A nurse is preparing to assess a 4-year-old child's visual acuity. Which of the following actions should the nurse plan to take?

Assess both eyes together first, then each eye separately.

Position the child 4.6 meters (15 feet) from the chart.

Test the child without glasses before testing with glasses.

Use a tumbling E chart for the assessment.

Answer and Explanation

The Correct Answer is D

A.   Visual acuity should be assessed for each eye separately first, then both eyes together to detect any differences between the eyes.
B.   The nurse should position the child 3 meters (10 feet) from the chart and ask the child to point in the direction of the open end of each letter.
C.   If the child wears glasses, they should be tested with and without their glasses to assess visual acuity accurately.
D.   A tumbling E chart, where the child identifies the direction of the E (up, down, left, or right), is commonly used for assessing visual acuity in young children who may not yet know letters.

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Correct Answer is B

Explanation

A. No head lag when pulled to a sitting position is a normal finding at 4 months of age.
B. They should not have doll's eye reflex intact, which means that their eyes move in the opposite direction of their head when turned. This reflex normally disappears by 3 months of age and its persistence may indicate brain damage.
C. The presence of tears when crying is a normal finding at 4 months of age.
D. They should also have positive Babinski reflex, which means that their toes fan out when their sole is stroked. This reflex normally disappears by 12 months of age.

A. Inactivated polio virus B. Varicella C. Human papillomavirus D. Hepatitis B

Correct Answer is B

Explanation

A. The first dose of inactivated polio virus vaccine (IPV) is typically administered at 2 months of age, not 12 months.
B. The first dose of varicella vaccine is usually given at 12 months of age.
C. Human papillomavirus (HPV) vaccination typically begins around 11-12 years of age, not at 12 months.
D. Hepatitis B vaccination usually starts at birth, not at 12 months of age.

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