Test Bank for Nursing Health Assessment,
Edition: Patricia Dillon
2nd
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1. The eye sends nerve impulses to which lobe of the brain?
A) Frontal
B) Parietal
C) Temporal
D) Occipital
2. The function of the eyelashes is to:
A) Protect the eyes from injury.
B) Distribute lubrication over the eye.
C) Secrete fluids to lubricate the eyes.
D) Transmit sensory innervation for pain.
3. What is the function of aqueous humor?
A) Controls the amount of light entering the retina
B) Supplies the lens and cornea with nutrition
C) Underlies the bulbar conjunctiva and gives the eyeball its white color
D) Produces tears to moisturize the globe and wash away foreign bodies
4. Accommodation in far vision is accomplished by:
A) Increasing pressure in the Schlemm's canal.
B) Increasing blood flow in the choroid layer.
C) Flattening the lens.
D) Stimulating rods and cones.
5. What is the function of the macula?
A) Detects color
B) Important in central vision
C) Responsible for motion detection
D) All of the above
6. Which structure in the eye controls the amount of light allowed onto the retina?
A) Iris
B) Macula
C) Fovea centralis
D) Pupil
7. People who have difficulty seeing objects that are near have the condition called:
A) Astigmatism.
B) Hyperopia.
C) Myopia.
D) Nystagmus.
8. Which of the following cranial nerves (CNs) control eye movements?
A) CN III
B) CN IV
C) CN VI
D) All of the above
9. A mother is concerned because her newborn is not able to follow a moving toy with her eyes. The nurse explains that infants should be able to follow an object by:
A) 2 weeks,
B) 1 month,
C) 2 months,
D) 3 months,
10. The nurse is screening children before they enter preschool. The expected visual acuity at this age is:
A) 20/20,
B) 20/40,
C) 20/60,
D) 20/100,
11. A 65-year-old professor complains of dryness of the eyes after reading or doing computer work. The nurse knows that this may be caused by:
A) Fatty deposits around the eyelids.
B) The lens becoming more opaque.
C) A decrease in tear production.
D) Decreased ability to constrict the pupil.
12. As one ages, night vision may become impaired because of:
A) Decreased contraction of ciliary body.
B) Degeneration of cones.
C) Degeneration of rods.
D) Arcus senilis.
13. Sudden loss of vision is most likely:
A) Retinal detachment.
B) Retinitis pigmentosa glaucoma.
C) Cataract.
D) Diabetic retinopathy.
14. The nurse documents that the patient's left eye is draining clear fluid. The nurse charts:
A) OD with clear drainage.
B) OS with clear drainage.
C) OU with clear drainage.
D) None of the above.
15. While visualizing the patient's eyes, the nurse notes a red reflex. This indicates:
A) Light is able to bounce off the retina.
B) The arteries are not constricted.
C) The arteries are constricted.
D) Color vision is intact.
16. Absence of the red reflex indicates:
A) Cataracts.
B) Glaucoma.
C) Macular degeneration.
D) Presbyopia.
17. Cotton-wool spots on the retina are an indication of:
A) Macular degeneration.
B) Colorblindness.
C) Microinfarctions.
D) Optic atrophy.
18. How often should diabetic patients have an ophthalmic exam?
A) Quarterly
B) Semiannually
C) Yearly
D) Every 2 years
19. Strabismus screening should be conducted by what age?
A) 2-week-old newborn
B) 6 months
C) 3 years
D) 5 years
20. Which of the following precautions should be followed after administration of mydriatic medication in the eye?
A) Keep eyes closed for 1 hour afterward.
B) Keep eyes open for a minimum of 2 hours.
C) Administer saline drops every 30 minutes following mydriatics.
D) Wear sunglasses or avoid bright lights.
21. The Weber test is used to screen for hearing deficits. When performing the Weber test, where should the nurse place the tuning fork?
A) On the mastoid process
B) In front of the ear
C) On the forehead
D) On the tragus
22. The ratio of the time sound remains audible when travelling through air compared with the time sound remains audible when travelling through bone is:
A) 1:5.
B) 2:3.
C) 1:2.
D) 2:1.
23. To perform the Rinne test of hearing function, the nurse:
A) Whispers several words to the patient and asks him or her to repeat what was heard.
B) Places a vibrating tuning fork in the middle of the head.
C) Places a set of earphones over both ears, plays several tones, and asks the patient to identify the sounds heard
D) Uses a tuning fork to compare the length of time the patient hears sound conducted by the mastoid bone versus air conduction.
24. During the Weber test, the nurse determines that the patient hears the sound of a tuning fork equally in each ear and:
A) Repeats the test again using a 200-Hz tuning fork.
B) Tells the patient that this represents a normal finding.
C) Refers the patient for additional testing of her or his hearing abnormality.
D) Asks the patient to keep her or his eyes closed so that the test can be repeated.
25. Before otoscopic exam, the nurse should palpate which areas for tenderness?
A) Helix, tragus, and stapes
B) Tragus, lobule, and concha
C) Tragus, mastoid process, and helix
D) Tragus, lobule, and mastoid
26. In choosing a speculum for the otoscope, the examiner should select:
A) The largest and longest.
B) The largest and shortest.
C) The smallest and longest.
D) The smallest and shortest.
27. During the otoscopic exam, how should the nurse hold the adult patient's ear?
A) Pull the helix up and back
B) Pull the lobule down and forward
C) Pull the lobule down and back
D) Pull the helix up and forward
28. Upon exam of the tympanic membrane, the normal color would be:
A) Light pink.
B) Deep red.
C) Pearly gray.
D) Yellow-white.
29. The otoscopic exam revealed cerumen build-up. Which type of hearing loss may this cause?
A) Sensorineural
B) Perceptive
C) Conductive
D) Central
30. Mary Barnett, age 57, is scheduled for a routine eye exam. Ms. Barnett's far vision is 20/25. How would you explain these findings to Ms. Barnett?
A) You can read from 20 ft. what the person with normal vision can read from 25 ft.
B) You can read the entire chart from 20 ft.
C) You can read from 25 ft. what the person with normal vision can read from 20 ft.
D) Your left eye can read the chart from 20 ft. and the right eye can read the chart from 25 ft.
31. Which test would best assess Ms. Barnett's extraocular function?
A) Superior field test
B) Pupillary reaction test
C) Denver Age Screening exam
D) Six cardinal positions of gaze test
32. Which of the following CNs are responsible for the functioning of the six extraocular muscles?
A) CNs I, II, and III
B) CNs III, IV, and VI
C) CNs III, IV, and V
D) CNs III, V, and VI
33. The corneal light reflex test is used to assess:
A) Peripheral vision.
B) Visual acuity.
C) Parallel alignment and ocular muscles.
D) Trigeminal nerve.
34. A patient with a gradual onset of cataracts tells the nurse, “I can't understand how this happened. I take good care of my eyes.” The nurse's response is based on the knowledge that:
A) Cataracts are not statistically connected to advancing age.
B) Years of exposure to ultraviolet light are a risk factor for cataracts.
C) Corticosteroids taken for several months can inhibit cataract formation.
D) Uncontrolled hypertension is associated with cataracts in older adult patients.
35. On assessing lacrimal function, which response by the patient requires additional investigation?
A) “My eyes water terribly when I get near onions.”
B) “I never seem to have trouble with my eyes watering.”
C) “I have noticed more tearing when my eyes are tired.”
D) “My left eye tears constantly and my right one is dry.”
36. The patient has decreased visual acuity in the left eye. The nurse records this as a problem with the:
A) OU.
B) OS.
C) OD.
D) OX.
37. The nurse notes that a patient has an irregularly shaped pupil in the left eye. The nurse will:
A) Ask the patient whether this is normal for him or her.
B) Check the patient's pupillary responses again.
C) Refer the patient to an ophthalmologist immediately.
D) Use a stronger light source to check the anterior chamber.
38. A patient's pupils are equal and reactive to light, direct, and consensual. Consensual constriction of the pupil indicates which of the following?
A) The pupil reacts immediately, equally, and briskly.
B) The pupil receiving the light constricts.
C) The pupil constricts and converges equally.
D) The pupil not receiving the direct light constricts with the pupil receiving the direct light.
39. The nurse also tests the patient's pupils for accommodation. What is the normal pupillary response to this test?
A) Constriction and convergence
B) Constriction and divergence
C) Dilation and convergence
D) Dilation and divergence
40. To inspect the cornea, the examiner should shine a light:
A) Directly on the cornea.
B) From the side across the cornea.
C) From the top of the cornea.
D) From an oblique angle.
41. When examining the fundus of the eye, which of the following structures should be viewed last?
A) Macula
B) Retina
C) Optic disc
D) Retinal vessels
42. In differentiating retinal veins from arteries, the examiner should note that normally:
A) Veins are darker and smaller than arteries.
B) Veins are larger and lighter than arteries.
C) Veins are smaller and lighter than arteries.
D) Veins are larger and darker than arteries.
43. Which light aperture is appropriate when performing an ophthalmoscopic exam on a patient with an undilated pupil?
A) Largest white light aperture
B) Green light aperture
C) Smallest white light aperture
D) Slit of white light aperture
44. Which of the following terms refers to the swelling of the optic disc visible upon ophthalmoscopic exam of the fundus?
A) Cataract
B) Glaucoma
C) Papilledema
D) Hordeolum
45. Anna Bryan, age 68, has obstructive jaundice. This could be detected by inspecting which structure of the eye?
A) Iris
B) Sclera
C) Cornea
D) Anterior chamber
46. To assess the palpebral conjunctiva, the nurse should:
A) Inspect the conjunctiva from an oblique angle.
B) Evert the eyelids.
C) Pull the lower lids down.
D) Use ophthalmoscopy.
47. Joan Lynch, age 72, is undergoing her annual eye exam. Considering her age, which assessment finding is considered normal?
A) Arcus senilis
B) Xanthelasma
C) Hordeolum
D) Nystagmus
48. The Rinne test indicates a conductive hearing loss if bone conduction (BC) > air conduction (AC).
A) True
B) False
49. In a healthy ear, the tragus is tender when palpated.
A) True
B) False
50. A patient with a middle ear injury will most likely have a conductive hearing loss. A) True B) False
51. The parotid gland is located on the floor of the mouth. A) True B) False
52. The Weber test is used to differentiate sound heard by AC and sound heard by BC. A) True B) False
53. Care should be taken when inserting an otoscope because the inner two-thirds of the canal is extremely sensitive. A) True B) False
54. The ear canal is routinely irrigated before otoscopic exam. A) True B) False
55. Retinal arterial venous crossings are normally smooth and without nicks. A) True B) False
56. During the ophthalmoscopic exam, the examiner should instruct the patient to focus directly on the ophthalmoscope light.
A) True
B) False
57. The normal pupillary response for convergence is constriction. A) True B) False
58. Positive or black diopters on the ophthalmoscope allow the examiner to focus on objects closer, such as the cornea and lens. A) True B) False
59. The conjuctiva in a healthy patient is usually white. A) True B) False
60. When performing an otoscopic exam on a child, the examiner should pull the ear up and back.
A) True
B) False
61. During an otoscopic exam, the patient should tilt his or her head toward the examiner.
A) True
B) False