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. Inversion of the foot refers to turning the sole inward, not pes planus.
B. Pes planus is the medical term for flat feet, a condition where the arches of the feet are flattened, allowing the entire sole to touch the ground. It can be flexible or rigid and may be asymptomatic in children.
C. Metatarsus refers to the long bones of the foot, not the arch configuration.
D. Pigeon toe (in-toeing) describes a rotational deformity of the feet, not the flattening of the arches.
Correct Answer is C
Explanation
Rationale:
A. Radioactive iodine is generally reserved for older children or adolescents when medical therapy fails, due to potential long-term effects on growth and fertility.
B. Propylthiouracil (PTU) is avoided in children as first-line therapy because of the risk of severe liver toxicity.
C. Methimazole (Tapazole) is the preferred initial treatment for pediatric hyperthyroidism, as it effectively controls thyroid hormone production with a safer side effect profile.
D. Levothyroxine (Synthroid) is used to treat hypothyroidism, not hyperthyroidism.
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