C HAPTER 12: E YES
Ball: Seidel’s Guide to Physical Examination, 9th Edition
MULTIPLE CHOICE
1. Mrs. Alden is a 29-year-old pregnant patient in her third trimester. She tells you
that her vision has been a little blurred, and she thinks she needs to get new
contact lenses. You should advise her to:
a. get new lenses as soon as possible to avoid complications.
b. wait until several weeks after delivery to get new lenses.
c. go to the nearest emergency department for evaluation.
d. change her diet to include more yellow vegetables.
ANS: B
Because of the increased level of lysozyme in the tears during pregnancy, a
blurred sensation may occur but will subside several weeks after pregnancy.
The blurred vision is a normal occurrence during pregnancy. It is not an
emergency, nor is it diet-dependent.
DIF: Cognitive Level: Applying (Application) OBJ: Nursing process—
assessment MSC: Physiologic Integrity: Physiologic Adaptation
2. A condition that typically develops by the age of 45 years is:
a. presbyopia.
b. hyperopia.
c. myopia.
, d. astigmatism.
ANS: A
By 45 years of age, a condition known as presbyopia develops; presbyopia
involves a weakening of accommodation. Hyperopia occurs in early infancy.
Myopia and astigmatism can occur at any time.
DIF: Cognitive Level: Understanding (Comprehension) OBJ: Nursing
process—assessment MSC: Physiologic Integrity: Physiologic
Adaptation
3. Which finding, when seen in the infant, is ominous?
a. Difficulty tracking objects with the eyes
b. Appearing to have better peripheral than central vision
c. Blinking when bright light is directed at the face
d. White pupils on photographs
ANS: D
The absence of a red reflex, determined by physical examination or the
appearance of white pupils on a photograph, is indicative of retinoblastoma, a
serious retinal tumor.
DIF: Cognitive Level: Analyzing (Analysis) OBJ: Nursing
process—assessment MSC: Physiologic Integrity: Physiologic
Adaptation
, 4. Mr. C's visual acuity is 20/50. This means that he:
a. can see 50% of what the average person sees at 20 feet.
b. has perfect vision when tested at 50 feet.
c. can see 20% of the letters on the chart's 20/50 line.
d. can read letters while standing 20 feet from the chart that the average
person could read at 50 feet.
ANS: D
Visual acuity is measured as a fraction, in which the top number is the
distance that the patient is standing from the chart; the bottom number is the
distance that an average person can stand and still read the line.
DIF: Cognitive Level: Analyzing (Analysis) OBJ: Nursing
process—assessment MSC: Physiologic Integrity: Physiologic
Adaptation
5. The criterion for determining the adequacy of a patient's visual field is:
a. the ability to discriminate primary colors.
b. the ability to discriminate details.
c. correspondence with the visual field of the examiner.
d. distance vision equal to that of an average person.
ANS: C
The examiner compares his or her own peripheral vision to that of the patient
while performing the confrontation test, so unless the examiner is aware of a
problem with his or her own vision, the examiner could assume that the fields
are full if they match.
Ball: Seidel’s Guide to Physical Examination, 9th Edition
MULTIPLE CHOICE
1. Mrs. Alden is a 29-year-old pregnant patient in her third trimester. She tells you
that her vision has been a little blurred, and she thinks she needs to get new
contact lenses. You should advise her to:
a. get new lenses as soon as possible to avoid complications.
b. wait until several weeks after delivery to get new lenses.
c. go to the nearest emergency department for evaluation.
d. change her diet to include more yellow vegetables.
ANS: B
Because of the increased level of lysozyme in the tears during pregnancy, a
blurred sensation may occur but will subside several weeks after pregnancy.
The blurred vision is a normal occurrence during pregnancy. It is not an
emergency, nor is it diet-dependent.
DIF: Cognitive Level: Applying (Application) OBJ: Nursing process—
assessment MSC: Physiologic Integrity: Physiologic Adaptation
2. A condition that typically develops by the age of 45 years is:
a. presbyopia.
b. hyperopia.
c. myopia.
, d. astigmatism.
ANS: A
By 45 years of age, a condition known as presbyopia develops; presbyopia
involves a weakening of accommodation. Hyperopia occurs in early infancy.
Myopia and astigmatism can occur at any time.
DIF: Cognitive Level: Understanding (Comprehension) OBJ: Nursing
process—assessment MSC: Physiologic Integrity: Physiologic
Adaptation
3. Which finding, when seen in the infant, is ominous?
a. Difficulty tracking objects with the eyes
b. Appearing to have better peripheral than central vision
c. Blinking when bright light is directed at the face
d. White pupils on photographs
ANS: D
The absence of a red reflex, determined by physical examination or the
appearance of white pupils on a photograph, is indicative of retinoblastoma, a
serious retinal tumor.
DIF: Cognitive Level: Analyzing (Analysis) OBJ: Nursing
process—assessment MSC: Physiologic Integrity: Physiologic
Adaptation
, 4. Mr. C's visual acuity is 20/50. This means that he:
a. can see 50% of what the average person sees at 20 feet.
b. has perfect vision when tested at 50 feet.
c. can see 20% of the letters on the chart's 20/50 line.
d. can read letters while standing 20 feet from the chart that the average
person could read at 50 feet.
ANS: D
Visual acuity is measured as a fraction, in which the top number is the
distance that the patient is standing from the chart; the bottom number is the
distance that an average person can stand and still read the line.
DIF: Cognitive Level: Analyzing (Analysis) OBJ: Nursing
process—assessment MSC: Physiologic Integrity: Physiologic
Adaptation
5. The criterion for determining the adequacy of a patient's visual field is:
a. the ability to discriminate primary colors.
b. the ability to discriminate details.
c. correspondence with the visual field of the examiner.
d. distance vision equal to that of an average person.
ANS: C
The examiner compares his or her own peripheral vision to that of the patient
while performing the confrontation test, so unless the examiner is aware of a
problem with his or her own vision, the examiner could assume that the fields
are full if they match.
