Eyes: FNP Board Review, questions and answers with verified content

Eyes: FNP Board Review, questions and answers with verified content Common causes of acute suppurative conjunctivitis include all except: Staph Aureus H. Influenzae Strep pneumoniae Pseudomonas aeruginosa Pseudomonas Aeruginosa Treatment for suppurative conjunctivitis include all except: Bacitracin-polymyxin B Ciprofloxacin Erythromycin Penicillin Penicillin Treatment options for allergic conjunctivitis include all the following except Chromodynamics ophthalmic drops Oral antihistamines Ophthalmic antihistamines Corticosteroid ophthalmic drops Corticosteroid ophthalmic drops What are the three components of an ophthalmological emergency? Painful, Red eye, with visual disturbance Angle Closure Glaucoma Caused by sudden dilation of pupils from medications to dilate pupils, or by sitting in a darkened movie theater Painful, Red eye, with sudden visual disturbance, halos around lights, nausea, conjunctival hypermedia, fixed mid-dilated pupil. Without intervention blindness in 3-5 days. Open Angle Glaucoma GRADUAL loss of vision, Slowly Progressive, PAINLESS, seldom produces symptoms. Anterior Uveitis DULL, Painful Red Eye with visual change. Tearing, photophobiaThe pupil is usually constricted, non reactive, and irregularly shaped pupil. (Uncommon disease) Anterior Uveitis Treatment Pupillary dilation and corticosteroids. Evaluate for cause (autoimmune/inflammatory, trauma) Anterior Uveitis Risk factors for Primary Open Angle Glaucoma African American, diabetes, family history, trauma, advancing age Is gradual-onset peripheral vision loss specific for open-angle glaucoma or angle-closure glaucoma? Open angle glaucoma Is A tonometry reading of > 25 mm Hg is associated with angle-closure or open-angle glaucoma? Angle-closure What is glaucomatous cupping and which glaucoma is it associated with? Increased IOP causes the optic disc and cup to be pushed in creating a cup to disk ratio of 0.3 or more. T/F: Pilocarpine is often used for treatment of open-angle glaucoma. False. This can cause pupillary construction. Use of beta blockers (timolol), alpha2 agonists (brimonidine), carbonic anhydrase inhibitors, and prostaglandin analogues (lantanoprost) are preferred. Macular Degeneration Presentation Painless loss of vision often with visual distortion when looking at straight lines. T/F: Age, Caucasian, smoking, HTN, Vascular disease, UV light, fatty diet are risk factors for macular degeneration, which is the leading cause of blindness in developed countries. True What presents with abnormal pigmentation or hemorrhaging in the macular area "drusen deposits" Macular Degeneration T/F: Quitting smoking and antioxidants can help manage macular degeneration. True A "pimple" on eyelid. Tender. Usually caused by staphylococcal infection of a hair follicle. Also called a stye. Hordeolum An inflammatory eyelid condition that may not involve infection but can follow a hordeolum and is characterized by a hard nontender swelling of the upper or lower lid. Chalazion Simple hordeolum treatment? Warm compresses for 10 minutes 3-4 times a day. Erythromycin or bacitracin ophthalmic ointment. Rarely I & D Chalazion Treatment? Warm soaks, no antibiotics, refer to ophthalmology for corticosteroid injections or excision Primary Open Angle Glaucoma Etiology Increased IOP due to abnormal drainage of aqueous humor through trabecular meshwork Orbital Cellulitus is an ophthalmologic emergency and is usually ____________ (bacterial or viral). Bacterial, consider fungal if immunosuppression, DM, etc. What would fluorescein staining with a wood lamp then slit lamp exam help to diagnose? Corneal Abrasion How does a corneal abrasion present? Severe eye pain, excessive tearing, hypermedia, and photophobia Management of a corneal abrasion includes: Topical anesthetic application (irrigation if chemical exposure or foreign body seen on exam) Erythromycin ointment helps to prevent excessive abrasion to regenerating tissue. Alternate: polymyxin sulfacetamide If corneal abrasion from contact lens wearing you MUST cover _____________ with ofloxacin, ciprofloxacin, or tobramycin ointment or drops. NO use of contacts until cleared by an ophthalmologist. Pseudomonas A cataract presents with painless progressive loss of vision due to opacification of the lens. It is diagnosed by loss of _____ reflex, and opacification of lens on slit-lamp exam. Red What presents with no pain, floaters and flashes, and "curtain falling" Retinal detachment What is the visual problem associated with presbyopia? Blurring of near vision What visual problem is associated with macular degeneration? Loss of central vision What visual problem is NOT associated with normal aging? A. Need for increased illumination B. Increased sensitivity to glare C. Washing out of colors D. Gradual loss of peripheral vision Gradual loss of peripheral vision is not associated with normal aging. T/F: With any eye complaint you should Always check Vision? True Which of the following is used as a screening test for macular problems: A. Slit Lamp Examination B. Snellen Chart C. Amsler Grid Test D. Tonometry Amsler Grid Test What does a slit lamp examination test Evaluates anterior eye structures including the cornea, conjunctiva, sclera, and iris Senile Cataracts are caused by lens clouding and cause progressive vision dimming, distance Vision problems, ________(far or near) vision is usually retained and often initially improves. Near Sudden increase in intraocular pressure. Usually unilateral, acutely red, painful, Vision changes like halos. Eyeball firm when compared to the other Angle-closure glaucoma What is the etiology of macular degeneration? Thickening sclerotic changes in retinal basement membrane complex Presbycusis. . . Which CN is affected. symptoms? Loss of CN 8 sensitivity. difficulty with conversation in noisy environment, person can hear but vm can't understand what is said. Accelerated by excessive noise exposure. What type of hearing loss is cerumen impaction an example of Conductive hearing loss Common causes of Supporative conjunctivitis (non-gonoccal/non chlamydial) S. aureus S. Pneumoniae H. influenzae Outbreaks typical due to S. pneumoniae Primary treatment for supporative conjunctivitis. Ophthalmic treatment with fluoroquinolone ocular solution. Alternatively polymyxin B with trimethoprim solution or azithromycin 1% ophthalmic solution Treatment options in suppurative conjunctivitis include all of the following ophthalmic preparations except: A. polymyxin B plus trimethoprim. B. levofloxacin. C. polymyxin. D. azithromycin. C The most common virological cause of conjunctivitis is: A. coronavirus. B. adenovirus. C. rhinovirus. D. human papillomavirus. B The mother of a 12-month-old reports that her child has excessive tearing of the right eye and appears to be oversensitive to light. On examination of the eyes, the nurse practitioner notices cloudiness of the right cornea. These symptoms could be suggestive of: congenital glaucoma. Cloudiness of the cornea could be suggestive of congenital glaucoma. A dark light reflex could result from cataracts, retinopathy of prematurity, or other disorders. Congenital cataracts are seen as cloudiness of the lens. A condition of the eyes caused by disorganized growth of retinal blood vessels which may result in scarring and retinal detachment is referred to as retinopathy of prematurity. Chorioretinitis is an inflammation of the choroid (thin pigmented vascular coat of the eye) and retina of the eye.