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
Having the patient in a clean diaper is a general standard of care, but it is not the primary nursing action during a lumbar puncture (LP) procedure; sterile technique for the procedure site is paramount to prevent infection. The crucial nursing role is safely maintaining the necessary positioning and continuously monitoring the child's physiological status during the invasive procedure.
Choice B rationale
Continuous monitoring of the patient's cardiorespiratory status (heart rate, respiratory rate, oxygen saturation) is the most critical nursing action during an LP, especially in infants and small children who are commonly held in a tightly flexed, side-lying position. This positioning can compromise ventilation, and changes in intracranial pressure may also affect vital signs.
Choice C rationale
The correct position for a lumbar puncture is usually the side-lying position with the back fully rounded (fetal position) to maximize the space between the vertebrae, or occasionally a sitting position, allowing the provider access to the L3-L4 or L4-L5 interspaces. The prone position is not used as it prevents access to the lumbar area for the procedure.
Choice D rationale
While conscious sedation or analgesia is frequently used to minimize movement and discomfort during an LP in children, starting an IV line is not always necessary if a quick, successful procedure is anticipated without sedation, or if alternative routes for sedation are used. The most essential action is the immediate safety and monitoring of the child's vital functions.
Correct Answer is B
Explanation
Choice A rationale
An increased eosinophil level, or eosinophilia, often indicates an allergic response or a parasitic infection, which is a significant finding but not immediately life-threatening. While needing further investigation, it does not represent an acute physiological crisis that demands emergent reporting, unlike critical oxygen-carrying capacity impairment. The normal range for eosinophils is typically 1 to 4 percent of the total white blood cell count.
Choice B rationale
A hemoglobin level of 6.1 grams per deciliter is severely low, far below the normal range for a child (approximately 11 to 14 g/dL), indicating significant anemia. This critically impairs the blood's oxygen-carrying capacity, risking tissue hypoxia, cardiac strain, and potential shock, requiring immediate intervention such as a blood transfusion.
Choice C rationale
A platelet count of 40,000 per cubic millimeter is low, consistent with the diagnosis of idiopathic thrombocytopenia purpura, which is defined by a count below 150,000. While this count increases the risk of bleeding and requires close monitoring, it is an expected part of the diagnosis and is not immediately as life-threatening as severe anemia unless active major bleeding is occurring.
Choice D rationale
An elevated reticulocyte count, or reticulocytosis, indicates increased production of immature red blood cells by the bone marrow, typically a compensatory response to anemia or hemorrhage. This finding suggests the body is actively trying to correct the low hemoglobin, which is a positive sign and not an immediate emergency requiring urgent reporting.
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