A nurse is preparing to administer naproxen 6 mg/kg PO to a child who weighs 27 lb and is experiencing pain. Available is naproxen 125 mg/5 mLs suspension. How many mL should the nurse administer? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.)

A cataract is an opacity of the lens of the eye that interferes with the normal passage of light to the retina. In toddlers, cataracts can be congenital or acquired and may lead to impaired visual development if not identified early. During eye assessment, the red reflex test is an important screening tool used to detect abnormalities of the lens or retina. Absence or abnormality of the red reflex is a significant finding that requires prompt evaluation.

Rationale:
A. Closing one eye at a time is more commonly associated with diplopia or strabismus rather than cataracts. A child may close one eye to compensate for misalignment of vision or double vision. Cataracts primarily cause clouding of the lens rather than extraocular muscle imbalance, so this is not the expected finding.

B. Absence of red reflex is a classic indication of cataract because the cloudy lens blocks light from reflecting normally off the retina. Normally, when light is directed into the eye, a reddish-orange glow is seen due to reflection from the retina. If the lens is opaque, this reflex is absent or appears white, signaling the need for urgent ophthalmologic assessment.

C. Absence of accommodation to light refers more to pupillary abnormalities or neurologic dysfunction rather than cataracts. Cataracts affect lens transparency and vision quality, not the pupil’s direct response to light. The pupillary light reflex may still be present even when a cataract exists.

D. Tilting the head to one side is more commonly seen with strabismus or certain visual field disturbances where the child tries to improve alignment or compensate for abnormal vision. It is not a typical hallmark of cataracts. Cataracts are better identified through lens opacity and abnormal red reflex findings rather than head positioning.

Gasoline inhalation is a form of hydrocarbon abuse commonly associated with inhalant use in adolescents. These substances rapidly affect the central nervous system because they are highly lipid-soluble and quickly cross the blood-brain barrier. Acute intoxication produces CNS depression similar to alcohol intoxication, leading to impaired coordination, dizziness, confusion, and slurred speech. Early recognition is important because severe exposure can also cause respiratory depression and cardiac dysrhythmias.

Rationale:
A. Pinpoint pupils are more commonly associated with opioid intoxication rather than hydrocarbon inhalation. Gasoline inhalation primarily causes central nervous system depression and neurologic impairment rather than the parasympathetic pupillary constriction seen with narcotic overdose. Therefore, this is not the expected finding.

B. Hyperactive reflexes are not typical of gasoline inhalation because hydrocarbons usually depress the central nervous system rather than stimulate it. Clients are more likely to present with slowed responses, dizziness, and decreased coordination instead of exaggerated reflex activity. CNS depression is the more characteristic effect.

C. Ataxia is expected because gasoline inhalation causes CNS depression that affects balance, coordination, and motor control. Adolescents may appear unsteady, stagger while walking, and have slurred speech similar to alcohol intoxication. This neurologic impairment is a common sign of inhalant abuse and should raise concern for hydrocarbon exposure.

D. Hypothermia is not the primary expected finding with gasoline inhalation. Although environmental exposure may influence body temperature, the major acute effects involve neurologic depression, dizziness, and impaired coordination. Temperature changes are less characteristic than ataxia in this type of intoxication.