NURS 401 Exam #3 – Visual Changes in Older Adults, Eye Disorders, and
Nursing Interventions (Practice Questions with Answers)
You have four rooms to choose from for your older client to be admitted this afternoon. Which
room would you choose?
a. A brightly lit, blue room with cozy throw rugs
b. An orange-carpeted room with soft lighting and yellow walls
c. A brightly lit, blue room with an EZ-Glide wax floor
d. A fluorescent-lighted room with green walls and a glossy, tiled floor - correct answer ANS: B
Light colors such as red, orange, and yellow are more easily seen by aging eyes. Softer lighting
will help reduce some of the glare and is also easier seen by aging eyes. Fidelity of color is less
accurate with the blues, greens, and violets of the spectrum, and the slowed ability of the
pupils to adjust to light makes glare a problem. Glare can come from sunlight, but a brightly
waxed floor and glossy tile can also cause glare.
An older adult client shares with the nurse that, "I don't know what it is but it seems that I need
more light for reading or even watching television as I get older." The nurse explains that aging
may cause this change due to the:
a. Slower ability of the pupil to adjust to changes in lighting.
b. Impact arcus senilis has on visual acuity
c. Flattening and thinning of the cornea.
d. Retinal changes that begin to occur with aging. - correct answer ANS: A
A slowed ability of the pupil to accommodate to changes in light accounts for the need of this
patient to have more light in order to read. Arcus senilis does not affect vision. It is true that the
cornea becomes flatter and thinner with aging, which results in astigmatism. Astigmatism does
not account for the need for increased light that this patient is reporting. The changes in the
retina do not account for the need for increased light that this patient is reporting.
,A 77-year-old client being treated for glaucoma asks the nurse what causes glaucoma. The
nurse's response is:
a. The exact etiology of glaucoma is variable and often unknown.
b. Spasms of the orbicular muscle.
c. Changes to the suspensory ligaments, ciliary muscles, and parasympathetic nerves.
d. Bits of broken coalesced vitreous from the peripheral or central part of the retina. - correct
answer ANS: A
The etiology of glaucoma is variable and often unknown. However, when the natural fluids of
the eye are blocked by ciliary muscle rigidity and the buildup of pressure, damage to the optic
nerve occurs. Spasms of the orbicular muscle can cause the lower lid to turn inward. If it stays
this way, it is called entropion. The changes described contribute to decreased accommodation.
Bits of coalesced vitreous that have broken off from the peripheral or central part of the retina
is the definition of floaters.
An older man tells a nurse, "The doctor says I have something wrong with my eyes, something
called presbyopia. Can you explain why I have this? I was always fortunate to have good
eyesight." The nurse formulates a response based on the knowledge that:
a. The lens of the eye loses elasticity causing a loss of focus for near objects.
b. The cornea of the eye becomes thicker and less curved causing an increase in astigmatism.
c. The lens of the eye increases in opacity causing a decrease in light refraction.
d. The cornea of the eye forms a gray ring at the edges. - correct answer ANS: A
Presbyopia is the loss of focus for near objects, caused by a loss of elasticity and hence a loss of
accommodation of the lens of the eye. All of the other options are normal age-related changes;
however, they are not related to presbyopia.
An older resident in a long-term care facility reports to the nurse that she has been noticing
changes in her vision, including the appearance of halos around objects and a yellow tint to
most objects. The nurse knows that these complaints are most often associated with:
,a. Cataracts.
b. Glaucoma.
c. Diabetic retinopathy.
d. Age-related macular degeneration. - correct answer ANS: A
Signs of cataracts include the appearance of halos around objects as light is diffused, blurring,
decreased perception of light and color giving a yellow tint to most objects, and a sensitivity to
glare.
An older patient reports the following symptoms to a nurse during a routine visit to the
geriatric clinic: blurry vision, the need for more light when reading, and blind spots in the
middle of his visual field. He also states, "Strangely enough my peripheral vision continues to be
pretty good." The nurse suspects that the patient has which of the following?
a. Glaucoma
b. Age related macular degeneration
c. Diabetic retinopathy
d. Cataracts - correct answer ANS: B
Blurry vision, needing more light, and blind spots in the middle of the visual field (scotomas) are
all characteristics of age related macular degeneration. The other three eye diseases do not
present with these symptoms.
A nurse is providing glaucoma education for a group of older adults in a senior center. The
nurse knows that the following groups are most likely to develop glaucoma. (Select all that
apply.)
a. African Americans
b. Mexican Americans
c. Individuals with a family history of glaucoma
d. Individuals with diabetes
e. Asian Americans - correct answer ANS: A, B, C, D
, African Americans are at risk of developing glaucoma at an earlier age than other racial and
ethnic groups. Mexican Americans, individuals with a family history of glaucoma, and
individuals with diabetes are among the other high-risk groups. Asian Americans are more likely
to lose eyesight from age-related macular degeneration than other groups.
A nurse is performing preoperative teaching for an older adult who is scheduled to have a
cataract extraction and lens implant. The nurse includes which of the following in the teaching
plan? (Select all that apply.)
a. Avoid lifting heavy objects after the surgery
b. Avoid bending from the waist after the surgery
c. Take stool softeners as needed
d. Maintain strict control of your blood sugar and blood pressure
e. Maintain a dry sterile dressing over the eye for 10 days - correct answer ANS: A, B, C
Postcataract surgery the individual needs to avoid heavy lifting, straining, and bending from the
waist. Fall prevention is also very important as is complying with eye drop administration.
Maintaining strict blood sugar and blood pressure control is most important for diabetic
retinopathy, not cataract extraction. There usually is not a dressing over the operative site, and
not for 10 days.
An older patient is diagnosed with diabetic retinopathy. The patient asks a nurse: "Is there
anything that I can do to prevent progression of this disease and blindness?" The nurse includes
which of the following into the response? (Select all that apply.)
a. Strict control of blood glucose levels is important in slowing disease progression
b. Laser photocoagulation treatments can stop progression of the disease
c. Control of blood pressure and cholesterol levels are important steps slowing disease
progression
d. Wearing sunglasses to protect the eyes from ultraviolet light can stop disease progression
e. Eating a diet high in beta-carotene can stop disease progression - correct answer ANS: A, B, C
Nursing Interventions (Practice Questions with Answers)
You have four rooms to choose from for your older client to be admitted this afternoon. Which
room would you choose?
a. A brightly lit, blue room with cozy throw rugs
b. An orange-carpeted room with soft lighting and yellow walls
c. A brightly lit, blue room with an EZ-Glide wax floor
d. A fluorescent-lighted room with green walls and a glossy, tiled floor - correct answer ANS: B
Light colors such as red, orange, and yellow are more easily seen by aging eyes. Softer lighting
will help reduce some of the glare and is also easier seen by aging eyes. Fidelity of color is less
accurate with the blues, greens, and violets of the spectrum, and the slowed ability of the
pupils to adjust to light makes glare a problem. Glare can come from sunlight, but a brightly
waxed floor and glossy tile can also cause glare.
An older adult client shares with the nurse that, "I don't know what it is but it seems that I need
more light for reading or even watching television as I get older." The nurse explains that aging
may cause this change due to the:
a. Slower ability of the pupil to adjust to changes in lighting.
b. Impact arcus senilis has on visual acuity
c. Flattening and thinning of the cornea.
d. Retinal changes that begin to occur with aging. - correct answer ANS: A
A slowed ability of the pupil to accommodate to changes in light accounts for the need of this
patient to have more light in order to read. Arcus senilis does not affect vision. It is true that the
cornea becomes flatter and thinner with aging, which results in astigmatism. Astigmatism does
not account for the need for increased light that this patient is reporting. The changes in the
retina do not account for the need for increased light that this patient is reporting.
,A 77-year-old client being treated for glaucoma asks the nurse what causes glaucoma. The
nurse's response is:
a. The exact etiology of glaucoma is variable and often unknown.
b. Spasms of the orbicular muscle.
c. Changes to the suspensory ligaments, ciliary muscles, and parasympathetic nerves.
d. Bits of broken coalesced vitreous from the peripheral or central part of the retina. - correct
answer ANS: A
The etiology of glaucoma is variable and often unknown. However, when the natural fluids of
the eye are blocked by ciliary muscle rigidity and the buildup of pressure, damage to the optic
nerve occurs. Spasms of the orbicular muscle can cause the lower lid to turn inward. If it stays
this way, it is called entropion. The changes described contribute to decreased accommodation.
Bits of coalesced vitreous that have broken off from the peripheral or central part of the retina
is the definition of floaters.
An older man tells a nurse, "The doctor says I have something wrong with my eyes, something
called presbyopia. Can you explain why I have this? I was always fortunate to have good
eyesight." The nurse formulates a response based on the knowledge that:
a. The lens of the eye loses elasticity causing a loss of focus for near objects.
b. The cornea of the eye becomes thicker and less curved causing an increase in astigmatism.
c. The lens of the eye increases in opacity causing a decrease in light refraction.
d. The cornea of the eye forms a gray ring at the edges. - correct answer ANS: A
Presbyopia is the loss of focus for near objects, caused by a loss of elasticity and hence a loss of
accommodation of the lens of the eye. All of the other options are normal age-related changes;
however, they are not related to presbyopia.
An older resident in a long-term care facility reports to the nurse that she has been noticing
changes in her vision, including the appearance of halos around objects and a yellow tint to
most objects. The nurse knows that these complaints are most often associated with:
,a. Cataracts.
b. Glaucoma.
c. Diabetic retinopathy.
d. Age-related macular degeneration. - correct answer ANS: A
Signs of cataracts include the appearance of halos around objects as light is diffused, blurring,
decreased perception of light and color giving a yellow tint to most objects, and a sensitivity to
glare.
An older patient reports the following symptoms to a nurse during a routine visit to the
geriatric clinic: blurry vision, the need for more light when reading, and blind spots in the
middle of his visual field. He also states, "Strangely enough my peripheral vision continues to be
pretty good." The nurse suspects that the patient has which of the following?
a. Glaucoma
b. Age related macular degeneration
c. Diabetic retinopathy
d. Cataracts - correct answer ANS: B
Blurry vision, needing more light, and blind spots in the middle of the visual field (scotomas) are
all characteristics of age related macular degeneration. The other three eye diseases do not
present with these symptoms.
A nurse is providing glaucoma education for a group of older adults in a senior center. The
nurse knows that the following groups are most likely to develop glaucoma. (Select all that
apply.)
a. African Americans
b. Mexican Americans
c. Individuals with a family history of glaucoma
d. Individuals with diabetes
e. Asian Americans - correct answer ANS: A, B, C, D
, African Americans are at risk of developing glaucoma at an earlier age than other racial and
ethnic groups. Mexican Americans, individuals with a family history of glaucoma, and
individuals with diabetes are among the other high-risk groups. Asian Americans are more likely
to lose eyesight from age-related macular degeneration than other groups.
A nurse is performing preoperative teaching for an older adult who is scheduled to have a
cataract extraction and lens implant. The nurse includes which of the following in the teaching
plan? (Select all that apply.)
a. Avoid lifting heavy objects after the surgery
b. Avoid bending from the waist after the surgery
c. Take stool softeners as needed
d. Maintain strict control of your blood sugar and blood pressure
e. Maintain a dry sterile dressing over the eye for 10 days - correct answer ANS: A, B, C
Postcataract surgery the individual needs to avoid heavy lifting, straining, and bending from the
waist. Fall prevention is also very important as is complying with eye drop administration.
Maintaining strict blood sugar and blood pressure control is most important for diabetic
retinopathy, not cataract extraction. There usually is not a dressing over the operative site, and
not for 10 days.
An older patient is diagnosed with diabetic retinopathy. The patient asks a nurse: "Is there
anything that I can do to prevent progression of this disease and blindness?" The nurse includes
which of the following into the response? (Select all that apply.)
a. Strict control of blood glucose levels is important in slowing disease progression
b. Laser photocoagulation treatments can stop progression of the disease
c. Control of blood pressure and cholesterol levels are important steps slowing disease
progression
d. Wearing sunglasses to protect the eyes from ultraviolet light can stop disease progression
e. Eating a diet high in beta-carotene can stop disease progression - correct answer ANS: A, B, C
