ADVANCED HEALTH ASSESSMENT EXAM
Q&A 2026 EXAM STUDY SHEET WITH FULL
SOLUTIONS
◉ What is iritis?
Answer: constrictive response, acute uveitis with pain and red eye
◉ What can occur to pupils with damage to CN III (oculomotor)
Answer: pupil dilated and fixed with eye deviated lateral and down
with ptosis
◉ What is an Adie pupil?
Answer: a tonically dilated pupil that reacts slowly or fails to react to
light but does respond to convergence. due to destruction of
postganglionic nerve innervation to the eye by an infection.
◉ What are normal finding when inspecting the lens?
Answer: it should be clear and transparent
◉ What are normal findings when inspecting the sclera?
Answer: it is white and visible above the iris only when eyes are
wide open
,◉ What are some abnormal findings when inspecting the sclera?
Answer: pigmentation of yellow or green. Senile hyaline plaque is a
dark, slate gray anterior to insertion of medial rectus muscle
◉ How do you inspect and palpate the lacrimal apparatus?
Answer: inspect it by palpating the lower orbital rim near the inner
canthus and the upper temporal orbit.
◉ What do you do if the temporal aspect of the upper eyelid feels
full?
Answer: then evert the superior eyelid and inspect the lacrimal
gland which is normally non-palpable with no tenderness and no
regurgitation of fluid from the nasolacrimal duct
◉ What can cause lacrimal gland enlargement?
Answer: tumors, lymphoid infiltration, sarcoid disease, sjogrens
syndrome
◉ How do you test the extraocular movements of CN II, CN IV, CN VI?
Answer: hold the patient's chin and ask them to watch your finder as
it moves through the 6 cardinal fields of gaze. Then have the patient
follow your finger in a vertical plane from ceiling to floor. Movement
should be smooth.
,◉ What are the six cardinal fields of gaze?
Answer: *Lateral to the left (left eye lateral rectus, CN IV; right eye
medial rectus CNIII)
*Left eye looking laterally and then up (left eye uses superior rectus
and right eye uses inferior oblique)
*Left eye looking laterally and then down (left eye uses inferior
rectus and right eye uses superior oblique
*Lateral to the right (right eye lateral rectus, CN VI; left eye medial
rectus CNIII
*right eye looking laterally and then up (right eye uses superior
rectus and left eye uses inferior oblique)
*right eye looking laterally and then down (right eye uses inferior
rectus and left eye uses superior oblique
◉ Abnormal findings when testing extraocular movements?
Answer: if lid lag occurs or sclera is seen above the iris it may
indicate thyroid disease
◉ How to test balance of extraocular muscles?
Answer: by using the corneal light reflex. direct the light at nasal
bridge from 30 cm and ask patient to look at a nearby object. Look
for convergence of eyes. if abnormal then do the cover uncover test
, ◉ Abnormalities when doing the cover uncover test?
Answer: eye moves outward from the midline (exotropic)
eye moved inward toward the nose (esotropia)
◉ What is the proper technique to examine the interior of the eye
with an ophthalmoscope?
Answer: examine patient's right eye with your right eye and
patient's left eye with your left eye. Change the lens with your index
finger starting with the setting at 0. get in close to the patient and
stabilize yourself and the patient by placing your free hand on the
patient's shoulder or head. Have the patient look at a distant fixed
point and direct light at pupil from about 12 in away, visualize red
reflex, then approach eye slowly and look for retina.
◉ What structures are visualized in the interior eye with the
ophthalmoscope?
Answer: *red reflex of retina first
*retina is red/pink or yellow background and depends on amount of
melanin in skin
*blood vessel will probably be the first structure seen when 3-5 cm
from patient. You will see branching of blood vessels.
*use the branching blood vessels to fing optic disc
*then look at vascular supply of retina
*venous pulsations may be seen on disc and must be noted
Q&A 2026 EXAM STUDY SHEET WITH FULL
SOLUTIONS
◉ What is iritis?
Answer: constrictive response, acute uveitis with pain and red eye
◉ What can occur to pupils with damage to CN III (oculomotor)
Answer: pupil dilated and fixed with eye deviated lateral and down
with ptosis
◉ What is an Adie pupil?
Answer: a tonically dilated pupil that reacts slowly or fails to react to
light but does respond to convergence. due to destruction of
postganglionic nerve innervation to the eye by an infection.
◉ What are normal finding when inspecting the lens?
Answer: it should be clear and transparent
◉ What are normal findings when inspecting the sclera?
Answer: it is white and visible above the iris only when eyes are
wide open
,◉ What are some abnormal findings when inspecting the sclera?
Answer: pigmentation of yellow or green. Senile hyaline plaque is a
dark, slate gray anterior to insertion of medial rectus muscle
◉ How do you inspect and palpate the lacrimal apparatus?
Answer: inspect it by palpating the lower orbital rim near the inner
canthus and the upper temporal orbit.
◉ What do you do if the temporal aspect of the upper eyelid feels
full?
Answer: then evert the superior eyelid and inspect the lacrimal
gland which is normally non-palpable with no tenderness and no
regurgitation of fluid from the nasolacrimal duct
◉ What can cause lacrimal gland enlargement?
Answer: tumors, lymphoid infiltration, sarcoid disease, sjogrens
syndrome
◉ How do you test the extraocular movements of CN II, CN IV, CN VI?
Answer: hold the patient's chin and ask them to watch your finder as
it moves through the 6 cardinal fields of gaze. Then have the patient
follow your finger in a vertical plane from ceiling to floor. Movement
should be smooth.
,◉ What are the six cardinal fields of gaze?
Answer: *Lateral to the left (left eye lateral rectus, CN IV; right eye
medial rectus CNIII)
*Left eye looking laterally and then up (left eye uses superior rectus
and right eye uses inferior oblique)
*Left eye looking laterally and then down (left eye uses inferior
rectus and right eye uses superior oblique
*Lateral to the right (right eye lateral rectus, CN VI; left eye medial
rectus CNIII
*right eye looking laterally and then up (right eye uses superior
rectus and left eye uses inferior oblique)
*right eye looking laterally and then down (right eye uses inferior
rectus and left eye uses superior oblique
◉ Abnormal findings when testing extraocular movements?
Answer: if lid lag occurs or sclera is seen above the iris it may
indicate thyroid disease
◉ How to test balance of extraocular muscles?
Answer: by using the corneal light reflex. direct the light at nasal
bridge from 30 cm and ask patient to look at a nearby object. Look
for convergence of eyes. if abnormal then do the cover uncover test
, ◉ Abnormalities when doing the cover uncover test?
Answer: eye moves outward from the midline (exotropic)
eye moved inward toward the nose (esotropia)
◉ What is the proper technique to examine the interior of the eye
with an ophthalmoscope?
Answer: examine patient's right eye with your right eye and
patient's left eye with your left eye. Change the lens with your index
finger starting with the setting at 0. get in close to the patient and
stabilize yourself and the patient by placing your free hand on the
patient's shoulder or head. Have the patient look at a distant fixed
point and direct light at pupil from about 12 in away, visualize red
reflex, then approach eye slowly and look for retina.
◉ What structures are visualized in the interior eye with the
ophthalmoscope?
Answer: *red reflex of retina first
*retina is red/pink or yellow background and depends on amount of
melanin in skin
*blood vessel will probably be the first structure seen when 3-5 cm
from patient. You will see branching of blood vessels.
*use the branching blood vessels to fing optic disc
*then look at vascular supply of retina
*venous pulsations may be seen on disc and must be noted
