A nurse is conducting a screening program for autism in infants and children. What would the nurse identify as a warning sign?

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.

Choice A rationale

An Apgar score of 7 at 1 minute indicates that the infant is experiencing only mild difficulty with the transition to extrauterine life, and an Apgar score of 9 at 5 minutes indicates a successful adaptation. Severe distress requiring immediate, aggressive resuscitation is suggested by scores of 0 to 3, which is not the case here.

Choice B rationale

An Apgar score of 7 at 1 minute and a score of 9 at 5 minutes is the most common pattern, indicating the newborn is successfully adjusting to extrauterine life with minimal or no difficulty. The score of 7 suggests some minor, non-life-threatening depression at birth that resolved quickly by the 5-minute assessment.

Choice C rationale

Moderate difficulty and the potential need for some intervention, such as oxygen or tactile stimulation, would typically be suggested by an Apgar score in the range of 4 to 6 at 1 minute. The score of 7 suggests a better initial status than moderate difficulty, and the score of 9 confirms a successful transition.

Choice D rationale

The Apgar score is primarily an assessment of a newborn's cardiorespiratory and neurological status during the immediate transition phase, and while it is generally a good indicator of immediate neonatal well-being, it is a poor predictor of long-term neurologic future outcomes. Low scores persisting at 5 minutes are more concerning for future outcomes.