A school nurse is assessing the visual acuity of a school-age child. Which of the following findings indicate that the child should be evaluated for strabismus?

Visual acuity 20/30 bilaterally

Peripheral vision 70° downward

Movement of the uncovered eye during a cover test

Light reflects symmetrically within each pupil during a corneal light reflex test

Answer and Explanation

The Correct Answer is C

A. Visual acuity 20/30 bilaterally: Visual acuity of 20/30 bilaterally indicates relatively good vision in both eyes, but it does not necessarily indicate strabismus. Strabismus is related to eye alignment rather than visual acuity.

B. Peripheral vision 70° downward: Peripheral vision refers to the ability to see objects outside the direct line of vision. While changes in peripheral vision can occur in various eye conditions, such as glaucoma, it is not specific to strabismus.

C. Movement of the uncovered eye during a cover test: This is the correct option. During a cover test, one eye is covered while the other eye fixates on an object. If the uncovered eye moves to try to align with the covered eye, it may indicate strabismus or a misalignment of the eyes.

D. Light reflects symmetrically within each pupil during a corneal light reflex test: A corneal light reflex test assesses the alignment of the eyes by observing the reflection of light on the corneas. While asymmetry in the corneal light reflex can indicate strabismus, the description provided in this option suggests that the light reflects symmetrically within each pupil, which is a normal finding.

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Correct Answer is B

Explanation

A. "Seal nonwashable items in a plastic bag for 2 days."

This instruction is incorrect. Items that cannot be laundered may be dry-cleaned or sealed in a plastic bag for two weeks

B. "Soak hair brushes in boiling water for 10 minutes."This is correct. According to CDC, combs and brushes should be soaked in hot water (at least 130 degrees fahrenheit) to help avoid re-infestation.

C. "Apply permethrin 1 percent cream rinse every day for 5 days."

This instruction is incorrect. Permethrin 1 percent cream rinse is a medication used to treat head lice infestations, but it is typically applied only once and then rinsed out after a specified period of time (usually 10 minutes). Repeated daily application for five days is not recommended and may lead to unnecessary exposure to the medication.

D. "After washing bed linens, place them in a dryer on a cool setting for 30 minutes."

This instruction is incorrect. To effectively kill lice and nits on bed linens, they should be washed in hot water (at least 130°F or 54°C) and then dried on a hot setting in the dryer. A cool setting may not be sufficient to kill lice and nits.

A. Green zone reading on peak expiratory flow meter B. Rhinitis C. Axillary temperature of 37.2° C (99° F) D. Hacking, nonproductive cough

Correct Answer is D

Explanation

A. Green zone reading on peak expiratory flow meter:

A green zone reading on a peak expiratory flow meter indicates that the child's peak expiratory flow rate (PEFR) is within the normal or stable range. This would not typically be indicative of an exacerbation of asthma. In fact, a green zone reading suggests that asthma is well-controlled.

B. Rhinitis:

Rhinitis, or inflammation of the nasal mucosa, is a common symptom in individuals with asthma, but it is not necessarily indicative of an exacerbation of asthma. Rhinitis can occur due to allergic or non-allergic triggers and may be present even when asthma is well-controlled.

C. Axillary temperature of 37.2°C (99°F):

An axillary temperature of 37.2°C (99°F) is within the normal range for body temperature and is not indicative of an exacerbation of asthma. While fever can occur during exacerbations of asthma, it is not a universal symptom and may be absent in some cases.

D. Hacking, nonproductive cough:

This is the correct option. A hacking, nonproductive cough is a common symptom of asthma exacerbation. During an exacerbation, the airways become inflamed and constricted, leading to coughing. The cough may be dry and unproductive, and it is often worse at night or early in the morning.

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A school nurse is assessing the visual acuity of a school-age child. Which of the following findings indicate that the child should be evaluated for strabismus?

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