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 C

Explanation

A. Examining the child for skin irritation at the cast edges is important to prevent complications, but it is not the priority over monitoring for circulation and potential complications.
B. Restricting strenuous activities is important for preventing damage to the cast, but it is not the priority over monitoring for circulatory compromise.
C. Monitoring for pallor or swelling in the child's affected hand is the priority because it indicates potential circulatory compromise, which is a critical concern following cast application.
D. Using a hair dryer on a cool setting to relieve itching is a helpful suggestion, but it is not the priority over monitoring for potential complications.

A. Encourage flexion and extension of the neck. B. Reposition the client using a turning sheet. C. Assess the pin sites for infection once every other day. D. Tighten the screws on the halo device one-quarter turn every 48 hr.

Correct Answer is B

Explanation

A. The nurse should not encourage flexion and extension of the neck, as this could cause further injury or damage to the spinal cord.
B. The nurse should reposition the client using a turning sheet to prevent skin breakdown and maintain alignment of the spine.
C. The nurse should assess the pin sites for infection at least once a day, not every other day.
D. The nurse should not tighten the screws on the halo device, as this could cause pressure ulcers or nerve damage. Only a provider can adjust the screws on the halo device.

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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?

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