A nurse develops a plan of care for a child that includes patching the eye. This plan of care would be most appropriate for which condition?
Astigmatism.
Hyperopia.
Myopia.
Amblyopia.
The Correct Answer is D
Choice A rationale
Astigmatism is an irregular curvature of the cornea or lens, which causes light rays to focus unevenly on the retina, resulting in distorted or blurred vision at any distance. The primary treatment for astigmatism is the use of corrective lenses, such as eyeglasses or contact lenses, not therapeutic eye patching.
Choice B rationale
Hyperopia, or farsightedness, occurs when the light focuses behind the retina because the eyeball is too short or the cornea is too flat, causing difficulty seeing objects up close. This condition is primarily managed by prescribing convex corrective lenses to help shift the focal point onto the retina.
Choice C rationale
Myopia, or nearsightedness, occurs when the light focuses in front of the retina because the eyeball is too long or the cornea is too steep, causing blurry distance vision. The standard treatment involves concave corrective lenses to diverge light rays and properly position the focal point on the retina.
Choice D rationale
Amblyopia, commonly called "lazy eye," is a reduction in visual acuity in one eye that results from the eye and brain not working well together, often caused by untreated strabismus or refractive errors. Patching the strong eye forces the brain to use the weaker, amblyopic eye, stimulating the development of the neural pathways necessary for clear vision.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale
The Apgar score is a rapid method, performed at one and five minutes after birth, to quickly assess the newborn's immediate adjustment to extrauterine life by evaluating five signs: heart rate, respiratory effort, muscle tone, reflex irritability, and color. It is an index of immediate postnatal transition and resuscitation need, but it does not correlate with or assess the infant's gestational age or physical maturity.
Choice B rationale
The Ballard score, a common assessment tool, systematically evaluates both the neuromuscular maturity (e.g., posture, square window, scarf sign) and physical maturity (e.g., skin texture, lanugo, plantar creases, breast development, ear cartilage, and genitalia) of a newborn. The total score is then used to estimate the infant's gestational age with a high degree of correlation, which is vital for providing appropriate clinical care.
Choice C rationale
Phenylketonuria (PKU) screening is a metabolic test performed as part of the newborn screening panel, usually after 24 hours of feeding, to detect the absence of the enzyme phenylalanine hydroxylase. This test is crucial for early detection of a treatable inborn error of metabolism but has no correlation with or utility in assessing the physical or neurological maturity of the newborn or estimating gestational age.
Choice D rationale
Length and weight measurements, along with head circumference, are standard anthropometric assessments used to track growth and compare the newborn's size relative to its estimated gestational age (e.g., small, appropriate, or large for gestational age). While important for growth monitoring, these measurements alone do not provide a comprehensive assessment of neurological or physical maturity for precise gestational age estimation. —.
Correct Answer is ["A","B","C","E"]
Explanation
Choice A rationale
Poor tone, or lethargy and hypotonia, is a common and often subtle non-specific sign of systemic illness in neonates because the central nervous system is affected by circulating bacterial toxins or poor tissue perfusion. The newborn may appear listless, "floppy," or difficult to arouse, indicating a significant compromise in neurological and physiological status secondary to sepsis.
Choice B rationale
Tachypnea, a respiratory rate greater than 60 breaths per minute, is a compensatory mechanism to combat the metabolic acidosis that often occurs in sepsis, or it may be due to a primary respiratory infection. Increased respiratory effort is a critical sign of distress in the newborn, reflecting the body's attempt to improve oxygenation and remove excess carbon dioxide.
Choice C rationale
Hypothermia (a body temperature < 36.5°C or 97.7°F) is a highly specific and often more common indicator of severe infection and sepsis in the neonate than fever. The newborn's immature thermoregulatory center can fail to mount a febrile response, and metabolic demands during sepsis can overwhelm the ability to maintain core body temperature.
Choice D rationale
A sunken fontanel usually indicates dehydration, a condition that can accompany sepsis, particularly if the infant has poor feeding or is vomiting/diarrheal. However, the signs of sepsis itself are often related to systemic inflammatory response, with a bulging fontanel being a more common sign if the neonate develops meningitis, a complication of sepsis.
Choice E rationale
Hypoglycemia (blood glucose typically < 40 mg/dL) is a frequent manifestation of neonatal sepsis. The overwhelming infection stresses the newborn's system, leading to increased metabolic rate and glucose consumption, combined with poor intake and potential liver dysfunction, which results in depleted glycogen stores and subsequent low blood sugar levels.
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