CEN OCULAR QUESTIONS AND ANSWERS
WHY should the nurse triage as most emergent A pt with Central retinal artery
occlusion? - 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. - 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 - Answer -Retinal detachment
requires consultation with an ophthalmologist to determine a definitive treatment, such
as laser repair or scleral buckling.
Herpes zoster ophthalmicus requires - Answer -Herpes zoster ophthalmicus requires
local wound care, administration of analgesics and antivirals, and possibly topical
steroids and antibiotics.
Hyphema requires consultation with an - 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 - 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? - 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? - 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: - Answer -this assesses
cranial nerves
III, IV, and VI (the oculomotor, trochlear, and abducens nerves).
Impaired extraocular movement may result from - 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. - 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 - 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? - 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 - 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 - 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. - 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 - 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: - 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. - 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? - 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 -
Answer -patch both eyes.
which eye structure is responsible for the wide field of vision that most people
experience. - Answer -The retina lines the back two-thirds of the eye and is responsible
for the wide field of vision that most people experience.
Cleaning the lid margins with mild shampoo is a treatment for which ocular problem? -
Answer -Blepharitis
Treatment of blepharitis includes removing the crusts and cleaning the lid margins twice
daily with a mild shampoo, applying warm compresses, and using artificial tears.
Treatment of a chalazion (internal stye) includes - Answer -topical antibiotic ointment
and incision and drainage if vision is affected.
Treatment of a herpes simplex infection of the lid and conjunctiva can include - Answer
-oral and topical antiviral agents and follow-up with an ophthalmologist in 2 to 3 days.
Treatment of viral conjunctivitis includes the application of - Answer -cool compresses
WHY should the nurse triage as most emergent A pt with Central retinal artery
occlusion? - 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. - 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 - Answer -Retinal detachment
requires consultation with an ophthalmologist to determine a definitive treatment, such
as laser repair or scleral buckling.
Herpes zoster ophthalmicus requires - Answer -Herpes zoster ophthalmicus requires
local wound care, administration of analgesics and antivirals, and possibly topical
steroids and antibiotics.
Hyphema requires consultation with an - 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 - 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? - 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? - 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: - Answer -this assesses
cranial nerves
III, IV, and VI (the oculomotor, trochlear, and abducens nerves).
Impaired extraocular movement may result from - 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. - 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 - 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? - 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 - 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 - 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. - 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 - 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: - 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. - 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? - 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 -
Answer -patch both eyes.
which eye structure is responsible for the wide field of vision that most people
experience. - Answer -The retina lines the back two-thirds of the eye and is responsible
for the wide field of vision that most people experience.
Cleaning the lid margins with mild shampoo is a treatment for which ocular problem? -
Answer -Blepharitis
Treatment of blepharitis includes removing the crusts and cleaning the lid margins twice
daily with a mild shampoo, applying warm compresses, and using artificial tears.
Treatment of a chalazion (internal stye) includes - Answer -topical antibiotic ointment
and incision and drainage if vision is affected.
Treatment of a herpes simplex infection of the lid and conjunctiva can include - Answer
-oral and topical antiviral agents and follow-up with an ophthalmologist in 2 to 3 days.
Treatment of viral conjunctivitis includes the application of - Answer -cool compresses
