Chapter 15: Emergencies and Triage
1. The first contact a patient makes with an eye care office is usually
by (p271)
A. telephone
B. personal visit
C. sight
D. letter
2. The first person the patient comes into contact with is usually the
(p271)
A. doctor
B. nurse
C. janitor
D. technical support staff
3. Obviously, the paraoptometric does not want to overlook a (p1)
A. VA deficiency
B. IOP increase
C. true emergency
D. status post cataract surgery follow-up need
4. A water discharge usually accompanies which one of the following?
(p274)
A. bacterial conjunctivitis
B. viral conjunctivitis
C. allergic conjunctivitis
D. B & C
5. Which part of the case history describes when, where, and possibly how the symptoms began, especially if
they are the result of an injury? (p272)
A. location
B. onset
C. frequency
D. duration
6. The presence of either one or both of two principal conditions helps determine the level of an emergency.
(p271)
A. vision loss, irritation
B. vision loss, pain
C. eye discharge, discomfort
D. none of the above
7. A patient who reports pain, light sensitivity, and tearing should be suspected to have: (p272)
A. keratitis sicca
B. an injured cornea
C. conjunctivitis
D. glaucoma attack
8. An abrasion to the _________layer of the cornea normally heals within 24-48 hours with no scarring. (p272273)
A. endothelial
B. stromal
C. descemet's
D. epithelial
9. Leukocytes and proteins floating in the aqueous is referred to as: (p273)
A. white blood cells
B. cells and flare
C. uveitis
D. limbal flare
10. Which of the following instruments is used to remove a corneal foreign body? (p274)
A. Bailey's loop
B. a bent 20 gauge hypodermic needle
C. Spud
D. any of the above
11. An Algerbrush may be used to (p274)
A. anesthetize the cornea
B. sterilize the cornea
C. remove a rust ring
D. remove a foreign body
12. A condition commonly known as "pink eye" is called: (p274)
A. uveitis
B. conjunctivitis
C. episcleritis
D. keratitis sicca
13. A report of severe pain, a reduction in vision, along with nausea, could suggest: (p275)
A. Angle closure glaucoma
B. Open-angle glaucoma
C. Episcleritis
D. A or B
14. Flashes and floaters could be a sign of: (p276)
A. Posterior vitreous detachment
B. Retinal detachment
C. Retinal tear
D. Any of the above
15. Which of the following is an example of a neurologic condition? (p276)
A. PVD
B. Flashes and floaters
C. Ophthalmic migraine
D. all of the above
16. When is “broken eyeglasses an urgent appointment? (p271)
A. When the patient wears contact lenses
B. If the call comes in first thing in the morning
C. Any day but Friday
D. If the prescription is over +/- 3.00 and the patient does not have another pair of glasses
17. Everyone involved with eye care has what is referred to as a (p271)
A. comfort zone
B. pain zone
C. treatment zone
D. patience level
18. The comfort zone is a zone in which a person feels comfortable __________ patients. (p271)
A. handling
B. diagnosing
C. treating
D. all of the above
19. If you are uncomfortable handling an emergency case over the phone, you should (p271)
A. tell the patient to call back.
B. consult with your doctor or another staff member.
C. refer the patient to another doctor.
D. try to make the best of it on your own.
20. Only with time and experience do you _____ this zone. (p271)
A. enlarge
B. shrink
C. enhance
D. magnify
21. Eye care is a vast science (p271)
A. everyone has limits
B. never feel embarrassed to admit you are unsure
C. take the time to broaden your knowledge base
D. all of the above
22. Which part of the case history describes how often the symptoms are present? (p272)
A. location
B. onset
C. frequency
D. duration
23. If a doctor or another staff member is unavailable to answer your question (p271)
A. make sure the patient is seen that day
B. have the patient come in when the doctor is available
C. have the patient come in the next day
D. have the patient hold until you can answer their concerns
24. Always err on the side of __________ for your patients. (p271)
A. potential earnings
B. caution
C. safety
D. respect
25. The Golden Rule is for the patient to be (p271)
A. treated the way you would want to be treated
B. treated the way you feel that day
C. how you have been treated
D. put in his or her place BMT style
26. Which part of the case history describes the length of time the symptoms last, helping to determine whether
or not any pattern exists with the patient’s symptoms? (p272)
A. location
B. onset
C. frequency
D. duration
27. It can be said that "if you do not know where you are going after the history is taken, you are truly
______." (p271-272)
A. incompetent
B. lost
C. confused
D. unprofessional
28. Taking an accurate history may be the ___________ job. (p272)
A. paraoptometric's
B. doctor's
C. patient's
D. administrative clerk's
29. Being thorough and complete, asking the right questions, and properly recording the patient's responses will
be critical in assisting the ________ in diagnosing and creating a treatment plan. (p272)
A. technician
B. patient
C. doctor
D. all of the above
30. First, record the patient's version of what exactly happened or how the patient came to notice something
was__________. (p272)
A. wrong
B. right
C. different
D. awkward
31. Make sure the case history includes: location, onset, _______, and ________ of all the patient's reported
symptoms. (p272)
A. infrequency, duration
B. frequency, duration
C. frequency, pain level
D. duration, pain level
32. The following are some of the more common emergencies except: (p272)
A. corneal abrasions
B. foreign bodies
C. glaucoma attack
D. frame repair
33. Which one of the following symptoms constitutes a true eye emergency? (p271)
a. headache
b. loss of vision
c. contact lens insertion difficulties
d. broken eyeglass temple
34. Even though ocular emergencies can happen at any time, when do they seem most likely to occur? (p271)
a. when the doctor’s schedule is light
b. after a cancellation
c. midafternoon
d. right before lunch or closing time
35. The most important part of the ocular emergency examination is ___________. (p271)
a. determining how the patient will pay
b. entering the patient data into the computer
c. briefing other staff members on the situation
d. case history
36. Documenting the patient’s symptoms, including onset, frequency, and duration, is known as the ________.
(p272)
a. prescription
b. case history
c. diagnosis
d. treatment plan
37. When the patient presents with symptoms including pain, photophobia, and lacrimation, what may
usually be concluded? (p272)
a. the cornea is involved
b. the injury is neurologic in nature
c. the patient has a retinal tear
d. the eyelids are irritated
38. Treatment for a superficial corneal abrasion usually includes which one of the following? (p272)
a. steroidal use
b. instilling artificial tears
c. cyclopleging the eye
d. hospitalization
39. Which of the following would be an eye emergency that includes cell and flare in the anterior chamber
but an intact cornea? (p273)
a. uveitis
b. cataract
c. corneal abrasion
d. retinal detachment
40. Where is redness usually concentrated in uveitis? (p274)
a. on the lid
b. in the fornices
c. near the limbus
d. there is no redness
41. A foreign body injury has symptoms similar to which one of the following? (p274)
a. glaucoma
b. conjunctivitis
c. a vitreous detachment
d. a corneal injury
42. The follow-up visit for most foreign body removals should be scheduled at ________. (p274)
a. 24 hours
b. 1 week
c. no follow up is required
d. 2-3 weeks
43. Treatment, once a foreign body has been removed, includes __________. (p272 & 274)
a. antibiotics
b. steroids
c. artificial tears
d. fluress
44. What usually brings the patient with a foreign body into the office? (p273)
a. the actual foreign body
b. inflammatory responses
c. cells and flare
d. flashes of light
45. Which one of the following ocular conditions is not considered a “true” emergency? (p271-274)
a. a foreign body
b. angle closure glaucoma
c. conjunctivitis
d. flashes of light
46. With conjunctivitis, where does redness usually appear? (p274)
a. the limbus
b. the lid margins
c. no redness exists
d. in the fornices
47. A mucopurlent discharge usually accompanies which one of the following? (p274)
a. bacterial conjunctivitis
b. viral conjunctivitis
c. allergic conjunctivitis
d. giant papillary conjunctivitis
48. Treatment for allergic conjunctivitis includes which one of the following? (p274)
a. cold compresses
b. antiviral medication
c. cycloplegic agents
d. steroids
49. Symptoms of episcleritis include ________. (p275)
a. hemorrhaging
b. mucous discharge
c. engorged vessels
d. flashes of light
50. A follow-up visit for episcleritis should be scheduled in _________. (p275)
a. 24 hours
b. 1 month
c. 1 week
d. 48 hours
51. A follow-up visit for corneal abrasions should be scheduled in _________. (p272)
a. 24 hours
b. 1 month
c. 1 week
d. 48 hours
52. All of the following can be treatments for corneal abrasions due their severity except: (p272)
a. cycloplegic agent
b. bandage lens
c. antibiotics
d. steroidal agent
53. Various injection presentations of red eyes include the following except: (p273)
a. uveitis or corneal problem
b. conjunctivitis
c. episcleritis
d. glaucoma attack
54. Which of the following will a patient present with the same symptoms as a corneal abrasion? (p273)
a. conjunctivitis
b. anterior uveitis
c. episcleritis
d. glaucoma attack
55. A follow-up visit for anterior uveitis should be scheduled in _________. (p273)
a. 24-36 hours
b. 72 hours
c. 48-72 hours
d. 48 hours
56. Conjunctivitis involving the cornea is referred to as keratoconjunctivitis and is distinguished from
conjunctivitis by: (p274)
a. basis of pain
b. redness
c. discharge
d. all of the above
57. A follow-up visit for all types of conjunctivitis and keratoconjunctivitis is based on the severity of each
case, but falls between: (p274)
a. 24-36 hours
b. 36-48 hours
c. 36-72 hours
d. 48-72 hours
58. Episcleritis is usually an eye problem with an underlying systemic problem, usually a form of (p275)
a. glaucoma
b. diabetes
c. arthritis
d. hypertension
59. On a Goldmann tonometer, the intraocular pressure is usually higher than _____ and may even be higher
than _____ for a glaucoma attack. (p275)
a. 30mm Hg, 50mm Hg
a. 40mm Hg, 60mm Hg
a. 50mm Hg, 70mm Hg
a. 60mm Hg, 80mm Hg
60. The following are medications used to “break” a glaucoma attack except: (p275)
a. miotic agent
b. beta-blocker agent
c. anesthetic agent
d. oral carbonic anhydrase inhibitors
61. Which type of glaucoma is seen most often on an emergency basis? (p276)
a. narrow-angle
b. congenital
c. open-angle
d. diabetic
62. __________ are always a symptom of a problem or change “within” the eye. (p276)
a. flashes and floaters
b. cloudiness and tearing
c. redness and discharge
d. haziness and discharge
63. Separation between the vitreous and the retina. (p276)
a. posterior vitreous detachment
b. retinal detachment
c. retinal hole
d. a & b
64. With retinal holes, tears, or detachments, the flashes are caused by: (p276)
a. the physical stimulation of the retina
b. loose portions of a retinal flap within the vitreous
c. blood elements floating within the vitreous
d. a & b
65. In general, __________ are those that occur either along the optic nerve or within the
brain itself. (p276)
a. flashes and floaters
b. neurologic conditions
c. glaucoma attacks
d. a & b
66. Not all emergencies in the optometric office are related to the eye. What other first
aid procedures should the paraoptometric be aware of? (p277)
a. bleeding
b. chest pain
c. diabetes
d. all of the above
67. What emergency information should the paraoptometric know? (p277)
a. location of the office emergency cart
b. phone numbers of area hospital emergency rooms
c. phone number of the poison control center
d. all of the above
68. What is one of the most common emergency situations in the optometric practice?
(p277)
a. glaucoma attack patient
b. diabetic patient blood sugar dropped
c. penetration of globe
d. corneal abrasions
69. Patients diagnosed with posterior vitreous detachment are asked to return in ______ to
rule out a retinal problem. (p276)
a. 2 weeks
b. 4 weeks
c. 6 weeks
d. 8 weeks