MARYVILLE 612 EXAM 1 2024 WITH 100% CORRECT ANSWERS
How do you test EOM? - correct answer Eye movement is controlled by 6 extraocular muscles and 3 cranial nerves, III, IV, and VI. To evaluate eye movement, use 4 techniques.
● First have the patient watch your finger move through the 6 card...
MARYVILLE 612 EXAM 1 2024 WITH
100% CORRECT ANSWERS
How do you test EOM? - correct answer✔✔ Eye movement is controlled by 6 extraocular muscles and 3
cranial nerves, III, IV, and VI. To evaluate eye movement, use 4 techniques.
● First have the patient watch your finger move through the 6 cardinal fields of gaze. Jerking or
sustained nystagmus is abnormal. A few beats of horizontal nystagmus may occur.
● Second have the patient follow your finger vertically from the ceiling to the floor.The globes and the
upper eyelids should move smoothly without eyelid lag or exposure of the sclera.
● Third, test extraocular muscle balance using the corneal light reflex. WIth the patient looking at a
nearby object, shine a light on the nasal bridge. The eyes should converge and reflect the light
symmetrically.
● Fourth, if the corneal light reflex is imbalanced, perform the cover-uncover test. As the patient stares
at a fixed point nearby, cover one eye and observe the uncovered eye. Then remove the cover and
observe that eye as it focuses on the object. Note any eye movement.
Your patient should be able to follow your finger with full, smooth extraocular movements and without
nystagmus, or "shaky" eye motion. Normal extraocular movements indicate intact cranial nerves III, IV,
and VI.
*******What is the difference between objective and subjective data? What components of the health
history are objective and subjective? *********** - correct answer✔✔ Seidel pg 618: objective: "direct
observation, what you see, hear, and touch". This includes vital signs and actual assessment. Subjective:
"information patients offer about their condition or feelings." This includes chief complaint, past medical
history, history or present illness, family history, and review of symptoms.
Order physical assessment is done - correct answer✔✔ Inspection, Palpation, Percussion, Auscultation
,Proper use of Otoscope on adult or child - correct answer✔✔ Adult- straighten the external auditory
canal by pulling auricle up and back
Child- face child sideways with one arm around parents waist. Pull auricle either downward and back or
upward and back to gain best view of tympanic membrane.
How do you assess for sensoineural hearing loss - correct answer✔✔ air conduction heard longer than
bone conduction with Rinne Test; lateralization to unaffected ear; loss of high-frequency sounds
How do you assess for conductive hearing loss - correct answer✔✔ bone conduction heard longer than
air conduction with Rinne Test; lateralization to affected ear with Weber Test; loss of low frequency
sounds; loss of 11-30 decibels on audiometry with cerumen impaction.
Rinne Test***** - correct answer✔✔ helps distinguish whether patient hears better by air or bone
conduction. Place the tuning fork at base of vibrating tuning fork against the patient's mastoid bone and
ask patient to tell you when the sound is no longer heard. Time this interval of bone conduction noting
number of seconds. Continue timing the interval of sound due to by air conduction heard by the patient.
Compare # of seconds air vs. bone. Air conducted should be heard twice as long as bone conducted
sounds. (If bone conducted heard for 15 seconds, air conducted should be heard for additional 15
seconds).
Weber Test - correct answer✔✔ helps assess unilateral hearing loss. Place base of fork on mid-line of
patient's head. Ask patient if sound heard equally in both ears or in one ear (lateralization of sound).
Should hear sound equally.
Presbyopia - correct answer✔✔ Progressive weakening of accommodation (focusing power). The major
physiologic change that occurs after the age of 45 years; the lens becomes more rigid, and the ciliary
muscle becomes weaker.
Strabismus - correct answer✔✔ a condition in which both eyes do not focus on the object
simultaneously, although either eye can focus independently; may be paralytic or non-paralytic.
Photopsia - correct answer✔✔ presence of perceived flashes of light. (Most commonly associated with
posterior vitreous detachment, migraine with aura, retinal break, or detachment).
, Amblyopia - correct answer✔✔ also called lazy eye; is disorder of sight d/t eye and brain not working
well together. Results in decreased vision in an eye that otherwise typically appears normal. Most
common cause of decreased vision in a single eye among children and younger adults.
Macular Degeneration - correct answer✔✔ is caused when part of the retina deteriorates; dry (atrophic)
from gradual breakdown of cells in macula resulting in gradual blurring of central vision and wet
(exudative or neovascular)- new abnormal vessels grow under the center of the retina; the blood vessels
leak, bleed, and scar the retina, distorting or destroying central vision. In contrast to dry, vision loss may
be rapid. Is leading cause of blindness in older than 55 years of age in U.S.
Xanthelasma - correct answer✔✔ condition characterized by elevated plaque of cholesterol; commonly
found on the nasal portion of the eyelid.
Snellen Test***** - correct answer✔✔ The optic nerve is assessed by testing for visual acuity and
peripheral vision.
Visual acuity is tested using a snellen chart, for those who are illiterate and unfamiliar with the western
alphabet, the illiterate E chart, in which the letter E faces in different directions, maybe used. The chart
has a standardized number at the end of each line of letters; these numbers indicates the degree of
visual acuity when measured at a distance of 20 feet.
The numerator 20 is the distance in feet between the chart and the client, or the standard testing
distance. The denominator 20 is the distance from which the normal eye can read the lettering, which
correspond to the number at the end of each letter line; therefore the larger the denominator the
poorer the version.
Measurement of 20/20 vision is an indication of either refractive error or some other optic disorder.
In testing for visual acuity you may refer to the following:
1. The room used for this test should be well lighted.
2. A person who wears corrective lenses should be tested with and without them to check fro the
adequacy of correction.
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