ENA Ocular Exam Questions Correctly Answered.
Which ocular emergency requires the most emergent management? A. Radiation burnB. Chemical burnC. Acute angle-closure glaucomaD. Central retinal artery occlusion - CORRECT ANSWER Your incorrect answer: D A chemical burn of the eye requires the most e...
ENA Ocular Exam Questions Correctly
Answered.
Which ocular emergency requires the most emergent management? A. Radiation burnB. Chemical
burnC. Acute angle-closure glaucomaD. Central retinal artery occlusion - CORRECT ANSWER Your
incorrect answer: D A chemical burn of the eye requires the most emergent intervention to avoid
permanent vision loss caused by cellular protein damage or ischemia. Acute angle-closure glaucoma and
central retinal artery occlusion are time-sensitive emergencies but not as emergent as a chemical burn.
A radiation burn is extremely painful but does not take priority over a chemical burn.
Measurement of intraocular pressure by tonometry is most helpful in identifying which disorder? A.
HyphemaB. Retinal detachmentC. GlaucomaD. Iritis - CORRECT ANSWER Your incorrect answer: B
Glaucoma results from elevated intraocular pressure, and tonometry is the diagnostic tool used to
identify this disorder. Although tonometry is not used to diagnose hyphema (bleeding in the anterior
chamber of the eye), it may be used to detect increased intraocular pressure caused by this ocular
injury. Tonometry is not used to identify retinal detachment or iritis.
Which ocular emergency typically requires treatment with antiviral medication? A. Herpes zoster
ophthalmicusB. ConjunctivitisC. IritisD. Orbital cellulitis - CORRECT ANSWER Your incorrect answer: D
Standard management of herpes zoster ophthalmicus (shingles of the ophthalmic division of the
trigeminal nerve) includes antivirals, analgesics, and local wound care. The patient should receive
antivirals within 72 hours of any vesicular eruptions on the face or periorbital area to decrease
complications such as permanent vision loss and postherpetic neuralgia. Although conjunctivitis
commonly results from viral infection, it does not require antivirals but may benefit from supportive
measures, such as artificial tears, cool compresses, and decongestant or antihistamine eye drops. Iritis
usually is an inflammatory process, which responds to treatment with topical steroids. Orbital cellulitis is
a potentially life-threatening infection deep in the orbital septum, which requires intravenous
antibiotics, not antivirals.
In a patient with an ocular chemical burn, visual acuity should be assessed after which activity has been
performed? A. Evaluation by an ophthalmologistB. Copious irrigationC. Application of bilateral eye
patchesD. Administration of ophthalmic antibiotic ointment - CORRECT ANSWER Your correct answer: B
A chemical burn of the eye is a vision-threatening emergency that requires immediate, copious
irrigation. After irrigation, the patient should receive a thorough eye examination, including a visual
acuity assessment. After irrigation and a thorough eye examination, the patient may receive topical
antibiotics, cycloplegics, and steroids, as prescribed. Bilateral eye patches may be applied, as ordered.
, Which assessment finding differentiates orbital cellulitis from periorbital cellulitis? A. FeverB. PainC.
Impaired extraocular movementD. Decreased vision - CORRECT ANSWER Your correct answer: C In
orbital cellulitis, extraocular muscle movement is impaired. In periorbital cellulitis, no extraocular muscle
impairment occurs. In both infections, fever, pain, and decreased vision also occur, although decreased
vision is a late finding in periorbital cellulitis.
What is the normal intraocular pressure? A. 10 to 20 mm HgB. 20 to 30 mm HgC. 30 to 40 mm HgD. 40
to 50 mm Hg - CORRECT ANSWER Your incorrect answer: B Intraocular pressure normally ranges from 10
to 20 mm Hg. An intraocular pressure of 20 to 30 mm Hg is mildly elevated, 30 to 40 mm Hg is elevated,
and 40 to 50 mm Hg is seriously elevated.
In a patient who presents with an orbital fracture and entrapment, which assessment finding is
expected? A. Pupil constriction in the affected eyeB. Hearing loss and tinnitusC. Facial spasmsD. Limited
upward gaze in the affected eye - CORRECT ANSWER Your incorrect answer: A Because of orbital
entrapment of the extraocular muscles, the patient is likely to display limited upward gaze in the
affected eye and normal movement in the unaffected eye. An orbital fracture may result in pupil
dilation, not constriction, on the side of orbital injury. Hearing loss, tinnitus, and facial spasms are not
associated with orbital fractures but may indicate other concomitant injuries.
Which disorder causes blood in the anterior chamber of the eye? A. GlaucomaB. HordeolumC.
HyphemaD. Iritis - CORRECT ANSWER Your incorrect answer: A A hyphema is characterized by blood in
the anterior chamber of the eye. Glaucoma is defined by elevated intraocular pressure. A hordeolum
(external stye) is an infection of the eyelash oil gland. Iritis is the inflammation of the anterior portion of
the uveal tract.
A patient presents with blunt trauma from being struck in the right eye by a baseball. The nurse notes a
vitreous hemorrhage. Which intervention is most appropriate? A. Administer analgesic eye drops.B.
Maintain the patient in a supine position.C. Assist with intraocular pressure measurement.D. Place a
protective shield over the affected eye and patch the unaffected eye. - CORRECT ANSWER Your incorrect
answer: A Vitreous hemorrhage suggests the patient has a ruptured globe. The nurse should place a
protective device over the injured eye and should patch the unaffected eye to minimize consensual
movement. If a ruptured globe is suspected, the nurse should not instill eye drops. The patient should
rest in the semi-Fowler's position. Intraocular pressure measurement is not indicated at this time.
Detailed examination of the ocular injury should be deferred until the ophthalmologist arrives.
A patient presents to triage complaining of a sudden, complete loss of vision in his left eye. He denies
any injury and rates his pain as 0 on a scale of 0 to 10. Which ocular emergency should you suspect? A.
Acute angle-closure glaucomaB. Central retinal artery occlusionC. Retinal detachmentD. Hyphema -
CORRECT ANSWER Your incorrect answer: C Central retinal artery occlusion produces sudden, painless
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