Questions
1. The primary care pediatric nurse practitioner performs a vision screen on a 4- ID: 13348411154
month-old infant and notes the presence of convergence and accommodation with mild esotropia
of the left eye. What will the nurse practitioner do?
A. Patch the right eye to improve coordination of the left eye.
B. Reassure the parents that the infant will outgrow this.
C. Recheck the infant’s eyes in 2 to 4 weeks.
D. Refer the infant to a pediatric ophthalmologist. Correct
2. During a well child exam on a 4-year-old child, the primary care pediatric nurse ID: 13348411168
practitioner notes that the clinic nurse recorded “20/50” for the child’s vision and noted that the
child had difficulty cooperating with the exam. What will the nurse practitioner recommend?
A. Follow up with a visual acuity screen in 6 months.
B. Refer to a pediatric ophthalmologist.
C. Re-test the child in 1 year.
D. Test the child’s vision in 1 month. Correct
3. During a well child assessment of an African-American infant, the primary care ID: 13348411148
pediatric nurse practitioner notes a dark red-brown light reflex in the left eye and a slightly brighter,
red-orange light reflex in the right eye. The nurse practitioner will
A. dilate the pupils and reassess the red reflex.
B. order auto-refractor screening of the eyes.
C. recheck the red reflex in 1 month.
D. refer the infant to an ophthalmologist. Correct
4. The primary care pediatric nurse practitioner performs a Hirschberg test to evaluate ID: 13348411150
A. color vision.
B. ocular alignment. Correct
C. peripheral vision.
D. visual acuity.
5. The primary care pediatric nurse practitioner applies fluorescein stain to a child’s
eye. When examining the eye with a cobalt blue filter light, the entire cornea ID: 13348411146
appears cloudy. What does this indicate?
A. The cornea has not been damaged.
, B. There is too little stain on the cornea.
C. There is damage to the cornea.
D. There is too much stain on the cornea. Correct
6. A toddler exhibits exotropia of the right eye during a cover-uncover screen. The ID: 13348411156
primary care pediatric nurse practitioner will refer to a pediatric ophthalmologist to initiate which
treatment?
A. Botulinum toxin injection
B. Corrective lenses
C. Occluding the affected eye for 6 hours per day
D. Patching of the unaffected eye for 2 hours each day Correct
7. The primary care pediatric nurse practitioner performs a well child examination on ID: 13348411140
a 9-month-old infant who has a history of prematurity at 28 weeks’ gestation. The infant was treated
for retinopathy of prematurity (ROP) and all symptoms have resolved. When will the infant need an
ophthalmologic exam?
A. At 12 months of age Correct
B. At 24 months of age
C. At 48 months of age
D. At 60 months of age
8. During a well-baby assessment on a 1-week-old infant who had a normal exam ID: 13348411144
when discharged from the newborn nursery 2 days prior, the primary care pediatric nurse practitioner
notes moderate eyelid swelling, bulbar conjunctival injections, and moderate amounts
of thick, purulent discharge. What is the likely diagnosis? A. Chemical-induced
conjunctivitis
B. Chlamydia trachomatis conjunctivitis Correct
C. Herpes simplex virus (HSV) conjunctivitis
D. Neisseria gonorrhea conjunctivitis
9. The primary care pediatric nurse practitioner performs a well baby assessment of ID: 13348411152
a 5-day-old infant and notes mild conjunctivitis, corneal opacity, and serosanguinous discharge in
the right eye. Which course of action is correct?
A. Administer intramuscular ceftriaxone 50 mg/kg.
B. Admit the infant to the hospital immediately. Correct
C. Give oral erythromycin 30 to 50 mg/kg/day for 2 weeks.
D. Teach the parent how to perform tear duct massage.
, 10. A preschool-age child who attends day care has a 2-day history of matted eyelids K. L. ID:
in the morning and burning and itching of the eyes. The primary care pediatric nurse practitioner
notes yellow-green purulent discharge from both eyes, conjunctival erythema, and mild URI
symptoms. Which action is correct?
I.
A. Culture the conjunctival discharge.
B. Observe the child for several days.
C. Order an oral antibiotic medication.
D. Prescribe topical antibiotic drops. Correct
11. A 14-year-old child has a 2-week history of severe itching and tearing of both J. ID:
eyes. The primary care pediatric nurse practitioner notes redness and swelling of the eyelids along
G.
with stringy, mucoid discharge. What will the nurse practitioner prescribe?
A. Saline solution or artificial tears
B. Topical mast cell stabilizer
C. Topical NSAID drops Correct
D. Topical vasoconstrictor drops
12. The primary care pediatric nurse practitioner observes a tender, swollen red H. ID:
furuncle on the upper lid margin of a child’s eye. What treatment will the nurse practitioner
recommend? E.
A. Culture of the lesion to determine causative organism
B. Referral to ophthalmology for incision and drainage
C. Topical steroid medication
D. Warm, moist compresses 3 to 4 times daily Correct
13. The primary care pediatric nurse practitioner is treating an infant with lacrimal duct F. ID:
obstruction who has developed bacterial conjunctivitis. After 2 weeks of treatment with topical
antibiotics along with massage and frequent cleansing of secretions, the infant’s symptoms have
not improved. Which action is correct?
A. Perform massage more frequently.
B. Prescribe an oral antibiotic.
C. Recommend hot compresses.
D. Refer to an ophthalmologist. Correct
14. A preschool-age child is seen in the clinic after waking up a temperature of ID: 13348411158
102.2°F, swelling and erythema of the upper lid of one eye, and moderate pain when looking from
1. The primary care pediatric nurse practitioner performs a vision screen on a 4- ID: 13348411154
month-old infant and notes the presence of convergence and accommodation with mild esotropia
of the left eye. What will the nurse practitioner do?
A. Patch the right eye to improve coordination of the left eye.
B. Reassure the parents that the infant will outgrow this.
C. Recheck the infant’s eyes in 2 to 4 weeks.
D. Refer the infant to a pediatric ophthalmologist. Correct
2. During a well child exam on a 4-year-old child, the primary care pediatric nurse ID: 13348411168
practitioner notes that the clinic nurse recorded “20/50” for the child’s vision and noted that the
child had difficulty cooperating with the exam. What will the nurse practitioner recommend?
A. Follow up with a visual acuity screen in 6 months.
B. Refer to a pediatric ophthalmologist.
C. Re-test the child in 1 year.
D. Test the child’s vision in 1 month. Correct
3. During a well child assessment of an African-American infant, the primary care ID: 13348411148
pediatric nurse practitioner notes a dark red-brown light reflex in the left eye and a slightly brighter,
red-orange light reflex in the right eye. The nurse practitioner will
A. dilate the pupils and reassess the red reflex.
B. order auto-refractor screening of the eyes.
C. recheck the red reflex in 1 month.
D. refer the infant to an ophthalmologist. Correct
4. The primary care pediatric nurse practitioner performs a Hirschberg test to evaluate ID: 13348411150
A. color vision.
B. ocular alignment. Correct
C. peripheral vision.
D. visual acuity.
5. The primary care pediatric nurse practitioner applies fluorescein stain to a child’s
eye. When examining the eye with a cobalt blue filter light, the entire cornea ID: 13348411146
appears cloudy. What does this indicate?
A. The cornea has not been damaged.
, B. There is too little stain on the cornea.
C. There is damage to the cornea.
D. There is too much stain on the cornea. Correct
6. A toddler exhibits exotropia of the right eye during a cover-uncover screen. The ID: 13348411156
primary care pediatric nurse practitioner will refer to a pediatric ophthalmologist to initiate which
treatment?
A. Botulinum toxin injection
B. Corrective lenses
C. Occluding the affected eye for 6 hours per day
D. Patching of the unaffected eye for 2 hours each day Correct
7. The primary care pediatric nurse practitioner performs a well child examination on ID: 13348411140
a 9-month-old infant who has a history of prematurity at 28 weeks’ gestation. The infant was treated
for retinopathy of prematurity (ROP) and all symptoms have resolved. When will the infant need an
ophthalmologic exam?
A. At 12 months of age Correct
B. At 24 months of age
C. At 48 months of age
D. At 60 months of age
8. During a well-baby assessment on a 1-week-old infant who had a normal exam ID: 13348411144
when discharged from the newborn nursery 2 days prior, the primary care pediatric nurse practitioner
notes moderate eyelid swelling, bulbar conjunctival injections, and moderate amounts
of thick, purulent discharge. What is the likely diagnosis? A. Chemical-induced
conjunctivitis
B. Chlamydia trachomatis conjunctivitis Correct
C. Herpes simplex virus (HSV) conjunctivitis
D. Neisseria gonorrhea conjunctivitis
9. The primary care pediatric nurse practitioner performs a well baby assessment of ID: 13348411152
a 5-day-old infant and notes mild conjunctivitis, corneal opacity, and serosanguinous discharge in
the right eye. Which course of action is correct?
A. Administer intramuscular ceftriaxone 50 mg/kg.
B. Admit the infant to the hospital immediately. Correct
C. Give oral erythromycin 30 to 50 mg/kg/day for 2 weeks.
D. Teach the parent how to perform tear duct massage.
, 10. A preschool-age child who attends day care has a 2-day history of matted eyelids K. L. ID:
in the morning and burning and itching of the eyes. The primary care pediatric nurse practitioner
notes yellow-green purulent discharge from both eyes, conjunctival erythema, and mild URI
symptoms. Which action is correct?
I.
A. Culture the conjunctival discharge.
B. Observe the child for several days.
C. Order an oral antibiotic medication.
D. Prescribe topical antibiotic drops. Correct
11. A 14-year-old child has a 2-week history of severe itching and tearing of both J. ID:
eyes. The primary care pediatric nurse practitioner notes redness and swelling of the eyelids along
G.
with stringy, mucoid discharge. What will the nurse practitioner prescribe?
A. Saline solution or artificial tears
B. Topical mast cell stabilizer
C. Topical NSAID drops Correct
D. Topical vasoconstrictor drops
12. The primary care pediatric nurse practitioner observes a tender, swollen red H. ID:
furuncle on the upper lid margin of a child’s eye. What treatment will the nurse practitioner
recommend? E.
A. Culture of the lesion to determine causative organism
B. Referral to ophthalmology for incision and drainage
C. Topical steroid medication
D. Warm, moist compresses 3 to 4 times daily Correct
13. The primary care pediatric nurse practitioner is treating an infant with lacrimal duct F. ID:
obstruction who has developed bacterial conjunctivitis. After 2 weeks of treatment with topical
antibiotics along with massage and frequent cleansing of secretions, the infant’s symptoms have
not improved. Which action is correct?
A. Perform massage more frequently.
B. Prescribe an oral antibiotic.
C. Recommend hot compresses.
D. Refer to an ophthalmologist. Correct
14. A preschool-age child is seen in the clinic after waking up a temperature of ID: 13348411158
102.2°F, swelling and erythema of the upper lid of one eye, and moderate pain when looking from
