NURS 629 EXAM PRACTICE QUESTIONS AND
ANSWERS|2025 UPDATE
1. The primary care pediatric nurse practitioner performs a vision screen on a 4-
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
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. orrect
3. During a well child assessment of an African-American infant, the primary care
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
A. color vision.
5. The
B. ocular alignment. Correct primary
C. peripheral vision. care
pediatric
D. visual acuity.
nurse
,practitioner applies fluorescein stain to a child’s eye. When examining the eye
with a cobalt blue filter light, the entire cornea 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
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
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
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
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 Npreschool-age Nchild Nwho Nattends Nday Ncare Nhas Na N2-day Nhistory Nof Nmatted
Neyelids
in Nthe Nmorning Nand Nburning Nand Nitching Nof Nthe Neyes. NThe Nprimary Ncare Npediatric Nnurse
Npractitioner Nnotes Nyellow-green Npurulent Ndischarge Nfrom Nboth Neyes, Nconjunctival Nerythema,
Nand Nmild NURI Nsymptoms. NWhich Naction Nis Ncorrect?
I.
A. N Culture Nthe Nconjunctival Ndischarge.
B. N Observe Nthe Nchild Nfor Nseveral Ndays.
C. N Order Nan Noral Nantibiotic Nmedication.
D. N Prescribe Ntopical Nantibiotic Ndrops. N Correct
11. A N14-year-old Nchild Nhas Na N2-week Nhistory Nof Nsevere Nitching Nand Ntearing Nof Nboth :
eyes. NThe Nprimary Ncare Npediatric Nnurse Npractitioner Nnotes Nredness Nand Nswelling Nof Nthe Neyelids Nalong
with Nstringy, Nmucoid Ndischarge. NWhat Nwill Nthe Nnurse Npractitioner Nprescribe?
A. N Saline Nsolution Nor Nartificial Ntears
B. N Topical Nmast Ncell Nstabilizer
C. NTopical NNSAID Ndrops Correct
D. NTopical Nvasoconstrictor Ndrops
12. The Nprimary Ncare Npediatric Nnurse Npractitioner Nobserves Na Ntender, Nswollen Nred
furuncle Non Nthe Nupper Nlid Nmargin Nof Na Nchild’s Neye. NWhat Ntreatment Nwill Nthe Nnurse Npractitioner
recommend?
A. N Culture Nof Nthe Nlesion Nto Ndetermine Ncausative Norganism
B. N Referral Nto Nophthalmology Nfor Nincision Nand Ndrainage
C. N Topical Nsteroid Nmedication
D. NWarm, Nmoist Ncompresses N3 Nto N4 Ntimes Ndaily Correct
13. The Nprimary Ncare Npediatric Nnurse Npractitioner Nis Ntreating Nan Ninfant Nwith Nlacrimal
Nduct
obstruction Nwho Nhas Ndeveloped Nbacterial Nconjunctivitis. NAfter N2 Nweeks Nof Ntreatment Nwith
Ntopical Nantibiotics Nalong Nwith Nmassage Nand Nfrequent Ncleansing Nof Nsecretions, Nthe Ninfant’s
Nsymptoms Nhave Nnot Nimproved. NWhich Naction Nis Ncorrect?
A. N Perform Nmassage Nmore Nfrequently.
B. N Prescribe Nan Noral Nantibiotic.
C. N Recommend Nhot Ncompresses.
D. N Refer Nto Nan Nophthalmologist. N Correct
14. N A Npreschool-age Nchild Nis Nseen Nin Nthe Nclinic Nafter Nwaking Nup Na Ntemperature Nof
102.2°F, Nswelling Nand Nerythema Nof Nthe Nupper Nlid Nof None Neye, Nand Nmoderate Npain Nwhen Nlooking Nfrom
ANSWERS|2025 UPDATE
1. The primary care pediatric nurse practitioner performs a vision screen on a 4-
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
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. orrect
3. During a well child assessment of an African-American infant, the primary care
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
A. color vision.
5. The
B. ocular alignment. Correct primary
C. peripheral vision. care
pediatric
D. visual acuity.
nurse
,practitioner applies fluorescein stain to a child’s eye. When examining the eye
with a cobalt blue filter light, the entire cornea 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
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
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
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
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 Npreschool-age Nchild Nwho Nattends Nday Ncare Nhas Na N2-day Nhistory Nof Nmatted
Neyelids
in Nthe Nmorning Nand Nburning Nand Nitching Nof Nthe Neyes. NThe Nprimary Ncare Npediatric Nnurse
Npractitioner Nnotes Nyellow-green Npurulent Ndischarge Nfrom Nboth Neyes, Nconjunctival Nerythema,
Nand Nmild NURI Nsymptoms. NWhich Naction Nis Ncorrect?
I.
A. N Culture Nthe Nconjunctival Ndischarge.
B. N Observe Nthe Nchild Nfor Nseveral Ndays.
C. N Order Nan Noral Nantibiotic Nmedication.
D. N Prescribe Ntopical Nantibiotic Ndrops. N Correct
11. A N14-year-old Nchild Nhas Na N2-week Nhistory Nof Nsevere Nitching Nand Ntearing Nof Nboth :
eyes. NThe Nprimary Ncare Npediatric Nnurse Npractitioner Nnotes Nredness Nand Nswelling Nof Nthe Neyelids Nalong
with Nstringy, Nmucoid Ndischarge. NWhat Nwill Nthe Nnurse Npractitioner Nprescribe?
A. N Saline Nsolution Nor Nartificial Ntears
B. N Topical Nmast Ncell Nstabilizer
C. NTopical NNSAID Ndrops Correct
D. NTopical Nvasoconstrictor Ndrops
12. The Nprimary Ncare Npediatric Nnurse Npractitioner Nobserves Na Ntender, Nswollen Nred
furuncle Non Nthe Nupper Nlid Nmargin Nof Na Nchild’s Neye. NWhat Ntreatment Nwill Nthe Nnurse Npractitioner
recommend?
A. N Culture Nof Nthe Nlesion Nto Ndetermine Ncausative Norganism
B. N Referral Nto Nophthalmology Nfor Nincision Nand Ndrainage
C. N Topical Nsteroid Nmedication
D. NWarm, Nmoist Ncompresses N3 Nto N4 Ntimes Ndaily Correct
13. The Nprimary Ncare Npediatric Nnurse Npractitioner Nis Ntreating Nan Ninfant Nwith Nlacrimal
Nduct
obstruction Nwho Nhas Ndeveloped Nbacterial Nconjunctivitis. NAfter N2 Nweeks Nof Ntreatment Nwith
Ntopical Nantibiotics Nalong Nwith Nmassage Nand Nfrequent Ncleansing Nof Nsecretions, Nthe Ninfant’s
Nsymptoms Nhave Nnot Nimproved. NWhich Naction Nis Ncorrect?
A. N Perform Nmassage Nmore Nfrequently.
B. N Prescribe Nan Noral Nantibiotic.
C. N Recommend Nhot Ncompresses.
D. N Refer Nto Nan Nophthalmologist. N Correct
14. N A Npreschool-age Nchild Nis Nseen Nin Nthe Nclinic Nafter Nwaking Nup Na Ntemperature Nof
102.2°F, Nswelling Nand Nerythema Nof Nthe Nupper Nlid Nof None Neye, Nand Nmoderate Npain Nwhen Nlooking Nfrom
