The assessment of a 4-year-old child's visual acuity demonstrates 20/30 vision in the left eye and 20/40 vision in the right eye using the Snellen eye chart. This means:
that vision is normal for age.
that vision is abnormal and further testing is warranted.
the patient may not be able to read and should be tested with the picture or "E" eye charts.
an astigmatism is present.
The Correct Answer is B
Rationale:
A. Normal visual acuity for a 4-year-old is generally around 20/25 in each eye.
B. Vision of 20/30 in one eye and 20/40 in the other indicates reduced visual acuity, which is abnormal for this age and warrants further evaluation to rule out amblyopia, refractive errors, or other ocular pathology.
C. While picture or “E” charts are used for younger children who cannot read letters, a 4-year-old may be able to use a standard Snellen chart, and the findings indicate decreased acuity regardless.
D. Astigmatism cannot be diagnosed solely based on these Snellen chart readings; additional testing such as refraction is required.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Rationale:
A. Bowel cleansing may be considered if constipation is contributing, but it is not the standard next step when behavioral strategies alone fail.
B. Urinalysis is useful for ruling out underlying urinary tract infections or diabetes but is typically performed earlier in the evaluation process.
C. A bedwetting alarm is a first-line second-step intervention after behavioral modifications have not produced improvement. It conditions the child to wake in response to bladder fullness and has demonstrated efficacy in reducing nocturnal enuresis.
D. Referral to a pediatric urologist is generally reserved for refractory cases, underlying anatomic abnormalities, or complicated presentations, not as the immediate next step after failed behavioral therapy.
Correct Answer is B
Explanation
Rationale:
A. Herpes simplex in infants typically presents with painful vesicles and sometimes systemic symptoms, not a persistent whitish coating.
B. Oral candidiasis (thrush) presents as a white, curd-like coating on the tongue, gums, or inner cheeks that cannot be wiped away. It is caused by an overgrowth of Candida species and is common in young infants.
C. A normal coating in infants (milk residue) is easily wiped away and does not persist.
D. Poor oral care may cause debris or plaque later in infancy but is not the cause of persistent white plaques in young infants.
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