NCLE EXAM, PRACTICE EXAM-with 100% verified solutions 2024-2025, Exams of Nursing

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Mary is wearing in her right eye RGP lens with a base curve of 43.50 and a power of +2.75. The doctor refracts -0.75 sphere over this lens. If you wish to order her a new lens with a curve of 43.00, what will the new power be? a. +1. b. +2. c. +2. d. +3.00 - ✔✔c. + Which of the following could be considered in the fitting of a keratoconus patient

1. aspheric
2. McGuire
3. Soper
4. tangent streak a. 1 & 2 b. 2 & 3 c. 3 & 4 d. 1, 2 and 3 - ✔✔d. 1, 2 and 3 Two designs helpful in orienting high riding myopic lenses are:
5. flattening the B.C. relationship

2. myo-flang
3. hyper-flang
4. prism ballast a. 1 & 2 b. 1 & 3 c. 2 & 3 d. 3 & 4 - ✔✔d. 3 & 4 Age/related signs of presbyopia include:
5. tear film abnormalities
6. reduce lid elasticity
7. lens opacities
8. pupil constriction a. 1 only b. 1 & 3 c. 2 & 4 d. all of the above ✔✔d. all of the above A good example of a bifocal contact lens which may rotate without vision imparement is: a. aspheric b. executive c. fused crescent d. tangent streak ✔✔d. tangent streak

Keratoconus and penetrating keratoplasty fittings are best accomplished by which of the following methods? a. nomogram b. Ks and Rx c. diagnostic fitting d. molded impression - ✔✔c. diagnostic fitting Given the following information: K's 45.00/44.00 @ 90 Rx -3.00 + 1.00 x 180 Which of the following set of lens specifications would most simulate an intrapalpebral RGP fitting? B.C Rx Dia. a. 44.50 -2.50 8. b. 43.50 -1.50 8. c. 43.50 -1.50 9. d. 44.50 -2.50 9.5 - ✔✔B.C Rx Dia. a. 44.50 -2.50 8. K's 45.00 @ 180/42.00 @ 90 Rx -2.00 -4.25 x 90 Which of the following RGP lens designs would best correct this wearers vision? a. 45.00 -2. b. 42.00 -2.00 -4.25 x 90 prism ballasted c. 42.00 -2.

d. 42.00/45.00 -2.00 - ✔✔d. 42.00/45.00 -2. A _________ lens is a translating bifocal: a. concentric b. aspheric c. deffractive d. segmented - ✔✔d. segmented Given the following information: K's 42.00@180/45.00@ Rx -3.00-2.25x Which of the following set of RGP lens specifications will best correct this wearers vision? a. 42.00/45.00 -3.00-2. b. 42.00 -3.00-2.75 x 177 prism ballasted c. 42.00 -3. d. 45.00 -3.00 - ✔✔a. 42.00/45.00 -3.00-2. A warped lens will show___________ base curve(s) on the radiuscope and a ________ power on the lensometer. a. one/spherical b. two/sphero-cylindrical c. one/sphero-cylindrical d. two/spherical - ✔✔d. two/spherical

The pre-corneal tear film is composed of three distinct layers. They are: a. Lysozyme, oil, lacrimal b. Sebacious, mucoid, BAK c. lipid, lacrimal, mucin d. water, mucoid, lysozyme - ✔✔c. lipid, lacrimal, mucin The pre-corneal tear film provides

1. A smooth optical surface
2. Metabolic nutrients
3. Endothelial reflex
4. Limbal Hyperemia a. 1& b. 1& c. 2& d. 3&4 - ✔✔b. 1& The main supply of oxygen to the cornea is derived from the a. Endothelium b. Collagen Fibrils c. Basal membrane d. Tears - ✔✔d. Tears

The cornea has five distinct layers. In order from anterior (front) to posterior(back) they are: a. Epithelium, Descemets membrane, Stroma, Bowmans membrane, Endothelium. b. Endothelium, Stroma, Bowmans membrane, Descemets membrane, Epithelium. c. Epithelium, Bowmans membrane, Stroma, Descemets membrane, Endothelium. d. Endothelium, Bowmans membrane, Stroma, Descemets membrane, Epithelium. ✔✔c. Epithelium, Bowmans membrane, Stroma, Descemets membrane, Endothelium. The normal cornea is transparent due to the pump action creating proper fluid balance. Which layer of the cornea is most responsible for maintaining this function? a. Endothelium b. Basal membrane c. Epithelium d. Bowmans membrane -

• ✔✔a. Endothelium The normal cornea is in a state of a. Turgesence b. Deturgesence c. Hyperemia d. Hypoxia - ✔✔b. Deturgesence

The cornea receives nutrients from 1 Aqueous humor 2 Tears 3 Limbal blood vessels 4 Orbicularis occuli a. 1, 3 & 4 b. 2 & 3 c. 1, 2 & 3 d. 3 & 4 - ✔✔c. 1, 2 & 3 Refraction -1.00-3.00 x 90 K Reading 44.00@180/ 41.00@ a. BC 41.00/44.00 Power -1.00/3. b. BC 41.00/44.00 Power -1.00/-4. c. BC 41.00/44.00 Power -4.00/-1. d. BC 44.00/41.00 Power -1.00/-3.00 -

• ✔✔b. BC 41.00/44.00 Power -1.00/-4. book lists C as answer? A dense white appearance of the entire peripheral circumference of the cornea which does not stain and is often seen in the elderly is known as: a. neovascularization b. Dellen c. Arcus senilus

d. Corneal ulcer - ✔✔c. Arcus senilus A normal tear break up time is a. 6-7 seconds b. 10-12 seconds c. Less than 5 seconds d. none of the above - ✔✔b. 10-12 seconds Which of the following materials will not require a weekly enzymatic cleaner? a. Polymethylmethacrylate lenses b. Sofperm c. Hydroxyethyl Methacrylate lenses d. Silicone - acrylate lenses - ✔✔a. Polymethylmethacrylate lenses Clinical management of RGP flexure may be eliminated by: a. redicing sagittal vaulting b. increasing center thickness c. Choosing a lower DK material d. all the above - ✔✔d. all the above

Upon removal of the crystalline lens, the patient is: a. aphakic b. myopic c. hyperopic d. astigmatic - ✔✔a. aphakic a hardening of the crystalline lens causing loss of accommodation is known as: a. presbyopia b. myopia c. hyperopia d. aphakia - ✔✔a. presbyopia A rigid contact lens measures +15.00 BVP. The FVP will measure. a. a lesser dioptric reading b. a greater dioptric reading c. an identical dioptric reading d. an astigmatic reading - ✔✔a. a lesser dioptric reading Which of the following will not measure lens parameters a. Keratometer b. Radiuscope c. Burton lamp

d. Thickness gauge - ✔✔c. Burton lamp A low riding high plus on a 40.00/40.75 cornea could be corrected with a. a myoflange b. a hyperflange c. a one cut d. a panafocal ✔✔a. a myoflange The following ametropia frequently results in high riding rigid lenses a. high myopia b. high hyperopia c. aphakia d. presbyopia -

• ✔✔a. high myopia Corneal deturgescence is maintained by the "pump action" of the ___________ layer a. Endothelial b. Stromal c. Descemet d. Bowman -
• ✔✔a. Endothelial

Which of the following could cause a patient's rigid contact lens to displace frequently and pop out without cause? 1 excessive posterior peripheral curve 2 insufficient peripheral curve 3 steep base curve relationship 4 flat base curve relationship a. 1 & 4 b. 2 & 3 c. 1 only d. 2 & 4 - ✔✔a. 1 & 4 Which of the following preservatives has a low incidence of ocular sensitivity with a soft contact lenses? a. Sorbic Acid b. Chlorobutanol c. Benzalkonium Chloride d. Hydrogen Peroxide 3% - ✔✔a. Sorbic Acid The following Rx represents: OD= +2.00 = 20/ OS= -3.00-2.00 x 180 = 20/ a. Presbyopia b. Anisometropia c. Amblyopia

d. Emmetropia - ✔✔b. Anisometropia The above patient will best achieve stereopsis with which following correction? a. Contact lenses b. Spectacles c. IOL d. Scleral lenses - ✔✔a. Contact lenses A soft lens has edge lift when observed on a cornea. How can this be corrected? a. Steepen base curve b. Decrease diameter c. Flatten base curve d. Change edge design -

• ✔✔a. Steepen base curve A back toric soft lens works best with: a. Residual astigmatism b. High corneal toricity c. Low corneal toricity d. Spherical toricity ✔✔b. High corneal toricity

Corneal edema is observed inferiorly under a prism ballast toric soft lens. What is the probable cause? a. Lens is too tight b. Oxygen demand for this cornea is too great c. Lens is too loose d. Prism thickness - ✔✔d. Prism thickness In evaluating a soft lens fit with either keratometry mires or retinoscopic reflex, you detect distortion immediately after the blink. This is caused by: a. A steep fitting lens b. A properly fitting lens c. A flat fitting lens d. A tight fitting lens - ✔✔c. A flat fitting lens A non-wetting RGP lens may cause: a. hazy, filmy vision b. lens awareness c. dryness or grittiness d. all of the above - ✔✔d. all of the above Causes of lens flexure may include: 1 pressure exerted by the upper lid

2 lens material 3 apical clearance lens design 4 against the rule corneal toricity a. 1 and 3 b. 2 and 4 c. 2 only d. all of the above - ✔✔d. all of the above The FDA has recommended that extended wear contact lenses be worn for a maximum of: a. 7 days b. 14 days c. 30 days d. 45 days - ✔✔a. 7 days Therapeutic soft lenses should be fit with minimal movement in which case? a. Keratitis sicca b. Trichiasis c. Recurrent erosion d. Keratoconus - ✔✔c. Recurrent erosion

An aphakic patient with K readings of 40.50 @ 180/41.25 @ 90, large palpebral fissures and flaccid lower lids is a good candidate for a. a one cut b. a myoflange lenticular c. a hyperflange lenticular d. a back toric - ✔✔b. a myoflange lenticular The CPC of a rigid lens was ordered 7.84mm and was received measuring 7.94mm. This lens is _____ than ordered. a. 0.50D steeper b. 1.00D flatter c. 0.50 flatter d. 1.00D steeper - ✔✔c. 0.50 flatter When evaluating fluorescein patterns, a special filter must be used with __________. a. Silicone acrylate b. Polymethylmethacrylate c. Fluropolymers d. Hydroxyethyl methacrylate - ✔✔c. Fluropolymers

When comparing high DK silicone acrylate polymers to earlier generation materials of the same type, the new "improved" silicone acrylates 1 increase oxygen permeability 2 flex less 3 have poorer wetting characteristics 4 scratch less a. 1 only b. 1 and 3 c. 2 and 4 d. all are correct - ✔✔b. 1 and 3 A normal fitting soft contact lens will have: a. three point touch (apex and periphery) b. apical clearance c. edge stand-off d. none of the above -

• ✔✔a. three point touch (apex and periphery) The keratometer is an instrument used to measure a. Corneal curvature b. Lens power c. Lens diameter d. Lens thickness - ✔✔a. Corneal curvature

A lens fitted for keratoconus should: a. Flatten the apex b. Ride high c. Align the apex d. Ride low - ✔✔c. Align the apex A soft contact lens which is too loose can show all the following EXCEPT: a. edge stand-off b. limbal compression c. a bubble under the lens edge d. clear retinoscopy directly after blinking - ✔✔b. limbal compression Correction of a high riding rigid minus lens is accomplished by using a a. Flatter lens b. Larger lens c. Minus carrier lenticular lens d. Prism lens - ✔✔d. Prism lens Advantages of a myo-flange vs single cut high plus lens unclude 1 reduced center thickness 2 increased optical zone 3 reduced weight

a. 1 only b. 1 and 3 c. 2 and 3 d. 1, 2 and 3 - ✔✔d. 1, 2 and 3 To increase tear exchange on an RGP lens, all of the following can be done EXCEPT: a. reduce the overall lens diameter b. flatten the peripheral curves c. increase the sagittal depth d. decrease the optic zone - ✔✔c. increase the sagittal depth Which of the following preservatives is a mercury based compound? a. sorbic acid b. thimerosal c. dymed d. polyquad - ✔✔b. thimerosal An instrument used to evaluate corneal irregularity which reflects concentric circles from the patient's cornea is called a __________. a. burton lamp b. con-ta-check c. topogometer

d. placido disk - ✔✔d. placido disk Which of the following polishing compounds should not be used with gas permeable lenses? a. Sil 02 care b. Silvo c. Alox PG d. X Pal - ✔✔b. Silvo Which of the following can NOT be used to measure the diameter of a rigid lens? a. profile analyzer b. measuring magnifier c. diameter gauge d. shadowgraph - ✔✔a. profile analyzer In order to effect a smooth blend on a contact lens which has a 10.5 mm PPC, one would use which of the following laps? a. 8.5mm b. 9.5mm c. 10.2mm d. 11.5mm - ✔✔b. 9.5mm

To correct an RGP lens which is fitted too flat, you may: a. enlarge the optical zone b. decrease the optical zone c. decrease the sagittal vaulting d. decrease the lens diameter -

• ✔✔a. enlarge the optical zone The patient has a horizontal visible iris diameter (HVID) of 12.5mm. The best choice of a diameter would be a. 13.0mm b. 13.5mm c. 14.5mm d. 15.5mm - ✔✔c. 14.5mm An excellent material for a patient with keratoconus would be: a. Polymacon b. Crofilcon c. Bufilcon A d. Silicone acrylate - ✔✔d. Silicone acrylate Prism ballast, truncation, double slab-off, and peri ballast are all ______designs.

a. soft toric b. bifocal c. therapeutic d. spherical - ✔✔a. soft toric Which of the following can NOT be done to increase the movement of a tight fitting RGP lens? a. enlarge the optical zone b. decrease the optical zone c. decrease the sagittal vaulting d. decrease the lens diameter - ✔✔a. enlarge the optical zone The performance of a soft toric lens depends upon 1 corneal topography 2 lid shape 3 lid positioning 4 lid tightness a. 1 only b. 1 & 3 c. 2 & 3 d. 1, 2 , 3 & 4 - ✔✔d. 1, 2 , 3 & 4 A high degree of with the rule astigmatism fitted with a rigid spherical lens will show touch

a. on the horizontal meridian b. on the vertical meridian c. on the oblique meridian d. on the residual meridian - ✔✔a. on the horizontal meridian A rigid lens showing no apical clearance is an indication of a. a steep fit b. an alignment fit c. a flat fit d. an astigmatic fit - ✔✔c. a flat fit A rigid lens showing apical pooling is an indication of a. steep fit b. an alignment fit c. a flat fit d. an astigmatic fit ✔✔a. steep fit A rigid lens showing apical vaulting is an indication of a. steep fit b. an alignment fit c. a flat fit d. an astigmatic fit - ✔✔a. steep fit

A rigid lens showing a band-shaped area of touch on the flattest meridian is an indication of a. steep fit b. an alignment fit c. a flat fit d. an astigmatic fit - ✔✔a. steep fit A single cut aphakic lens is best suited for patients with ______ apertures and ______corneas. a. small / flat b. small / steep c. large / flat d. large / steep - ✔✔b. small / steep In choosing the diameter of a soft lens, what is the general rule of thumb? a. 1.0 mm larger than HVID b. 2.0 mm larger than HVID c. 3.0 mm larger than HVID d. none of the above - ✔✔b. 2.0 mm larger than HVID ✔✔b. 2.0 mm larger than HVID

• ✔✔a. an aspherical lens

Whenverifying a rigid lens on a radiuscope, you notice that the mires are not in focus in all principal meridians. This indicates a 1 warped lens 2 back toric 3 bi-toric 4 front toric a. 1 only b. 1 and 3 c. 2 and 4 d. 1, 2 & 3 - ✔✔d. 1, 2 & 3 All of the following will enable the practitioner to verify the overall rigid gas permeable lens diameter except: A. Slot gauge B. Shadowgraph C. Measuring magnifer D. Radiuscope - ✔✔D. Radiuscope The slot gauge, shadowgraph and measuring magnifier will all enable the practitioner to verify the overall lens diameter of rigid gas permeable lens. The radiuscope is an instrument that will

measure the base curve of a rigid lens. Placing the concave side of a rigid gas permeable lens against the lens stop of the lensometer, will provide you with which of the following? A. Back vertex power B. Front vertex power C. Best vertex power D. Closest vertex power - ✔✔A. Back vertex power A keratometer measures the corneal curvature. A profile analyzer measures the peripheral curves (blends) and a v-groove gauge measures the diameter of a rigid contact lens. The tolerance for lens power under +/-10.00D is: A. 0.12D B. 0.25D C. 0.37D D. 0.50D - ✔✔A. 0.12D The bas curve of a rigid lens was ordered 7.84mm and was received measuring 7.94mm. This lens is __________ than ordered. A. 0.50D steeper B. 1.00D steeper C. 0.50D flatter D. 1.00D flatter -