Chapter 31: The Child with a Sensory Alteration

1. A child tells the school nurse that he cant see things at a distance very clearly but he can read up close fine. The nurse
knows that the refractive disorder causing the ability to see distant objects less clearly than those close up is termed:
a.

hyphema.

b.

astigmatism.

c.

amblyopia.

d.

myopia.

ANS: D
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.
2. The parents of a child needing glasses ask the nurse when can we consider contact lenses for our child? The nurse
should respond to this question relating that 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.

ANS: C
The child must be able to care for the lenses independently. Serious eye damage can occur with irresponsible use of
contact lenses; confidence and wanting do not equal responsibility. Chronological age is not the major determinant. A
responsible 10-year-old child might be permitted to wear contact lenses, but the ability to read does not indicate
understanding of the instructions.
3. Which statement best describes how a cataract affects a childs vision?
a.

It increases intraocular pressure.

b.

It alters the ability to distinguish between colors.

c.

It causes double vision.

d.

It prevents a clear image from forming on the retina.

ANS: D
A cataract is an opacity of the lens or loss of transparency of the lens and usually does not cause double vision.
Coughing, straining, or vomiting can increase intraocular pressure postoperatively. Nystagmus and strabismus are
clinical signs of a cataract. Color deficiency is not a sign.
4. Which statement about conjunctivitis made by a parent would indicate that further teaching is needed?

a.

Ill have separate towels and washcloths for each family member.

b.

Ill notify my doctor if the eye gets redder or the drainage increases.

c.

When the eye drainage improves, well stop giving the antibiotic ointment.

d.

After taking the antibiotic for 24 hours, my child can return to school.

ANS: C
The antibiotic should be continued for the full prescription and the child should be kept home from school or day care
until he receives the antibiotic for 24 hours. Maintaining separate towels and washcloths will prevent the other family
members from acquiring the infection. If the infection proliferates, the physician should be contacted.
5. Which teaching guideline would help 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.

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.

ANS: C