Chapter 4: Communication and Physical Assessment of the Child and Family - Nurselytic

Questions 30

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Wong's Essentials of Pediatric Nursing 11th Edition Test Bank

Chapter 4 : Communication and Physical Assessment of the Child and Family Questions

Question 1 of 5

During a funduscopic examination of a school-age child, the nurse notes a brilliant, uniform red reflex in both eyes. The nurse should recognize that this is which?

Correct Answer: A

Rationale: A brilliant, uniform red reflex is an important normal finding. It rules out many serious defects of the cornea, aqueous chamber, lens, and vitreous chamber.

Question 2 of 5

Which explains why correcting strabismus in young children is important?

Correct Answer: B

Rationale: By the age of 3 to 4 months, infants are able to fixate on one visual field with both eyes simultaneously. In strabismus, or cross-eye, one eye deviates from the point of fixation. If misalignment is constant, the weak eye becomes lazy, and the brain eventually suppresses the image produced from that eye. If strabismus is not detected and corrected by age 4 to 6 years, blindness from disuse, known as amblyopia, may occur. Color vision is not the only concern. Epicanthal folds are not related to amblyopia. In children with strabismus, the corneal light reflex will not be symmetric for each eye.

Question 3 of 5

Which is the most frequently used test for measuring visual acuity?

Correct Answer: A

Rationale: The Snellen letter chart, which consists of lines of letters of decreasing size, is the most frequently used test for visual acuity. The Ishihara Vision Test is used for color vision. The Allen picture card test and Denver eye screening test involve single cards for children ages 2 years and older who are unable to use the Snellen letter chart.

Question 4 of 5

The nurse is testing an infants visual acuity. By which age should the infant be able to fix on and follow a target?

Correct Answer: C

Rationale: Visual fixation and ability to follow a target should be present by ages 3 to 4 months. One to 2 months is too young for this developmental milestone. If an infant is not able to fix and follow by 6 months, further ophthalmologic evaluation is needed.

Question 5 of 5

During an otoscopic examination on an infant, in which direction is the pinna pulled?

Correct Answer: C

Rationale: In infants and toddlers, the ear canal is curved upward.
To visualize the ear canal, it is necessary to pull the pinna down and back to the 6 to 9 oclock range to straighten the canal. In children older than age 3 years and adults, the canal curves downward and forward. The pinna is pulled up and back to the 10 oclock position. Up and forward and down and forward are positions that do not facilitate visualization of the ear canal.

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