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).

Answer and Explanation

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.

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Correct Answer is D

Explanation

A. Nystagmus in extreme superior gaze: A few beats of nystagmus in extreme lateral gaze may be normal, but sustained nystagmus, especially in superior gaze, suggests neurological impairment such as vestibular dysfunction or multiple sclerosis.

B. Slight amount of lid lag when moving the eyes from a superior to an inferior position: Lid lag, where the upper eyelid lags behind the downward movement of the eye, is often associated with hyperthyroidism (e.g., Graves' disease). It is not a normal finding in the diagnostic positions test.

C. Convergence of the eyes: Convergence is assessed when a person focuses on a near object, such as during an accommodation test. The diagnostic positions test evaluates extraocular muscle function and cranial nerves III, IV, and VI, focusing on coordinated movement rather than convergence.

D. Parallel/synchronized movement of both eyes: The normal finding in the diagnostic positions test is smooth, coordinated movement of both eyes in all six cardinal directions without lagging, misalignment, or significant nystagmus. This indicates intact extraocular muscles and proper cranial nerve function.

A. Sinoatrial (SA) node B. Bundle of His C. Atrioventricular (AV) node D. Bundle branches

Correct Answer is A

Explanation

A. Sinoatrial (SA) node: The SA node is known as the natural pacemaker of the heart because it initiates electrical impulses that regulate the heartbeat. Located in the right atrium, the SA node generates impulses that cause the atria to contract and set the pace for the heart rate. This function is essential for maintaining a normal sinus rhythm.

B. Bundle of His: The Bundle of His, also known as the atrioventricular bundle, is part of the conduction system that transmits electrical impulses from the AV node to the bundle branches. While it plays an important role in conducting impulses, it does not initiate them and is not referred to as the pacemaker.

C. Atrioventricular (AV) node: The AV node is responsible for receiving impulses from the SA node and delaying them briefly to allow the ventricles to fill with blood before contracting. Although it can act as a secondary pacemaker if the SA node fails, it is not the primary pacemaker of the heart.

D. Bundle branches: The bundle branches carry electrical impulses from the Bundle of His to the ventricles, causing them to contract. They do not initiate impulses and therefore are not considered the pacemaker of the heart.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is performing the diagnostic positions test (6 Cardinal Gazes). Which result is a normal finding?

Correct Answer is D

Explanation

What component of the conduction system is referred to as the pacemaker of the heart?

Correct Answer is A

Explanation

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