When assessing the pupillary light reflex, the nurse should use which technique

1.
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1. When examining the eye, the nurse notices that the patient’s eyelid margins approximate completely. The nurse recognizes that this assessment finding:
- A.
  Is expected.
- B.
  May indicate a problem with extraocular muscles.
- C.
  May result in problems with tearing.
- D.
  Indicates increased intraocular pressure.
2.
2. During ocular examinations, the nurse keeps in mind that movement of the extraocular muscles is:
- A.
  Decreased in the older adult.
- B.
  Impaired in a patient with cataracts.
- C.
  Stimulated by cranial nerves (CNs) I and II.
- D.
  Stimulated by CNs III, IV, and VI.
3.
3. The nurse is performing an external eye examination. Which statement regarding the outer layer of the eye is true?
- A.
  The outer layer of the eye is very sensitive to touch.
- B.
  The outer layer of the eye is darkly pigmented to prevent light from reflecting internally.
- C.
  The trigeminal nerve (CN V) and the trochlear nerve (CN IV) are stimulated when the outer surface of the eye is stimulated.
- D.
  The visual receptive layer of the eye in which light waves are changed into nerve impulses is located in the outer layer of the eye.
4.
4. When examining a patient’s eyes, the nurse recalls that stimulation of the sympathetic branch of the autonomic nervous system:
- A.
  Causes pupillary constriction.
- B.
  Adjusts the eye for near vision.
- C.
  Elevates the eyelid and dilates the pupil.
- D.
  Causes contraction of the ciliary body.
5.
5. The nurse is reviewing causes of increased intraocular pressure. Which of these factors determines intraocular pressure?
- A.
  Thickness or bulging of the lens
- B.
  Posterior chamber as it accommodates increased fluid
- C.
  Contraction of the ciliary body in response to the aqueous within the eye
- D.
  Amount of aqueous produced and resistance to its outflow at the angle of the anterior chamber
6.
6. The nurse is conducting a visual examination. Which of these statements regarding visual pathways and visual fields is true?
- A.
  The right side of the brain interprets the vision for the right eye.
- B.
  The image formed on the retina is upside down and reversed from its actual appearance in the outside world.
- C.
  Light rays are refracted through the transparent media of the eye before striking the pupil.
- D.
  Light impulses are conducted through the optic nerve to the temporal lobes of the brain.
7.
7. The nurse is testing a patient’s visual accommodation, which refers to which action?
- A.
  Pupillary constriction when looking at a near object
- B.
  Pupillary dilation when looking at a far object
- C.
  Changes in peripheral vision in response to light
- D.
  Involuntary blinking in the presence of bright light
8.
8. A patient has a normal pupillary light reflex. The nurse recognizes that this reflex indicates that:
- A.
  The eyes converge to focus on the light.
- B.
  Light is reflected at the same spot in both eyes.
- C.
  The eye focuses the image in the center of the pupil.
- D.
  Constriction of both pupils occurs in response to bright light.
9.
9. A mother asks when her newborn infant’s eyesight will be developed. The nurse should reply:
- A.
  “Vision is not totally developed until 2 years of age.”
- B.
  “Infants develop the ability to focus on an object at approximately 8 months of age.”
- C.
  “By approximately 3 months of age, infants develop more coordinated eye movements and can fixate on an object.”
- D.
  “Most infants have uncoordinated eye movements for the first year of life.”
10.
10. The nurse is reviewing in age-related changes in the eye for a class. Which of these physiologic changes is responsible for presbyopia?
- A.
  Degeneration of the cornea
- B.
  Loss of lens elasticity
- C.
  Decreased adaptation to darkness
- D.
  Decreased distance vision abilities
11.
11. Which of these assessment findings would the nurse expect to see when examining the eyes of a black patient?
- A.
  Increased night vision
- B.
  Dark retinal background
- C.
  Increased photosensitivity
- D.
  Narrowed palpebral fissures
12.
12. A 52-year-old patient describes the presence of occasional floaters or spots moving in front of his eyes. The nurse should:
- A.
  Examine the retina to determine the number of floaters.
- B.
  Presume the patient has glaucoma and refer him for further testing.
- C.
  Consider these to be abnormal findings, and refer him to an ophthalmologist.
- D.
  Know that floaters are usually insignificant and are caused by condensed vitreous fibers.
13.
13. The nurse is preparing to assess the visual acuity of a 16-year-old patient. How should the nurse proceed?
- A.
  Perform the confrontation test.
- B.
  Ask the patient to read the print on a handheld Jaeger card.
- C.
  Use the Snellen chart positioned 20 feet away from the patient.
- D.
  Determine the patient’s ability to read newsprint at a distance of 12 to 14 inches.
14.
14. A patient’s vision is recorded as 20/30 when the Snellen eye chart is used. The nurse interprets these results to indicate that:
- A.
  At 30 feet the patient can read the entire chart.
- B.
  The patient can read at 20 feet what a person with normal vision can read at 30 feet.
- C.
  The patient can read the chart from 20 feet in the left eye and 30 feet in the right eye.
- D.
  The patient can read from 30 feet what a person with normal vision can read from 20 feet.
15.
15. A patient is unable to read even the largest letters on the Snellen chart. The nurse should take which action next?
- A.
  Refer the patient to an ophthalmologist or optometrist for further evaluation.
- B.
  Assess whether the patient can count the nurse’s fingers when they are placed in front of his or her eyes.
- C.
  Ask the patient to put on his or her reading glasses and attempt to read the Snellen chart again.
- D.
  Shorten the distance between the patient and the chart until the letters are seen, and record that distance.
16.
16. A patient’s vision is recorded as 20/80 in each eye. The nurse interprets this finding to mean that the patient:
- A.
  Has poor vision.
- B.
  Has acute vision.
- C.
  Has normal vision.
- D.
  Is presbyopic.
17.
17. When performing the corneal light reflex assessment, the nurse notes that the light is reflected at 2 o’clock in each eye. The nurse should:
- A.
  Consider this a normal finding.
- B.
  Refer the individual for further evaluation.
- C.
  Document this finding as an asymmetric light reflex.
- D.
  Perform the confrontation test to validate the findings.
18.
18. The nurse is performing the diagnostic positions test. Normal findings would be which of these results?
- A.
  Convergence of the eyes
- B.
  Parallel movement of both eyes
- C.
  Nystagmus in extreme superior gaze
- D.
  Slight amount of lid lag when moving the eyes from a superior to an inferior position
19.
19. During an assessment of the sclera of a black patient, the nurse would consider which of these an expected finding?
- A.
  Yellow fatty deposits over the cornea
- B.
  Pallor near the outer canthus of the lower lid
- C.
  Yellow color of the sclera that extends up to the iris
- D.
  Presence of small brown macules on the sclera
20.
20. A 60-year-old man is at the clinic for an eye examination. The nurse suspects that he has ptosis of one eye. How should the nurse check for this?
- A.
  Perform the confrontation test.
- B.
  Assess the individual’s near vision.
- C.
  Observe the distance between the palpebral fissures.
- D.
  Perform the corneal light test, and look for symmetry of the light reflex.
21.
21. During an examination of the eye, the nurse would expect what normal finding when assessing the lacrimal apparatus?
- A.
  Presence of tears along the inner canthus
- B.
  Blocked nasolacrimal duct in a newborn infant
- C.
  Slight swelling over the upper lid and along the bony orbit if the individual has a cold
- D.
  Absence of drainage from the puncta when pressing against the inner orbital rim
22.
22. When assessing the pupillary light reflex, the nurse should use which technique?
- A.
  Shine a penlight from directly in front of the patient, and inspect for pupillary constriction.
- B.
  Ask the patient to follow the penlight in eight directions, and observe for bilateral pupil constriction.
- C.
  Shine a light across the pupil from the side, and observe for direct and consensual pupillary constriction.
- D.
  Ask the patient to focus on a distant object. Then ask the patient to follow the penlight to approximately 7 cm from the nose.
23.
23. The nurse is assessing a patient’s eyes for the accommodation response and would expect to see which normal finding?
- A.
  Dilation of the pupils
- B.
  Consensual light reflex
- C.
  Conjugate movement of the eyes
- D.
  Convergence of the axes of the eyes
24.
24. In using the ophthalmoscope to assess a patient’s eyes, the nurse notices a red glow in the patient’s pupils. On the basis of this finding, the nurse would:
- A.
  Suspect that an opacity is present in the lens or cornea.
- B.
  Check the light source of the ophthalmoscope to verify that it is functioning.
- C.
  Consider the red glow a normal reflection of the ophthalmoscope light off the inner retina.
- D.
  Continue with the ophthalmoscopic examination, and refer the patient for further evaluation.
25.
25. The nurse is examining a patient’s retina with an ophthalmoscope. Which finding is considered normal?
- A.
  Optic disc that is a yellow-orange color
- B.
  Optic disc margins that are blurred around the edges
- C.
  
  Presence of pigmented crescents in the macular area
- D.
  Presence of the macula located on the nasal side of the retina

Which technique will the nurse use to assess pupillary reflexes?

Test pupillary reaction to light. Using a penlight, approach the patient from the side, and shine the penlight on one pupil. Observe the response of the lighted pupil, which is expected to quickly constrict. Repeat by shining the light on the other pupil.

Which technique is correct when assessing the patient's pupillary light reflex?

Evaluation of the pupillary light reflexes (PLR) is conventionally performed by shining light into the patient's eye and subjectively described by examiners.

Which technique should the nurse use to assess the pupillary light reflex on client quizlet?

When assessing the pupillary light reflex, the nurse should use which technique? Shine a light across the pupil from the side and observe for direct and consensual pupillary constriction.

What is the pupillary reflex quizlet?

The pupillary light reflex controls the diameter of the pupil, in response to the intensity of light that falls on the retinal ganglion cells of the retina in the back of the eye, thereby assisting in adaptation to various levels of lightness/darkness.

When assessing the pupillary light reflex, the nurse should use which technique

Which technique will the nurse use to assess pupillary reflexes?

Which technique is correct when assessing the patient's pupillary light reflex?

Which technique should the nurse use to assess the pupillary light reflex on client quizlet?

What is the pupillary reflex quizlet?

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