Which subjective clinical manifestation alerts the nurse to the possible presence of a cataract?

This quiz will test your knowledge on an eye disorder called cataracts, which can help in preparation for the NCLEX exam and other nursing school exams.

Cataracts form in the eye and affect vision. It can lead to blindness which is reversible with surgery. The nurse should be aware of the pathophysiology of this disorder along with signs and symptoms and surgical care.

Cataracts NCLEX Questions

• 1. In your patient's health history you read that the patient has a cataract in the right eye. You know that this eye disorder can be best described by which statement below?*
  • A. This eye disorder is caused by increased intraocular pressure that results in damage to the optic nerve.
  • B. Cataracts occur in the eye when the macula of the retina become damaged and impair the central vision.
  • C. The development of a cataract occurs when the lens of the eye loses its transparency.
  • D. This eye disorder occurs from uncontrolled high blood glucose levels which lead to retinal damage.

• 2. What is the most common cause of cataracts?*
  • A. Congenital
  • B. Aging
  • C. Trauma
  • D. Uncontrolled blood glucose levels

• 3. In the development of cataracts, light is scattered and cannot travel properly to the retina's _____________________, and this leads to visual impairment.*
  • A. crystalline proteins
  • B. amacrine cells
  • C. ganglion cells
  • D. cones and rods

• 4. Which patient finding below is associated with the development of cataracts?*
  • A. Loss of central vision
  • B. Loss of peripheral vision
  • C. Cloudy, hazy vision
  • D. Black spots in vision

• 5. A patient is being evaluated for cataracts. The doctor uses a slit-lamp to assess the patient's eyes. As the nurse you know that this device will?*
  • A. help test the patient's visual acuity.
  • B. test the strength of the ciliary muscles.
  • C. enlarge the front area of the eye (cornea, iris, lens etc.).
  • D. help for visualization of the fundus.

• 6. Your patient is having a phacoemulsification for treatment of a cataract. You're providing education to the patient about the procedure. Which statement by the patient demonstrates he understood the educational material provided about this procedure?*
  • A. "The cloudy lens in my eye will be broken up with sound waves and removed. Then a new permanent lens, called an intraocular lens, will be placed in my eye."
  • B. "A small air bubble is injected into the eye to help push the retina back into position to help the lens refract light."
  • C. "An incision is made to remove the trabecular meshwork and this will help drain fluid out of the cloudy lens."
  • D. "The surgeon will remove parts of the iris and lens."

• 7. TRUE OR FALSE: If a patient has bilateral cataracts and needs surgery, both eyes can be surgically treated at the same time.*
  • True
  • False

• 8. A patient has a cataract in the left eye and has decided to prolong having surgery as long as possible until her activities of daily living are affected. What are some measures the patient can take to help manage the cataract at this time? Select all that apply:*
  • A. Wearing sunglasses with UVA protection.
  • B. Enlarging text or visual images with a magnifier.
  • C. Adding more light when reading.
  • D. Wearing anti-glare glasses.

• 9. Your patient has several risk factors that increase his risk for developing cataracts. What preventive measures can you educate the patient about? Select all that apply:*
  • A. Wearing large brim hats while in the sun
  • B. Eating a diet rich in vegetables and fruits
  • C. Quit smoking
  • D. Reducing alcohol consumption
  • E. Managing blood glucose levels
  • F. Scheduling regular eye exams

• 10. A patient will be having outpatient cataract surgery in 3 days. The surgeon ordered the patient to begin instilling two types of eye drop medications 3 days prior to the surgery. You have demonstrated and educated the patient on how to do this properly. Which action by the patient is incorrect and requires re-education about how to instill the eye drops?*
  • A. The patient instills the eye drops onto the conjunctival sac.
  • B. The patient instilled the anti-inflammatory eye drops before the antibiotic eye drops.
  • C. The patient waited 30 seconds before instilling the second eye drop medication into the eye.
  • D. After instilling each type of eye drop medication, the patient kept the eye closed and took her index finger and placed it at the side of the bridge of the nose for 2 minutes.

• 11. The nurse is preparing to instill eye dilation drops to a patient prior to cataract surgery. The nurse confirms that the operative eye is the right eye. On assessment, the nurse notes the patient has dark brown eyes and that a cataract is present in the right eye. Which of the following nursing actions is incorrect prior to instillation of the eye drops?*
  • A. The nurse will lower the lights in the room prior to administration.
  • B. The nurse prepares the patient for blurry vision.
  • C. The nurse is aware that pupil dilation effects will occur quickly in this patient and should be administered at a time that correlates with the actual time of the surgery.
  • D. The nurse places the call light within reach of the patient.

• 12. A 68-year-old male patient is considering cataract surgery. You're collecting the patient's health and medication history. Which medication below on the patient's home medication list should the nurse notify the doctor about?*
  • A. Tamsulosin
  • B. Levothyroxine
  • C. Atorvastatin
  • D. Omeprazole

• 13. Prior to cataract surgery, the nurse is ordered to administer an eye medication that paralyzes the ciliary muscle of the eye which results in the loss of accommodation. Which medication group below has this type of mechanism of action?*
  • A. Rho Kinase Inhibitors
  • B. Mydriatrics
  • C. Cycloplegics
  • D. Carbonic Anhydrase Inhibitors

• 14. A patient has arrived for a post-op visit to the clinic after cataract surgery in the left eye. Which statement by the patient causes concern and requires further investigation?*
  • A. "My left eye has experienced some itchiness."
  • B. "The vision in my left eye was blurry for a few days."
  • C. "I have been experiencing flashes of light in my left eye."
  • D. "I had pain in my left eye after surgery and took Acetaminophen."

• 15. Which activity below is allowed after cataract surgery?*
  • A. Bending
  • B. Running
  • C. Watching TV
  • D. Swimming

• 16. A patient is 2 hours post-op from cataract surgery in the right eye. You're collecting vital signs and assessing the patient. Which finding in your patient after cataract surgery requires to you re-educate the patient?*
  • A. The patient is asleep on their right side.
  • B. The patient is wearing the eye shield while asleep.
  • C. The patient fell asleep watching TV.
  • D. The patient is not wearing his glasses.

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Cataracts NCLEX Questions

1. In your patient’s health history you read that the patient has a cataract in the right eye. You know that this eye disorder can be best described by which statement below?

A. This eye disorder is caused by increased intraocular pressure that results in damage to the optic nerve.

B. Cataracts occur in the eye when the macula of the retina become damaged and impair the central vision.

C. The development of a cataract occurs when the lens of the eye loses its transparency.

D. This eye disorder occurs from uncontrolled high blood glucose levels which lead to retinal damage.

The answer is C. Option A describes glaucoma, option B describes macular degeneration, and option D describes diabetic retinopathy.

2. What is the most common cause of cataracts?

A. Congenital

B. Aging

C. Trauma

D. Uncontrolled blood glucose levels

The answer is B: aging. Most cataracts are known as senile cataracts and happen due to aging. This is because over time the eye lens starts to lose its transparency and proteins start to stick together on the lens causing the lens to become cloudy.

3. In the development of cataracts, light is scattered and cannot travel properly to the retina’s _____________________, and this leads to visual impairment.

A. crystalline proteins

B. amacrine cells

C. ganglion cells

D. cones and rods

The answer is D: cones and rods. In the development of cataracts, light is scattered and cannot travel properly to the retina’s CONES AND RODS (photoreceptors) and this leads to visual impairment.

4. Which patient finding below is associated with the development of cataracts?

A. Loss of central vision

B. Loss of peripheral vision

C. Cloudy, hazy vision

D. Black spots in vision

The answer is C: cloudy, hazy vision. Option A is found in macular degeneration, option B is glaucoma, and option D is diabetic retinopathy.

5. A patient is being evaluated for cataracts. The doctor uses a slit-lamp to assess the patient’s eyes. As the nurse you know that this device will?

A. help test the patient’s visual acuity.

B. test the strength of the ciliary muscles.

C. enlarge the front area of the eye (cornea, iris, lens etc.).

D. help for visualization of the fundus.

The answer is C. The slit-lamp is helpful with detecting cataracts because it enlarges the front area of the eye so the doctor can observe the cornea, iris, lens etc.. This is particularly useful with detecting cataracts because remember in cataract the lens has lost transparency and will appear cloudy.

6. Your patient is having a phacoemulsification for treatment of a cataract. You’re providing education to the patient about the procedure. Which statement by the patient demonstrates he understood the educational material provided about this procedure?

A. “The cloudy lens in my eye will be broken up with sound waves and removed. Then a new permanent lens, called an intraocular lens, will be placed in my eye.”

B. “A small air bubble is injected into the eye to help push the retina back into position to help the lens refract light.”

C. “An incision is made to remove the trabecular meshwork and this will help drain fluid out of the cloudy lens.”

D. “The surgeon will remove parts of the iris and lens.”

The answer is A. A phacoemulsification is the most common type of cataract surgery. It consists of the cloudy lens in the eye being broken up with sound waves and removed. Then a new permanent lens, called an intraocular lens, will be placed in the eye.

7. TRUE OR FALSE: If a patient has bilateral cataracts and needs surgery, both eyes can be surgically treated at the same time. 

The answer is FALSE: Only one eye is treated with cataract surgery at a time. Typically, the patient will have to wait a few weeks before having surgery in the other affected eye.

8. A patient has a cataract in the left eye and has decided to prolong having surgery as long as possible until her activities of daily living are affected. What are some measures the patient can take to help manage the cataract at this time? Select all that apply:

A. Wearing sunglasses with UVA protection.

B. Enlarging text or visual images with a magnifier.

C. Adding more light when reading.

D. Wearing anti-glare glasses.

The answers B,C, D. Option A is wrong because sunglasses that provide UVA and UVB protection should be used (not just UVA).

9. Your patient has several risk factors that increase his risk for developing cataracts. What preventive measures can you educate the patient about? Select all that apply:

A. Wearing large brim hats while in the sun

B. Eating a diet rich in vegetables and fruits

C. Quit smoking

D. Reducing alcohol consumption

E. Managing blood glucose levels

F. Scheduling regular eye exams

All the answers are correct. These are all preventive measures the patient can take to help prevent cataracts.

10. A patient will be having outpatient cataract surgery in 3 days. The surgeon ordered the patient to begin instilling two types of eye drop medications 3 days prior to the surgery. You have demonstrated and educated the patient on how to do this properly. Which action by the patient is incorrect and requires re-education about how to instill the eye drops?

A. The patient instills the eye drops onto the conjunctival sac.

B. The patient instilled the anti-inflammatory eye drops before the antibiotic eye drops.

C. The patient waited 30 seconds before instilling the second eye drop medication into the eye.

D. After instilling each type of eye drop medication, the patient kept the eye closed and took her index finger and placed it at the side of the bridge of the nose for 2 minutes.

The answer is C. Option C is INCORRECT. The patient should wait at least 3-5 minutes in between instilling each type of eye drop medication. Options A, B, and D are correct ways to instill eye drops. It doesn’t matter the sequence for how the eye drops are instilled (anti-inflammatory vs. antibiotic), and option D demonstrates the patient is performing punctual occlusion, which helps prevent the eye medication from being absorbed by the bloodstream and entering systemic circulation.

11. The nurse is preparing to instill eye dilation drops to a patient prior to cataract surgery. The nurse confirms that the operative eye is the right eye. On assessment, the nurse notes the patient has dark brown eyes and that a cataract is present in the right eye. Which of the following nursing actions is incorrect prior to instillation of the eye drops?

A. The nurse will lower the lights in the room prior to administration.

B. The nurse prepares the patient for blurry vision.

C. The nurse is aware that pupil dilation effects will occur quickly in this patient and should be administered at a time that correlates with the actual time of the surgery.

D. The nurse places the call light within reach of the patient.

The answer is C. Option C is incorrect because patients with dark brown eyes have a lot of pigment in their eyes compared to a patient with blue or green eyes. The pigment actually binds or bounds the eye drop medication. Therefore, it takes longer for the medication to dilate the eyes and higher doses of the medication may be needed.

12. A 68-year-old male patient is considering cataract surgery. You’re collecting the patient’s health and medication history. Which medication below on the patient’s home medication list should the nurse notify the doctor about?

A. Tamsulosin

B. Levothyroxine

C. Atorvastatin

D. Omeprazole

The answer is A: Tamsulosin. Tamsulosin, also called Flomax, is used to treat an enlarged prostate and relaxes the smooth muscle. It also can affect the eye’s muscle such as the iris. Remember the iris is responsible for dilation and constriction of the pupils. In order to have a successful surgery to remove the cataract, the eye must be dilated properly. However, Tamsulosin (or other alpha-blockers) can make the iris floppy. The eye doctor must be aware that the patient is taking this medication prior to surgery because the patient is at risk for intraoperative floppy iris syndrome.

13. Prior to cataract surgery, the nurse is ordered to administer an eye medication that paralyzes the ciliary muscle of the eye which results in the loss of accommodation. Which medication group below has this type of mechanism of action?

A. Rho Kinase Inhibitors

B. Mydriatrics

C. Cycloplegics

D. Carbonic Anhydrase Inhibitors

The answer C: Cycloplegic.

14. A patient has arrived for a post-op visit to the clinic after cataract surgery in the left eye. Which statement by the patient causes concern and requires further investigation?

A. “My left eye has experienced some itchiness.”

B. “The vision in my left eye was blurry for a few days.”

C. “I have been experiencing flashes of light in my left eye.”

D. “I had pain in my left eye after surgery and took Acetaminophen.”

The answer is C. A possible complication after cataract surgery is retinal detachment. This could present with the patient experiencing flashes of light or seeing floaters in the vision. The nurse should report this to the surgeon who will further evaluate the patient.

15. Which activity below is allowed after cataract surgery?

A. Bending

B. Running

C. Watching TV

D. Swimming

The answer is C. Patients can watch TV or read if they desire and should take breaks as needed. All the other activities should be avoided until the doctors clears the patient.

16. A patient is 2 hours post-op from cataract surgery in the right eye. You’re collecting vital signs and assessing the patient. Which finding in your patient after cataract surgery requires to you re-educate the patient?

A. The patient is asleep on their right side.

B. The patient is wearing the eye shield while asleep.

C. The patient fell asleep watching TV.

D. The patient is not wearing his glasses.

The answer is A. The patient should sleep on his non-operative side (the left side NOT the right). The patient should wear an eye shield while sleeping and during naps to protect the eye. It is okay to watch TV and the patient doesn’t have to be wearing his glasses unless needed at this time.

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