSWER-if unconscious or impaired patient,
look for and remove contact lenses as soon as possible.
in a multisystem trauma patient what do you NOT want to do when it comes to
assessing the eyes? - CORRECT ANSWER-Do not force open the eyelids because this
action may exacerbate any injury.
Do not instill eye drops before assessing for an ocular injury in a trauma patient.
minimize severe pain associated with ocular trauma without topical anesthetics, by -
CORRECT ANSWER-patch both eyes.
Which eye structure controls the amount of light that enters the eye by dilating or
constricting the pupil?
A. Vitreous body B. Crystalline lens C. Iris D. Retina - CORRECT ANSWER-The iris
has a round opening, the pupil, through which the light passes.
AND ANSWERS)
WHY should the nurse triage as most emergent A pt with Central retinal artery
occlusion? - CORRECT ANSWER-Central retinal artery occlusion produces the sudden
onset of unilateral, painless vision loss and is a true ocular emergency.
Retinal circulation must be restored within 60 to 120 minutes (or less) to prevent
permanent vision loss.
To assess the external eye, the nurse should perform which activity?
A. Have the patient identify letters or objects on a chart or card.
B. Inspect and gently palpate the eyelids, lashes, and surrounding bony structures.
C. Have the patient follow the nurse's fingers with his or her eyes.
D. Visualize the external structures with a slit lamp. - CORRECT ANSWER-An external
eye assessment consists of the inspection and gentle palpation of the eyelids, lashes,
and surrounding bony structures.
Visual acuity is assessed by having the patient identify letters or objects on a chart or
card.
Cardinal fields of gaze are assessed by having a patient follow the nurse's fingers with
his or her eyes.
A slit-lamp microscope is used to help visualize the superficial structures and the
anterior chamber.
Retinal detachment requires consultation with an - CORRECT ANSWER-Retinal
detachment requires consultation with an ophthalmologist to determine a definitive
treatment, such as laser repair or scleral buckling.
Herpes zoster ophthalmicus requires - CORRECT ANSWER-Herpes zoster
ophthalmicus requires local wound care, administration of analgesics and antivirals, and
possibly topical steroids and antibiotics.
Hyphema requires consultation with an - CORRECT ANSWER-Hyphema requires
consultation with an ophthalmologist.
In a patient with a globe rupture, which sign or symptom is expected?
A. Altered depth of the posterior chamber
B. Dilated pupil
C. Teardrop-shaped pupil
,D. Decreased pain sensation - CORRECT ANSWER-Signs and symptoms of a globe
rupture include hyphema, a teardrop-shaped pupil, altered depth of the anterior
chamber, altered light perception, vitreous hemorrhage (occasionally), and minimal to
severe pain.
WHAT disorder results in abnormal extraocular movements? - CORRECT ANSWER-
Orbital cellulitis
The nurse evaluates extraocular movements by testing the six cardinal fields of gaze.
This assesses cranial nerves III, IV, and VI (the oculomotor, trochlear, and abducens
nerves).
A PT WITH Orbital cellulitis WHEREIN A NURSE NEEDS TO EVALUATE THEIR
EXTRAOCULAR MOVEMENTS IS TEST HOW? - CORRECT ANSWER-in Orbital
cellulitis, the nurse evaluates extraocular movements by testing the six cardinal fields of
gaze.
six cardinal fields of gaze assesses which cranial nerves: - CORRECT ANSWER-this
assesses cranial nerves
III, IV, and VI (the oculomotor, trochlear, and abducens nerves).
Impaired extraocular movement may result from - CORRECT ANSWER-an entrapped
muscle caused by orbital cellulitis, an orbital blowout fracture, muscular injury, or an
underlying central nervous system problem.
the three ocular dx do not affect extraocular movement. - CORRECT ANSWER-Corneal
ulcer
retinal detachment, and glaucoma do not affect extraocular movement.
For a patient with an alkali burn of the eye, what is the pH that indicates the endpoint for
continuous irrigation?
B - CORRECT ANSWER-Ocular pH of 7.4
For a patient with an alkali burn, continue irrigation until the ocular pH reaches about 7.3
or 7.4.
Normal conjunctival pH is? - CORRECT ANSWER-Normal conjunctival pH is 7.0 to 7.3.
If litmus paper is not available for pH measurement of the conjunctiva then to mark the
end point of irrigation of eye is - CORRECT ANSWER-irrigate for at least 60 minutes
with 2 L of fluid.
A severe chemical burn may require 2 to 4 hours of irrigation. Measure the pH
periodically during and after the initial irrigation.
, A patient with a corneal infection may develop a - CORRECT ANSWER-hypopyon
(collection of pus due to white blood cells in the anterior chamber of the eye).
Which intervention is appropriate for a hypopyon?
A. Apply an eye patch for comfort.
B. Apply cool compresses.
C. Obtain a specimen for culture and sensitivity testing.
D. Irrigate the eye with copious fluids. - CORRECT ANSWER-Obtain a specimen of the
hypopyon for culture and sensitivity testing to determine the specific cause of the
infection. Other interventions include applying warm compresses and administering
broad-spectrum antibiotics and possibly antifungal eye drops.
because of the risk of Pseudomonas infection, DO NOT APPLY ? TO A PATIENT WITH
HYPOPYN - CORRECT ANSWER-Do not patch the eye because of the risk of
Pseudomonas infection, which is a particular concern with contact lens wearers.
Irrigation with copious fluids is an intervention for a chemical burn, not a hypopyon.
When caring for a multisystem trauma patient, what should you expect to assess after
airway, breathing, circulation and disability: - CORRECT ANSWER-Ocular injuries
commonly occur with head and facial injuries, so carefully evaluate patients with these
injuries for coexisting ocular injuries after evaluating and stabilizing airway, breathing,
circulation, and disability.
When caring for a multisystem trauma patient with a suspected ocular injury, what step
should you take after the primary survey?
A. Instill saline eye drops.
B. Forcibly open the eyelids, if needed, to assess ocular structures.
C. Remove the patient's contact lenses.
D. Apply a topical anesthetic. - CORRECT ANSWER-if unconscious or impaired patient,
look for and remove contact lenses as soon as possible.
in a multisystem trauma patient what do you NOT want to do when it comes to
assessing the eyes? - CORRECT ANSWER-Do not force open the eyelids because this
action may exacerbate any injury.
Do not instill eye drops before assessing for an ocular injury in a trauma patient.
minimize severe pain associated with ocular trauma without topical anesthetics, by -
CORRECT ANSWER-patch both eyes.
Which eye structure controls the amount of light that enters the eye by dilating or
constricting the pupil?
A. Vitreous body B. Crystalline lens C. Iris D. Retina - CORRECT ANSWER-The iris
has a round opening, the pupil, through which the light passes.
