Question 1

A 3-year-old girl is brought to the pediatric clinic by her parents, who are concerned about her eyes not aligning properly. They mention that it seems like one of her eyes tends to “wander” away when she is focusing on objects. Upon examination, the pediatric nurse notes that the child’s right eye drifts outward while trying to focus on a near object. This finding is most consistent with which type of strabismus?

A. Esotropia
B. Exotropia
C. Hypertropia
D. Hypotropia
E. Amblyopia

Correct Answer: B. Exotropia

Rationale: Exotropia is a form of strabismus where the eye drifts outward away from the nose. It is often noticed when the child focuses on an object, causing one eye to turn away. Esotropia, on the other hand, is when the eye turns inward. Hypertropia and hypotropia involve upward and downward movement, respectively. Amblyopia, or “lazy eye,” can result from any form of untreated strabismus but is not a type of strabismus itself.

Question 2

During a well-child visit, a nurse observes a 4-year-old boy with consistent inward turning of his left eye. The nurse knows that early intervention is crucial in preventing further complications. Which of the following is the most important reason for early treatment of this type of strabismus?

A. To improve cosmetic appearance
B. To prevent amblyopia
C. To enhance peripheral vision
D. To correct color blindness
E. To increase eye mobility

Correct Answer: B. To prevent amblyopia

Rationale: The primary goal of early treatment for strabismus, particularly forms like esotropia where the eye turns inward, is to prevent amblyopia, or “lazy eye.” Amblyopia occurs when the brain starts to ignore the visual input from the misaligned eye, leading to vision loss in that eye. Improving cosmetic appearance and enhancing peripheral vision are secondary benefits. Strabismus does not affect color vision or inherently limit eye mobility but rather affects the alignment and coordination of the eyes.

Question 3

A pediatric nurse is educating the parents of a child diagnosed with strabismus about potential treatment options. Which of the following treatment options should the nurse mention as a non-surgical intervention that can be used to correct strabismus in children?

A. Eye patching of the dominant eye
B. Immediate corrective surgery
C. Laser eye surgery
D. Use of antibiotics
E. No treatment, as the child will outgrow it

Correct Answer: A. Eye patching of the dominant eye

Rationale: Eye patching of the dominant (or stronger) eye is a common non-surgical intervention for strabismus, particularly when aiming to prevent or treat amblyopia. By covering the dominant eye, it forces the child to use the weaker eye, thereby strengthening its muscles and improving alignment. Surgical interventions might be necessary in some cases but are not the only option. Laser surgery is generally not used for strabismus. Antibiotics are not effective as strabismus is not caused by an infection, and not all forms of strabismus resolve without treatment.

Question 4

A 5-year-old child is diagnosed with strabismus and is referred for corrective surgery. After surgery, which of the following instructions should the nurse provide to the parents for post-operative care?

A. Keep the child in a darkened room for 48 hours.
B. Administer eye drops to dilate the pupil daily.
C. Use a cold compress to reduce swelling and discomfort.
D. Avoid any reading or close work for one month.
E. Encourage frequent eye rubbing to promote healing.

Correct Answer: C. Use a cold compress to reduce swelling and discomfort.

Rationale: After strabismus surgery, using a cold compress can help reduce swelling and discomfort around the eyes. Keeping the child in a darkened room or dilating the pupil daily with eye drops is not standard post-operative care for strabismus surgery. While some restrictions on activities like reading or close work may be advised shortly after surgery, avoiding them for an entire month is generally unnecessary. Encouraging eye rubbing is contraindicated as it can cause harm to the surgical site.

Question 5

During a health education session, a nurse is explaining the different types of strabismus to a group of nursing students. She describes a type of strabismus where the vertical alignment of the eyes is affected, with one eye positioned higher than the other. This type of strabismus is known as:

A. Esotropia
B. Exotropia
C. Hypertropia
D. Hypotropia
E. Diplopia

Correct Answer: C. Hypertropia

Rationale: Hypertropia is a type of strabismus characterized by the misalignment of the eyes in a vertical direction, where one eye is positioned higher than the other. This contrasts with esotropia and exotropia, which are forms of horizontal misalignment (inward and outward, respectively). Hypotropia is the opposite of hypertropia, where one eye is positioned lower. Diplopia, or double vision, is a symptom that can occur with various forms of strabismus but is not a type of strabismus itself.

Question 6

A nurse is assessing a 6-month-old infant for signs of strabismus during a routine check-up. The nurse understands that identifying strabismus early is crucial for effective treatment. Which of the following signs would most likely indicate the presence of strabismus in an infant?

A. Consistent eye contact when spoken to
B. Red reflex present in both eyes
C. Eyes that do not follow a moving object together
D. Frequent blinking when exposed to light
E. Pupils that constrict uniformly in response to light

Correct Answer: C. Eyes that do not follow a moving object together

Rationale: In infants, a key sign of strabismus is the inability of the eyes to follow a moving object in unison. This indicates a lack of coordination between the eyes, suggesting misalignment. Consistent eye contact, a red reflex in both eyes, frequent blinking in light, and pupils that constrict uniformly in response to light are all normal findings and do not specifically indicate strabismus.

Question 7

A child with strabismus is undergoing treatment with corrective glasses. The nurse understands that the primary reason for prescribing glasses in cases of strabismus is to:

A. Completely cure the strabismus
B. Correct refractive errors that may be contributing to the strabismus
C. Replace the need for surgical intervention
D. Enhance the cosmetic appearance
E. Strengthen the eye muscles directly

Correct Answer: B. Correct refractive errors that may be contributing to the strabismus

Rationale: Corrective glasses in the treatment of strabismus are primarily prescribed to correct any underlying refractive errors, such as myopia, hyperopia, or astigmatism, that may be contributing to the misalignment of the eyes. While glasses can help in managing strabismus by addressing these errors, they do not directly cure strabismus or strengthen the eye muscles. Surgical intervention may still be necessary in some cases, and the role of glasses is not primarily cosmetic.

Question 8

During a pediatric health screening, a nurse notices that a child exhibits strabismus when focusing on distant objects but not on close ones. This observation suggests which type of strabismus?

A. Intermittent exotropia
B. Constant exotropia
C. Esotropia
D. Hypertropia
E. Intermittent esotropia

Correct Answer: A. Intermittent exotropia

Rationale: Intermittent exotropia is characterized by the outward drifting of an eye that occurs primarily when the individual is focusing on distant objects, but not when looking at close ones. This condition contrasts with constant exotropia, where the eye drifts outward regardless of the distance of the object being focused on. Esotropia involves inward turning of the eye, and hypertropia involves vertical misalignment. Intermittent esotropia would involve the eye turning inward, not outward, and typically under specific conditions or at certain times.

Question 9

A 7-year-old child diagnosed with strabismus is being prepared for surgical correction. Which of the following outcomes is a primary goal of strabismus surgery?

A. To eliminate the need for eyeglasses
B. To improve binocular vision
C. To enhance color perception
D. To increase the field of vision
E. To cure any existing amblyopia

Correct Answer: B. To improve binocular vision

Rationale: The primary goal of strabismus surgery is to improve binocular vision by realigning the eyes. This can enhance depth perception and the overall coordination between the eyes, crucial for normal visual development. Surgery does not eliminate the need for eyeglasses, especially if refractive errors are present. It also does not directly enhance color perception or significantly increase the field of vision. While improving alignment may prevent the worsening of amblyopia, surgery alone does not cure it; amblyopia requires specific treatments like patching or vision therapy to strengthen the weaker eye.

Question 10

A pediatric nurse is providing education to the parents of a child with strabismus regarding the importance of follow-up care. The nurse emphasizes that regular eye exams are crucial for monitoring:

A. The progression of the child’s nearsightedness
B. Changes in the alignment of the eyes over time
C. The development of color blindness
D. Increases in the child’s visual field
E. The need for stronger eyeglass prescriptions

Correct Answer: B. Changes in the alignment of the eyes over time

Rationale: Regular eye exams are crucial for children with strabismus to monitor changes in the alignment of the eyes over time. This allows healthcare providers to adjust treatment plans as needed, whether that involves changes in non-surgical interventions (like patching or glasses) or considering surgical options. While eye exams also monitor for changes in visual acuity and the need for different eyeglass prescriptions, they do not primarily focus on the progression of color blindness or significant changes in the visual field as a result of strabismus treatment.