West Coast University NURS 190 Exam 2 (pdf) | 2026/2027 | Physical
Assessment Q&A | Nursing
1. The nurse is assessing a client's visual acuity using a Snellen chart. The
client is positioned 20 feet from the chart and can read the line that a person
with normal vision can read at 40 feet. How should the nurse document this
finding?
A) 20/20
B) 20/40
C) 40/20
D) 20/15
Correct Answer: 20/40
Rationale: Visual acuity is recorded as a fraction where the numerator is the
distance the client stands from the chart (20 feet) and the denominator is
the distance at which a person with normal vision can read the same line. If
the client can read at 20 feet what a normal eye can read at 40 feet, the
documentation is 20/40. 20/20 is normal vision.
2. A nurse is assessing a client's peripheral vision. The nurse stands 2-3 feet
in front of the client, asks the client to cover one eye and look directly at the
nurse's eye, and then moves a penlight into the client's visual field from four
directions. The client is to indicate when the object is first seen. Which
cranial nerve is primarily being assessed?
A) Cranial nerve I (Olfactory)
B) Cranial nerve II (Optic)
C) Cranial nerve III (Oculomotor)
D) Cranial nerve IV (Trochlear)
Correct Answer: Cranial nerve II (Optic)
,Rationale: Peripheral vision testing assesses the visual fields, which is a
function of the optic nerve (Cranial Nerve II). Cranial nerve I is for smell, CN
III controls most eye movements and pupil constriction, and CN IV controls
the superior oblique muscle.
3. A nurse is assessing a client's extraocular movements. The client is unable
to move the eye laterally (outward). Which cranial nerve is most likely
affected?
A) Cranial nerve III (Oculomotor)
B) Cranial nerve IV (Trochlear)
C) Cranial nerve VI (Abducens)
D) Cranial nerve II (Optic)
Correct Answer: Cranial nerve VI (Abducens)
Rationale: The lateral rectus muscle, which abducts the eye (moves it
laterally), is innervated by cranial nerve VI (Abducens). Cranial nerve III
innervates most extraocular muscles, CN IV innervates the superior oblique,
and CN II is the optic nerve for vision.
4. A client has an eye that deviates inward (toward the nose). The nurse
should document this as:
A) Exotropia
B) Esotropia
C) Strabismus
D) Ptosis
Correct Answer: Esotropia
,Rationale: Esotropia is a condition in which the eye deviates inward
(convergent). Exotropia is outward deviation (divergent). Strabismus is the
general term for crossed eyes, and ptosis is drooping of the eyelid.
5. The nurse is assessing a client's eyes and notes a thin, triangular tissue
growing into the cornea from the conjunctiva. The client reports a history of
prolonged sun exposure. The nurse should document this finding as:
A) Pterygium
B) Pinguecula
C) Cataract
D) Glaucoma
Correct Answer: Pterygium
Rationale: A pterygium is a thin, triangular tissue growth into the cornea
from the conjunctiva, often caused by prolonged sun exposure (UV-induced).
A pinguecula is a yellowish growth on the conjunctiva, a cataract is clouding
of the lens, and glaucoma is increased intraocular pressure.
6. A nurse is reviewing the anatomy of the eye. The yellowish region of the
retina responsible for central vision is known as the:
A) Fovea centralis
B) Macula
C) Optic disc
D) Pupil
Correct Answer: Macula
, Rationale: The macula is the yellowish region of the retina responsible for
central vision. The fovea centralis is the pit-like center of the macula. The
optic disc is the blind spot, and the pupil is the opening in the iris.
7. A nurse is assessing a client's near vision. The client is 45 years old and
reports difficulty reading small print. The nurse should suspect which
condition?
A) Hyperopia
B) Myopia
C) Presbyopia
D) Astigmatism
Correct Answer: Presbyopia
Rationale: Presbyopia is the age-related loss of near vision that typically
begins around age 40. Hyperopia (farsightedness) is a refractive error
causing difficulty with near vision but is present from birth. Myopia is
nearsightedness, and astigmatism causes blurred vision at all distances.
8. A nurse is performing a neurological assessment. Which cranial nerve is
responsible for the sense of smell?
A) Cranial nerve I (Olfactory)
B) Cranial nerve II (Optic)
C) Cranial nerve V (Trigeminal)
D) Cranial nerve VII (Facial)
Correct Answer: Cranial nerve I (Olfactory)
Assessment Q&A | Nursing
1. The nurse is assessing a client's visual acuity using a Snellen chart. The
client is positioned 20 feet from the chart and can read the line that a person
with normal vision can read at 40 feet. How should the nurse document this
finding?
A) 20/20
B) 20/40
C) 40/20
D) 20/15
Correct Answer: 20/40
Rationale: Visual acuity is recorded as a fraction where the numerator is the
distance the client stands from the chart (20 feet) and the denominator is
the distance at which a person with normal vision can read the same line. If
the client can read at 20 feet what a normal eye can read at 40 feet, the
documentation is 20/40. 20/20 is normal vision.
2. A nurse is assessing a client's peripheral vision. The nurse stands 2-3 feet
in front of the client, asks the client to cover one eye and look directly at the
nurse's eye, and then moves a penlight into the client's visual field from four
directions. The client is to indicate when the object is first seen. Which
cranial nerve is primarily being assessed?
A) Cranial nerve I (Olfactory)
B) Cranial nerve II (Optic)
C) Cranial nerve III (Oculomotor)
D) Cranial nerve IV (Trochlear)
Correct Answer: Cranial nerve II (Optic)
,Rationale: Peripheral vision testing assesses the visual fields, which is a
function of the optic nerve (Cranial Nerve II). Cranial nerve I is for smell, CN
III controls most eye movements and pupil constriction, and CN IV controls
the superior oblique muscle.
3. A nurse is assessing a client's extraocular movements. The client is unable
to move the eye laterally (outward). Which cranial nerve is most likely
affected?
A) Cranial nerve III (Oculomotor)
B) Cranial nerve IV (Trochlear)
C) Cranial nerve VI (Abducens)
D) Cranial nerve II (Optic)
Correct Answer: Cranial nerve VI (Abducens)
Rationale: The lateral rectus muscle, which abducts the eye (moves it
laterally), is innervated by cranial nerve VI (Abducens). Cranial nerve III
innervates most extraocular muscles, CN IV innervates the superior oblique,
and CN II is the optic nerve for vision.
4. A client has an eye that deviates inward (toward the nose). The nurse
should document this as:
A) Exotropia
B) Esotropia
C) Strabismus
D) Ptosis
Correct Answer: Esotropia
,Rationale: Esotropia is a condition in which the eye deviates inward
(convergent). Exotropia is outward deviation (divergent). Strabismus is the
general term for crossed eyes, and ptosis is drooping of the eyelid.
5. The nurse is assessing a client's eyes and notes a thin, triangular tissue
growing into the cornea from the conjunctiva. The client reports a history of
prolonged sun exposure. The nurse should document this finding as:
A) Pterygium
B) Pinguecula
C) Cataract
D) Glaucoma
Correct Answer: Pterygium
Rationale: A pterygium is a thin, triangular tissue growth into the cornea
from the conjunctiva, often caused by prolonged sun exposure (UV-induced).
A pinguecula is a yellowish growth on the conjunctiva, a cataract is clouding
of the lens, and glaucoma is increased intraocular pressure.
6. A nurse is reviewing the anatomy of the eye. The yellowish region of the
retina responsible for central vision is known as the:
A) Fovea centralis
B) Macula
C) Optic disc
D) Pupil
Correct Answer: Macula
, Rationale: The macula is the yellowish region of the retina responsible for
central vision. The fovea centralis is the pit-like center of the macula. The
optic disc is the blind spot, and the pupil is the opening in the iris.
7. A nurse is assessing a client's near vision. The client is 45 years old and
reports difficulty reading small print. The nurse should suspect which
condition?
A) Hyperopia
B) Myopia
C) Presbyopia
D) Astigmatism
Correct Answer: Presbyopia
Rationale: Presbyopia is the age-related loss of near vision that typically
begins around age 40. Hyperopia (farsightedness) is a refractive error
causing difficulty with near vision but is present from birth. Myopia is
nearsightedness, and astigmatism causes blurred vision at all distances.
8. A nurse is performing a neurological assessment. Which cranial nerve is
responsible for the sense of smell?
A) Cranial nerve I (Olfactory)
B) Cranial nerve II (Optic)
C) Cranial nerve V (Trigeminal)
D) Cranial nerve VII (Facial)
Correct Answer: Cranial nerve I (Olfactory)
