During the ophthalmic exam in an infant, the nurse practitioner notices an absent red reflex. The remaining examination findings are within normal limits. The nurse practitioner should:
order routine immunizations and schedule the infant's next routine exam.
refer the infant to a pediatric ophthalmologist.
delay the scheduled immunizations and send the infant for a computed tomography (CT) scan of the brain.
refer the infant to a pediatric neurologist.
The Correct Answer is B
Rationale:
A. Routine follow-up is inappropriate because an absent red reflex can indicate serious ocular pathology, such as congenital cataract, retinoblastoma, or other intraocular abnormalities. Waiting until the next routine exam could delay critical diagnosis and treatment.
B. Referral to a pediatric ophthalmologist is the correct action. Early evaluation is essential to preserve vision and rule out life-threatening conditions. Pediatric ophthalmologists can perform a thorough dilated eye exam and additional imaging if needed.
C. Delaying immunizations and ordering a CT scan is not the standard initial step; imaging may be indicated later depending on ophthalmologic findings, but urgent ophthalmology referral takes priority.
D. Referral to a pediatric neurologist is not indicated at this stage, as the absent red reflex points primarily to an ocular rather than neurologic issue.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Rationale:
A. A urethral opening on the dorsal aspect of the glans penis is consistent with epispadias, not hypospadias.
B. Hypospadias is a congenital condition in which the urethral opening is located on the ventral (underside) aspect of the penis, rather than at the tip of the glans. Early detection is important for surgical planning and preventing complications with urination or future sexual function.
C. Inability to retract the foreskin over the glans penis is phimosis and is not diagnostic of hypospadias.
D. Inability to palpate a testicle suggests cryptorchidism, which is unrelated to the urethral meatus position.
Correct Answer is A
Explanation
Rationale:
A. Uncomplicated mononucleosis is generally self-limiting, and management focuses on symptom relief. Acetaminophen (or ibuprofen) can be used to manage fever and sore throat.
B. Corticosteroids are reserved for severe complications, such as significant tonsillar hypertrophy causing airway obstruction, and are not indicated for uncomplicated cases.
C. Adolescents with mononucleosis should avoid contact sports or strenuous activity for at least 3–4 weeks, as splenomegaly increases the risk of splenic rupture.
D. Antibiotics like amoxicillin are not indicated and may cause rash in patients with Epstein-Barr virus infection, a hallmark of mononucleosis.
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