| NA | NA |
| The nurse is caring for a toddler who is scheduled to have myringotomy
tubes placed. Which statement by the child’s parents indicates a lack of
understanding? | "The tubes will likely fall out on their own in 1 to 2 years." |
| The vision impairment in which the child can see objects at close range but not at a distance is known as: | Myopia |
| The nurse is teaching a group of parents about eyes and eye concerns. The nurse tells these caregivers about a condition that occurs when unequal curvatures in the cornea bend the light rays in different directions and this causes images to be blurred. The condition the nurse is referring to is: | Astigmatism |
| In children with otitis media, a procedure known as a myringotomy may be performed. Which statement is most accurate regarding this procedure? | During this procedure, small tubes are inserted into the tympanic membrane |
| The nurse is obtaining the history from the parents of an infant who is suspected of having infantile glaucoma. Which statement by the parents would help to confirm this suspicion? | "It seems like bright lights really bother him." |
| A child returns to the clinic after an episode of otitis externa, which has resolved. What would the nurse emphasize as the priority for preventing future episodes? | Keeping ear canals dry |
| A nurse develops a plan of care for a child that includes patching the eye. This plan of care would be most appropriate for which condition? | Amblyopia |
| The nurse is assessing vision during a well child visit and is focusing her priority assessment technique on the most common cause of visual difficulties. Which vision impairment is this? | Refractive errors |
| A nursing student is doing a clinical rotation on a pediatric floor and is learning about normal growth and development. What can impact normal growth and development? Select all that apply | Interference with vision
Interference with hearing |
| When does the nursing instructor tell students is the best time to do a first hearing and vision test on a child? | In the first few days of life |
| A child has been diagnosed with strabismus. After further examination, the patient is told that the resting position of the right eye is convergent. The nurse further explains that this means which of the following? | The resting position of the eye is turned in. |
| A child has recently been diagnosed with cataracts. The treatment for cataracts is: | Surgery |
| Nursing students are learning about inflammation and infections of the eyes in children. What does the instructor identify to the class as a major cause of eye infections in the newborn? | Transfer of vaginal secretions |
| Parents request help from the nurse in managing their young child’s "poor behavior.” They describe “loud talk and play, not coming when called, seldom following directions, ‘blasting’ the volume on the TV set, and difficulty understanding spoken words.” The appropriate nursing action is: | arranging for an evaluation of the child’s hearing. |
| A young preschooler with impaired visual acuity can be treated with glasses. The parents are reluctant to agree. The nurse explains: | with impaired vision, children have difficulty interacting with their environment and meeting developmental milestones. |
| The nurse in the acute care setting is caring for a child with deafness. Which nursing intervention is appropriate for this child? | Allow the child to see the nurse prior to touching or completing any assessments or procedures. |
| The Stereo Fly dot test is planned for a 4-year-old child. After the nurse completes the instructions with the parent, which response indicates the parent's understanding of the planned test? | "My child will be asked to point to a specific part of the diagram." |
| The parents of an 8-year-old child report that the child’s teachers noted the child is having problems seeing the board in school but state they do not understand this since the child is able to read from the computer with no difficulty. Which response from the nurse is most appropriate? | "What you are describing may be what is called myopia." |
| The 12-year-old child has developed a stye. Which may be included in the child’s care? | Apply hot, moist compresses to the affected area. |
| The nurse is assessing a 7-year-old with a hearing aid. His mother says he is losing his hearing again. Which of the following findings would the nurse expect to make? | Overproduction of cerumen |
| The nurse is caring for a child who has conductive hearing loss. What is true regarding this type of hearing loss? | It is caused by chronic otitis media or another infection |
| The nurse is caring for a 6-month-old infant diagnosed with otitis media.
Which clinical manifestation would likely have been noted in this child? | Shaking the head and pulling the ear |
| The nurse recognizes that if the infant is following normal development, the infant will be able to focus and follow an object with the eyes by what age? | 2 months of age |
| What would the nurse include when teaching parents how to prevent otitis externa? | Wearing ear plugs when swimming |
| A nursing instructor identifies a need for further teaching when a student
makes which of the following statements? | "Color blindness can be treated." |
| A 7-year-old girl who recently immigrated to the United States from India as a refugee is suffering from night blindness. The nurse recognizes that this condition is caused by a deficiency in which of the following vitamins? | Vitamin A |
| A nurse is assessing a child's vision. Which test should the nurse use to test for accommodation? | Moving a penlight toward the client's nose and observing whether his eyes can follow it |
| The nurse is caring for a child with hearing loss due to damage from chronic inner ear infections. The nurse knows that the child most likely has which type of hearing loss? | Conductive |
| The nurse is providing teaching to the parent of a 4-year-old child being treated for otits media. When discussing the condition, the parent indicates an understanding of the information provided when making which statement? | “Swelling behind my child's ears is a normal occurrence as the
infection resolves.” |
| The nurse is caring for a toddler who is scheduled to have myringotomy tubes placed. Which statement by the child’s parents indicates a lack of understanding? | "The tubes will likely fall out on their own in 1 to 2 years." |
| An infant is diagnosed with a congenital cataract. What would the nurse expect to assess? | Absent red reflex |
| A child has been diagnosed with strabismus. After further examination, the patient is told that the resting position of the right eye is convergent. The nurse further explains that this means which of the following? | The resting position of the eye is turned in. |
| In examining the vision of a 9-year-old girl, the nurse notices that she
frequently reaches either too far or not far enough when attempting to take an object from the nurse's hand. Which conditions does the nurse suspect? | Lack of depth perception (stereopsis) |
| The nurse is performing a physical assessment for an 8-year-old with an earache. Which sign or symptom indicates acute otitis externa? | The child cries out when the ear is grasped. |
| The nurse is preparing a nursing care plan for a 2-year-old child with hearing impairment. Which intervention will be part of the plan? | Assess the child's ability to convey information. |
| The caregiver of a 2-year-old child tells the nurse, “They told me my daughter has an eye disorder called hyperopia.” Which statement made by the mother indicates she has an understanding of this child's current condition? | “Now I know why when she is working on puzzles she says her eye is sleepy.” |
| The nurse is caring for a 3-month-old with nasolacrimal duct obstruction. Which intervention would be most appropriate for the nurse to implement? | Teaching the parents how to gently massage the duct |
| An 8-year-old boy comes to the emergency room with an eye injury after having a glass bottle shatter near his face. Which intervention should the nurse do first while assisting this client? | Instill a few drops of a topical anesthetic into the affected eye |
| The nurse is assessing an infant with ophthalmia neonatorum. Which of the following findings indicate the need to alert the doctor? | Elevated temperature and irritability |
| The nurse is taking a health history for a 9-year-old with conjunctivitis. Which finding would suggest that this is allergic conjunctivitis? | Recently helped clean the basement |
| The nurse is caring for an 8-year-old hospitalized child who is visually impaired. Which nursing intervention would be the highest priority in helping this child reduce anxiety related to hospitalization? | The nurse talks to the child when entering and leaving the room. |
| The nurse is talking with the mother of a 4-year-old boy who will soon be going to a pre-kindergarten program. The child has had the Snellen vision test done at home, and he was unable to distinguish the pictures at the distance that would indicate his vision is normal. The child's mother asks the nurse if he will need glasses. Which statement made by the nurse would be most appropriate regarding the child's vision? | “Children's vision is not completely developed by this age. Your child might outgrow this nearsightedness.” |
| A 7-month-old is scheduled for surgical correction of strabismus. The child’s mother says to the nurse, “I’m glad my child will never have to wear that patch again.” Which of these responses would be most appropriate for the nurse to make? | “Your child will need to wear the patch for a few days to keep him/her from rubbing or putting pressure on the eye.” |
| During physical assessment of a 2-year-old child, the nurse becomes concerned that the child may have a cataract in one eye. Which sign or symptom suggests the child has a cataract? | Absence of the red reflex |
| A nursing student is learning about structural problems of the eye in children. The student correctly identifies incomplete closure of the facial cleft as which of the following? | Coloboma |
| A 12-year-old boy with color blindness asks his nurse what causes this condition. The nurse should explain to him that which of the following eye structures are genetically absent? | Cones |
| The nurse is caring for a child with amblyopia. The parent states, “Our child frequently asks for breaks from the eye patch during meals and play time. Is this permissible?” How should the nurse respond? | Reinforce the importance of limiting breaks to 1 hour per day |
| In children with otitis media, a procedure known as a myringotomy may be performed. Which statement is most accurate regarding this procedure? | During this procedure, small tubes are inserted into the tympanic
membrane. |
| A child diagnosed with conjunctivitis is being seen in the pediatric clinic. Which statements are correct regarding conjunctivitis? Select all that apply. | Purulent drainage is a common symptom.
It is highly contagious.
Warm compresses are used to remove crusts that form on the eyes. |
| The nurse is educating the parents of a 6-year-old child about preventing hearing loss. Which will be included in the discussion? | Prevention and treatment of otitis media |
| A nurse is preparing a presentation for a group of parents about vision impairment. Which factors would be appropriate to include in the teaching plan? Select all that apply | Refractive error
Infantile glaucoma
Amblyopia
Retinopathy of prematurity |
| The nurse is screening a 4-year-old girl for vision problems. What problem could result in loss of vision? | Amblyopia |
| A mother brings her 2-year-old son in for a check up and tells the nurse that she is worried that her son does not hear well. After further testing a diagnosis of hearing loss is confirmed. Which nursing instruction is most beneficial? | Enroll him in early preschool education. |
| A nursing instructor is teaching students about vision disturbances in children. In reviewing the anatomy of the eye, what does the instructor tell students is the area of closely packed cones where color is best perceived? | Fovea centralis |
| The nurse caring for a deaf child is preparing to give the child an intramuscular injection in the child's upper arm. The child's attention is focused on the caregiver on the opposite side of the bed. Before administering the injection, it would be most important for the nurse to do which of the following? | Move around the bed and make eye contact, then show the child the syringe and indicate that the shot is going to be given. |
| A 1-year-old comes to the clinic for a routine visit. The eye examination reveals an enlarged, edematous, and hazy cornea. The child appears sensitive to light. What should the nurse suspect? | Infantile glaucoma |
| An 8-month-old child is brought to the clinic by the parents with reports of a cold for the past 3 days and increased crying and irritability today. What does the nurse anticipate in the plan of care for this child, based on the assessment (above)? Select all that apply | Oral antibiotics
acetaminophen |
| A young child in the clinic has watery eyes and reddened conjunctiva. The child keeps the eyes closed a lot, because it hurts to have them open. Which problem does the nurse suspect for this client? | Conjunctivitis |
| A 9-year-old child is brought to the urgent care center by the parent. Based on assessment findings, the nurse suspects external otitis (acute otitis externa or swimmer's ear). Which finding on otoscopic examination supports this suspicion? | Swollen, inflamed ear canal |
| A child presents to the clinic after receiving a letter from the local school requesting a hearing evaluation. In assessing the child, the nurse notes that the child has slight speech impairment and doesn't seem to hear when turned away from the nurse while the nurse is speaking. The nurse assesses that the child may have what degree of hearing impairment? | Mild |
| After performing eye tests, the school nurse notes a child has symptoms of myopia. Which recommendation will the nurse make to the child's teacher? | Place the child close to the blackboard |
| The nurse is educating the parents of an18-month-old child being prepared to receive cochlear implants. Which statement by the parents requires further teaching? | After the implant surgery our child will have normal hearing |
| The child has conjunctivitis with much mattering of the eyes. What instruction should the nurse give the family? Select all that apply. | All family members should use frequent and proper hand hygiene.
Use measures (such as distraction) to keep the child from rubbing the eyes.
Consider the child contagious until treated with prescribed medication for 24 hours.
Avoid sharing towels, clothing, pillow cases and other personal items with others |
| The nurse admits a 13-year-old client with possible appendicitis to the hospital, accompanied by the parent. The client and parent are both deaf and use sign language to communicate. The nurse needs to assess baseline vital signs and the intake assessment. What should the nurse do while awaiting the arrival of the sign language interpreter? | Write a note to explain the need to assess vital signs. |
| A school nurse knows that most of the students in the community's elementary school have not received routine vision screening because the families live below the federal poverty threshold. What is the most effective method to promote vision screening for this client population? | offering vision screening to all students in kindergarten |
| Which measures should receive priority when planning care for the child who is having surgery to remove a cataract? | Evaluation of intraocular pressure (IOP) and adherence to the occlusive patch regimen |
| The nurse is caring for an infant who is malnourished. When analyzing the child's diet, the nurse suspects a deficiency of vitamin A. For which condition will the nurse assess? | Blindness |
| The nurse is providing teaching to the parent of a 4-year-old child being treated for otitis media. When discussing the condition, the parent indicates an understanding of the information provided when making which statement? | “A brief hearing loss after the infection is an abnormal development.” |
| A parent calls the nurse triage line to say the child accidentally got hit in the eye and the parent believes the child will have a black eye. Which instruction is important for the nurse to provide this parent? | Place ice on the eye for 20 minutes/off the eye for 20 minutes for 24 hours. |
| The school nurse is educating the parents of a child with infectious conjunctivitis. Which comment provides the most value for prevention? | “Don't use anything that touches her face.” |
| A 4-month-old child underwent cataract surgery 3 hours ago. The parents ask why they are only allowed to give the child small amounts of fluid now. How does the nurse respond? | “Introducing fluids slowly reduces the risk of vomiting, which can increase intraocular pressure.” |
| The nurse is educating the parents of a child with otitis media. Which statement made by the parents indicates a need for further teaching? | "I will be certain to dry the outer ear well after each time we go swimming." |
| The nurse is caring for a 6-year-old visually impaired boy and is about to begin the physical examination. Which intervention would be most appropriate to promote effective communication with the child? | use his name before touching him |
| A nursing student learning about vision problems correctly identifies which of the following as a symptom and not a disease itself? | nystagmus |
| The nurse will help parents of a child with amblyopia understand that occluding vision in the unaffected eye is therapeutic because: | Use of the affected eye promotes vision development. |
| The nurse is examining a 7-year-old boy with blepharitis. What symptom would be most unlikely to assess? | Pain |
| A 10-year-old boy develops bacterial conjunctivitis of the right eye. The eye is inflamed and drains a thick yellow discharge. An important measure you would want to teach him is | to clean the discharge away from the inner to outer canthus.
Preventing the infection from spreading to the other eye is important. |
| The mother of a child with conjunctivitis asks you if her son will develop amblyopia later in childhood because of the infection. You would teach her that amblyopia results from a condition such as | ptosis.
Amblyopia occurs when vision in the two eyes shows a marked difference. It is
associated with poor refraction, ptosis, and strabismus. |
| When teaching a mother about amblyopia, it would be most important to explain that | amblyopia is correctable if the child is properly treated before 6 years of age.
Amblyopia can be treated if discovered before 6 years of age; early recognition is
therefore important. |
| A boy is seen in the emergency room with tearing and pain in his right eye. To assess for a foreign body under the upper lid, which method would you use? | Evert the upper lid over an applicator stick.
Averting the upper lid over an applicator stick offers a full view of the anterior globe. |
| When assessing school-age children for vision problems, which child would be most important to assess for a deficiency in color perception? | A boy who says he does not like television.
Color deficiency is a sex-linked trait, so it only occurs in males; middle ear infections are not associated with color deficiency. |
| You screen a school-age boy for hearing and discover he has a hearing loss of 60 dB. This means he would have difficulty hearing | normal conversation and above.
Normal conversation is conducted at about 50 dB. |
| A mother telephones you because her physician told her that her son has wax in one ear canal. What advice would you give the mother? | Inform her that ear wax is helpful in removing dirt from the ear canal.
Earwax rarely leads to hearing impairment. Excess removal can interfere with its
function of removing dirt from the ear canal. |
| A 5-year-old is diagnosed with acute otitis media. Which nursing intervention below would be a primary one? | Relief of pain
Acute otitis media is painful. Children need pain relief until the antibiotic also prescribed reduces the inflammation and pressure. |
| A mother asks you if there is any way to prevent acute otitis media. A suggestion you would make to her would be | the frequency of otitis media is reduced in breast-fed infants.
Acute otitis media tends to occur less often in breast-fed than bottle-fed infants, probably because of the more upright position in which they are fed. |
| A school-age boy develops otitis media with effusion. He and his mother are told that he will need myringotomy tubes inserted into his ears. She asks, “Why does this have to be done at the hospital?” What would be your best response? | “He will need to lie still afterward, so he will need to remain at the hospital for a short time.”
It is important that children lie still while the tubes are inserted so a portion of the tympanic membrane, important for hearing, is not punctured. |
| A child having myringotomy tubes placed asks, “How and when will the tubes be removed?” What is your best response? | “The tubes remain in place for 6 to 12 months until they come out by themselves.”
Because myringotomy tubes are foreign objects, the tympanic membrane will extrude them after a time |
| The mother of a child having myringotomy tubes placed asks, “Will my son lose his hearing while the tubes are in place?” What is your best answer? | The tubes are inserted into a section of eardrum in which the hearing is not affected.”
Myringotomy tubes do not interfere with hearing because they are inserted into a portion of the tympanic membrane that is not instrumental to hearing. |
| The most effective approach to prepare a school-age boy for a myringotomy procedure is to | explain the procedure to the child using puppets.
Young children respond best to concrete illustrations introduced as a fun activity or game. |
| Which statement by a parent would best indicate that she understands the precautions required for her son after the insertion of myringotomy tubes? | “I will be certain he does not swim with the tubes in place.”
Myringotomy tubes would allow water to enter the middle ear and lead to infection. |
| An infant is born with congenital glaucoma. She is scheduled for surgery to relieve this condition at age 2 days. Which preoperative order would you question for her? | A preoperative injection of atropine.
Glaucoma means the exit for intraocular fluid is blocked. A drug that causes pupil dilation narrows the exit of fluid further and thus is contraindicated. |
| A 9-year-old boy who is blind is admitted to the hospital. When serving him a meal in bed, which of the following statements would be most appropriate to increase his self-esteem? | “You have a sandwich on your plate, a glass of milk to your right, and an apple to your left.”
Helping children who are visually impaired remain as independent as possible increases self-esteem. |
| The best way to approach a child who is blind would be to | call his name and then identify yourself
Touching a child before he or she realizes you are there can be frightening. |
| You care for a 5-year-old with a chalazion on her upper eyelid. Her father asks you why it is important to have this removed. What would be your best answer? | This can lead to amblyopia because of ptosis.
A chalazion can create ptosis, or inability of the eyelid to open fully. This could lead to amblyopia. |
| In preparing a school-age child for eye surgery, the nurse discusses the use of eye patches. Which intervention would be most helpful with this age of child? | Allow him to wear an eye patch preoperatively
This actual use will give the child an idea of what it will be like postoperatively. |
| A school-age child with external otitis media wonders how she got the illness. What information would the nurse discuss with her as a common cause? | Swimming.
Swimming or the presence of a foreign body are leading causes of “swimmer's ear.” Secondary infections may also occur. |
