Question 1

An adolescent goes to the primary care provider complaining of difficulty with vision.When the nurse asks the adolescent to explain the visual deficits,the adolescent states,"I am having difficulty seeing distant objects; they are less clear than things that are close." What disorder does the nurse suspect the adolescent has?
A) Hyphema
B) Astigmatism
C) Amblyopia
D) Myopia

Accepted Answer

Myopic patients have the ability to see near objects more clearly than those at a distance; it is caused by the image focusing beyond the retina.Hyphema includes hemorrhage in the anterior chamber and is not a refractive disorder.Astigmatism is caused by an abnormal curvature of the cornea or lens.Amblyopia is a problem of reduced visual acuity not correctable by refraction.

Question 2

A child just returned from cataract eye surgery.What is the most significant nursing intervention to prevent increasing intraocular pressure in this child?
A) Monitor for hypertension.
B) Prevent coughing and vomiting.
C) Lower the head of the bed slightly.
D) Avoid use of steroids after the surgery.

Accepted Answer

Preventing coughing,straining,vomiting,and touching the operative site are all measures directed toward avoiding increased intraocular pressure.Hypertension is not a symptom of increased intraocular pressure.The head of the bed should be raised slightly.Steroids,antibiotics,and mydriatics may be used after the surgery.

Question 3

Teaching parents about the use and application of an eye patch to treat strabismus should include which instruction?
A) Check under the patch four times a day.
B) Apply the patch directly to the face.
C) Sometimes patching alone will straighten the eye.
D) Negotiate the number of hours per day that the patch is to be worn.

Accepted Answer

The patch should be securely applied to the face and should remain in place for the prescribed number of hours.There is no need to check under the patch.Patching alone will not straighten the eye.The amount of time the child wears the eye patch is not negotiable.Parents should learn strategies for dealing with resistant behaviors.

Question 4

Parents of a 4-year-old child are concerned because the child continues to stutter.What nursing intervention is correct?
A) Remind the parents that stuttering is normal in children younger than 10 years.
B) Facilitate a speech evaluation performed if the stuttering continues beyond age 5 years.
C) Reinforce the fact that this common speech defect requires no treatment.
D) Tell the parents that speech problems are most treatable during the child's teen years.

Accepted Answer

If stuttering persists after 5 years of age,the child should be seen by the physician and referred to a speech therapist.Stuttering is not normal after age 5 years.Early diagnosis and intervention are important to correct speech disorders.

Question 5

The teaching plan for a 7-year-old boy with color deficiency should include what instruction?
A) Buy only one color of clothing to ensure the child's ability to match items himself.
B) Patching the weaker eye will improve his color vision.
C) Teach him an alternate way to distinguish between the colors of traffic signals.
D) Botulism toxin drops must be administered every 2 months to improve color vision.

Accepted Answer

Distinguishing colors of warning signals must be taught an alternative way to identify them.Clothes may be labeled or organized so the child can identify them.They do not have to be purchased only in one color.There is no cure for color blindness.Because the eye is not weak,patching will not correct the color deficiency.Color deficiency cannot be treated or corrected.The child can be taught adaptive measures to compensate for the condition.

Question 6

The nurse should know that the results of untreated amblyopia ("lazy eye")in the child may include which of the following?
A) Impaired depth perception
B) Strabismus
C) Color deficiency
D) Ptosis

Accepted Answer

Untreated amblyopia causes the child to lose binocular vision,which may impair depth perception.Amblyopia,or decreased vision in the deviated eye,can result from strabismus.Color deficiency is not a result of amblyopia.Ptosis,or drooping of the eyelid,is not a result of untreated amblyopia.

Question 7

The correct position for the postoperative child who has had a cataract removed from the right eye is the ________ position.
A) supine
B) prone
C) knee-chest
D) right lateral Sims

Accepted Answer

To prevent edema and pressure on the operative site,the nurse should elevate the head of the bed slightly and avoid placing the child in a dependent position.The prone position is a dependent position,which is contraindicated after cataract surgery.The knee-chest position is contraindicated after cataract surgery.The right lateral Sims position increases pressure on the operative site.

Question 8

Initial care of the child with a chemical burn to the eye(s)is focused on which of the following?
A) Irrigation of the affected eye(s)
B) Application of topical steroids
C) Administration of an analgesic
D) Administration of medication to constrict the pupils

Accepted Answer

Chemical eye burns are an ocular emergency and best managed by immediate irrigation of the eye(s)with water or normal saline solution.The other actions are not part of initial care.

Question 9

A 13-year-old adolescent is suspected to have a visual deficit and is scheduled for further evaluation.The teen asks the nurse to tell "the truth" about the tests.What is the nurse's best response?
A) "Don't worry about anything. We're here to take good care of you."
B) "Ask your parents. They have talked with the physicians."
C) "Most of the vision tests are painless and noninvasive."
D) "Trust the doctors. They know what is best for you."

Accepted Answer

The nurse should be knowledgeable and honest in Answerwering questions about procedures.The nurse should not belittle the teen's concerns by giving false reassurance,having the teen ask the parents for information,or telling the teen to trust the doctors.

Question 10

The teaching plan for the parents of a 3-year-old child with amblyopia ("lazy eye")should include what instruction?
A) Apply a patch to the child's eyeglass lenses.
B) Apply a patch only during waking hours.
C) Apply a patch over the "bad" eye to strengthen it.
D) Cover the "good" eye completely with a patch.

Accepted Answer

The "good" eye is patched to force the child to use the "bad" eye,thus strengthening the muscles.The patch should always be applied directly to the child's face,not to eyeglasses.The patch should be left in place even when the child is sleeping.Covering the "bad" eye will not contribute to strengthening it.The "good" eye should be patched.

Question 11

The nurse is caring for a 2-year-old child who has a history of meningitis as an infant.The child is not speaking and does not turn the head to the sound of a rattle.Which type of hearing loss in a child may have resulted from a previous infection with meningitis?
A) Conductive
B) Sensorineural
C) Central
D) Mixed

Accepted Answer

When hearing loss is caused by malformations,auditory nerve damage,or infection,the loss is usually permanent.Damage caused by inflammation or obstruction usually causes a temporary and reversible hearing loss.A central type of hearing loss usually causes difficulties in differentiating sounds and problems with auditory memory,and it is reversible.A combination of conductive and sensorineural loss.Conductive loss is often reversible,whereas sensorineural is permanent.

Question 12

A 10-year-old patient is talking to the nurse about wanting to try contact lenses instead of wearing glasses.The child states that the other children at school call her "four-eyes." Contact lenses should be prescribed for a child who is
A) at least 12 years of age.
B) able to read all the written information and instructions.
C) able to independently care for the lenses in a responsible manner.
D) confident that she really wants contact lenses.

Accepted Answer

The child must be able to care for the lenses independently.Serious eye damage can occur with irresponsible use of contact lenses.Chronologic age is not the major determinant.A responsible 10-year-old child might be permitted to wear contact lenses.The ability to read does not indicate understanding of the instructions.Confidence and "wanting" do not equal responsibility.

Question 13

Which statement by a parent indicates understanding of instructions on the care of a child with conjunctivitis?
A) "I should treat my other children with these eye drops to prevent spread of the disease."
B) "My child must remain home from school until she has received 72 hours of antibiotic drops."
C) "I should avoid touching the tip of the ointment tube to my child's eye."
D) "My child may go back to wearing her contact lenses 24 hours after treatment has started."

Accepted Answer

Care should be taken to avoid touching the tip of the ointment tube or dropper to the eye to avoid contamination of the medication.The other statements indicate a need for further instruction.

Question 14

On the second postoperative day of an eye surgery,the child has puffy eyes,increased tearing,and fever.What is the most applicable nursing diagnosis?
A) Risk for Infection related to surgical procedure
B) Infection related to surgical procedure
C) Disturbed Sensory Perception (Visual) related to surgical procedure
D) Acute Pain related to recent surgical intervention

Accepted Answer

Any surgical procedure leaves the patient vulnerable to infection and with a nursing diagnosis of Risk for Infection.However,this child is manifesting signs of infection,which changes the diagnosis to an actual,not risk for,diagnosis.There is no data to support disturbed sensory perception or acute pain.

Question 15

A 2-year-old has excessive tearing and corneal haziness.The nurse knows that these symptoms may indicate which of the following?
A) Viral conjunctivitis
B) Paralytic strabismus
C) Congenital cataract
D) Infantile glaucoma

Accepted Answer

Excessive tearing and corneal haziness are indicative of glaucoma.Because the child is younger than 3 years of age,it would be classified as "infantile." Discharge is noted with conjunctivitis.Corneal haziness is not a symptom of conjunctivitis.Neither tearing nor corneal haziness is a symptom of paralytic strabismus.A congenital cataract will cause an opacity but not excessive tearing.

Question 16

Which statement best describes how a cataract affects a child's vision?
A) It increases intraocular pressure.
B) It alters the ability to distinguish among colors.
C) It causes double vision.
D) It prevents a clear image from forming on the retina.

Accepted Answer

A cataract is an opacity of the lens or loss of trAnswerparency of the lens.Coughing,straining,or vomiting can increase intraocular pressure postoperatively.Nystagmus and strabismus are clinical signs of a cataract.Color deficiency is not a sign.A cataract usually does not cause double vision.

Question 17

What manifestation in a 5-month-old child could indicate visual problems?
A) Lack of binocularity
B) Visual acuity of 20/50
C) Strabismus
D) Hyperopia

Accepted Answer

Strabismus is normal in the young infant but should not be present after 3 months of age.Binocularity,the ability to fixate on one visual field with both eyes,is not present at birth but is established by 6 months of age.Visual acuity by 4 months of age is between 20/50 and 20/80.Hyperopia,or farsightedness,is normal until about 7 years of age.

Question 18

Which teaching guideline helps prevent eye injuries during sports and play activities?
A) Restrict helmet use to those who wear eye glasses or contact lenses.
B) Discourage the use of goggles with helmets so the child can see better.
C) Wear eye protection when participating in high-risk sports such as paintball.
D) Wear a face mask when playing any sport or playing roughly.

Accepted Answer

High-risk sports such as paintball can cause penetrating eye injuries.Eye protection should be worn.All children who play games should be protected by the appropriate headgear.Goggles and helmets can and should be used concurrently.A face mask does not prevent damage to the child's head.

Question 19

Which statement by a parent about conjunctivitis indicates that further teaching is needed?
A) "I'll have separate towels and washcloths for each family member."
B) "I'll notify my doctor if the eye gets redder or the drainage increases."
C) "When the eye drainage improves, we'll stop giving the antibiotic ointment."
D) "After taking the antibiotic for 24 hours, my child can return to school."

Accepted Answer

The antibiotic should be continued for the full prescription.Maintaining separate towels and washcloths will prevent the other family members from acquiring the infection.If the infection proliferates,the physician should be contacted.The child should be kept home from school or day care until the child receives the antibiotic for 24 hours.

Question 20

A 5-year-old diagnosed with chlamydial conjunctivitis should be carefully assessed for which of the following?
A) Sexual abuse
B) Immune deficiency
C) Congenital cataract
D) Secondary glaucoma

Accepted Answer

A diagnosis of chlamydial conjunctivitis in a nonsexually active child should signal the health care provider to assess the child for sexual abuse.Chlamydial infection is not related to immune deficiencies,cataracts,or glaucoma.

Quiz 55: The Child with a Sensory Alteration

A child just returned from cataract eye surgery.What is the most significant nursing intervention to prevent increasing intraocular pressure in this child?

Teaching parents about the use and application of an eye patch to treat strabismus should include which instruction?

Parents of a 4-year-old child are concerned because the child continues to stutter.What nursing intervention is correct?

The teaching plan for a 7-year-old boy with color deficiency should include what instruction?

The nurse should know that the results of untreated amblyopia ("lazy eye") in the child may include which of the following?

The correct position for the postoperative child who has had a cataract removed from the right eye is the ________ position.

Initial care of the child with a chemical burn to the eye(s) is focused on which of the following?

A 13-year-old adolescent is suspected to have a visual deficit and is scheduled for further evaluation.The teen asks the nurse to tell "the truth" about the tests.What is the nurse's best response?

The teaching plan for the parents of a 3-year-old child with amblyopia ("lazy eye") should include what instruction?

The nurse is caring for a 2-year-old child who has a history of meningitis as an infant.The child is not speaking and does not turn the head to the sound of a rattle.Which type of hearing loss in a child may have resulted from a previous infection with meningitis?

A 10-year-old patient is talking to the nurse about wanting to try contact lenses instead of wearing glasses.The child states that the other children at school call her "four-eyes." Contact lenses should be prescribed for a child who is

Which statement by a parent indicates understanding of instructions on the care of a child with conjunctivitis?

On the second postoperative day of an eye surgery,the child has puffy eyes,increased tearing,and fever.What is the most applicable nursing diagnosis?

A 2-year-old has excessive tearing and corneal haziness.The nurse knows that these symptoms may indicate which of the following?

Which statement best describes how a cataract affects a child's vision?

What manifestation in a 5-month-old child could indicate visual problems?

Which teaching guideline helps prevent eye injuries during sports and play activities?

Which statement by a parent about conjunctivitis indicates that further teaching is needed?

A 5-year-old diagnosed with chlamydial conjunctivitis should be carefully assessed for which of the following?