The nurse is performing an eye-screening clinic at a daycare center. When examining a 2-year-old child, the nurse suspects that the child has a "lazy eye". What should the nurse do next?
Assess child's ability to read.
Consider this a normal finding.
Assess the child's visual fields with the confrontation test.
Test for strabismus by performing the corneal light reflex test (Sparkle Test).
The Correct Answer is D
A. Assess child's ability to read: A 2-year-old is too young for a standard reading assessment, as they may not yet recognize letters. Visual acuity tests for this age group typically use pictures or symbols rather than reading letters. Assessing reading ability would not be appropriate or useful in diagnosing strabismus, as the condition affects eye alignment rather than literacy skills.
B. Consider this a normal finding: Strabismus, or "lazy eye," is not a normal finding beyond infancy. If left untreated, it can lead to amblyopia (permanent vision loss in the weaker eye). Early detection and intervention are crucial for proper visual development, and dismissing the finding as normal could result in a missed opportunity for corrective treatment, such as patching or corrective lenses.
C. Assess the child's visual fields with the confrontation test: The confrontation test assesses peripheral vision, not strabismus. It is more appropriate for older children and adults, as it requires the child to understand and follow instructions. While it can identify visual field deficits, it does not evaluate binocular vision or eye misalignment, which are essential in diagnosing strabismus.
D. Test for strabismus by performing the corneal light reflex test (Sparkle Test): The corneal light reflex test evaluates eye alignment by shining a light at the child's eyes and observing the reflection on the corneas. If the light reflex is asymmetrical, it suggests strabismus, which requires further evaluation and possible treatment. Early detection is critical to prevent amblyopia, and this simple test is a quick and effective method to screen for misalignment in young children.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","D"]
Explanation
A. Intercostals: The intercostal muscles, including the external and internal intercostals, are primary muscles of respiration. They play a crucial role in expanding and contracting the thoracic cavity during inhalation and exhalation, facilitating airflow into and out of the lungs.
B. Scalene: The scalene muscles assist in elevating the first two ribs during deep inhalation, making them accessory muscles of respiration rather than primary muscles. They support breathing but are not the main muscles involved in the normal respiratory cycle.
C. Sternomastoid: The sternocleidomastoid muscles are also considered accessory muscles of respiration. They help elevate the sternum during forced inhalation, but they are not classified as primary muscles of respiration, which are more involved in the regular breathing process.
D. Diaphragm: The diaphragm is the primary muscle of respiration and is crucial for normal breathing. It contracts and flattens during inhalation, increasing the volume of the thoracic cavity and allowing air to flow into the lungs. This muscle is essential for the majority of airflow during normal breathing.
E. Pectoralis major: The pectoralis major is primarily involved in shoulder movement and is not a primary muscle of respiration. Although it can assist during forceful inhalation when the arms are raised, it does not function as a main muscle in the respiratory process.
Correct Answer is C
Explanation
A. Changes in peripheral vision in response to bright light: This assessment relates more to visual field testing and does not evaluate accommodation. Accommodation specifically involves the ability of the eye to focus on near objects.
B. Pupillary dilation when looking at a near object: Pupillary dilation occurs when focusing on distant objects due to decreased light and increased depth of focus, not during accommodation.
C. Pupillary constriction when looking at a near object: This is the correct assessment for visual accommodation. When a person looks at a near object, the pupils constrict to enhance focus and reduce light entry, aiding in clearer vision of nearby objects. This reaction is part of the accommodation reflex, which also involves changes in lens shape.
D. Involuntary blinking in the presence of bright light: This response is known as the photo pupillary reflex, which involves blinking in reaction to bright light but does not assess accommodation. Accommodation specifically evaluates the eye's ability to focus on objects at different distances.
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