What actions should a nurse implement when assessing a patient's accommodation? (Select all that apply.)

Move his or her finger slowly toward the patient's nose

Checking for a nystagmus

Assess for convergence

Observe for pupillary constriction.

Note blinking

Hold his or her finger approximately 20 inches in front of the patient's eyes.

Answer and Explanation

Correct Answer : A,C,D

a) Move his or her finger slowly toward the patient's nose: This is an appropriate action for testing accommodation, as it assesses the ability of the eyes to converge and maintain focus on the object as it moves closer.
b) Checking for a nystagmus: This is not directly related to accommodation, though nystagmus can be observed in other assessments for visual and neurological conditions.
c) Assess for convergence: Convergence is part of the accommodation process. It involves the eyes turning inward to focus on a near object.
d) Observe for pupillary constriction: Pupillary constriction is a key part of the accommodation response when focusing on a near object.
e) Note blinking: This is not necessary for assessing accommodation. Blinking can occur for various reasons but is not a direct sign of accommodation.
f) Hold his or her finger approximately 20 inches in front of the patient's eyes: For accommodation testing, the object should be moved closer, typically within 6-8 inches from the eyes.

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Correct Answer is C

Explanation

a) 2 weeks: It’s typically too early for fitting a prosthesis after enucleation. Healing time is required before the fitting.
b) 4 weeks: While closer, the patient will likely need a longer healing period before fitting.
c) 8 weeks: Generally, a prosthesis can be fitted around 8 weeks post-enucleation, allowing enough time for the eye socket to heal and settle.
d) 12 weeks: Although healing may take longer, 8 weeks is the most common timeframe for prosthesis fitting.

A. Assess the 6 cardinal gazes B. Ask the client to her clench teeth. C. Anticipate the use of a tonometer D. Use a Snellen chart.

Correct Answer is D

Explanation

a) Assess the 6 cardinal gazes: This test assesses cranial nerve III, IV, and VI (oculomotor, trochlear, and abducens), which control eye movement, not the optic nerve.
b) Ask the client to clench teeth: This tests cranial nerve V (trigeminal nerve), which controls sensation in the face and motor functions like chewing.
c) Anticipate the use of a tonometer: A tonometer measures intraocular pressure (IOP), which is related to glaucoma, but it does not specifically assess cranial nerve II.
d) Use a Snellen chart: The Snellen chart is used to test visual acuity, which evaluates the function of cranial nerve II (optic nerve).

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What actions should a nurse implement when assessing a patient's accommodation? (Select all that apply.)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A 60-year-old patient who has had an enucleation asks when he can get his prosthesis fitted. In approximately how many weeks should this patient expect to be fitted?

Correct Answer is C

Explanation

A nurse is collecting data about a client's cranial nerves. Which of the following methods should the nurse use to identify a problem with cranial nerve II?

Correct Answer is D

Explanation

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