The mother of a 1-month-old infant states to the examining nurse, ...

[aabwk4]

The mother of a 1-month-old infant states to the examining nurse, There is something wrong with my baby's eyes. She seems to be cross-eyed. What is the most appropriate response by the nurse?
 
  a. I will need to perform a thorough eye examination.
  b. This is not uncommon in infants in their first 2 months of life.
  c. Please try not to overreact. You are new parents and there is much for you to learn.
  d. I will report your concerns to the pediatrician.

Question 2

An older adult's fingernails appear concave and spoon shaped. The nurse associates this observation with:
 
  a. Normal finding in older adults
  b. Chronic lung disease
  c. An iron deficiency
  d. Chronic heart disease

[tennis14576]

Answer to Question 1

B
The most appropriate response by the nurse is to first reassure the parents that this may be normal. Strabismus (crossed-eye) is a condition in which one or both eyes deviate from the object they are looking at. It is normal during the first 1 to 2 months of life. After that, it may be caused by weak intraocular muscles or a lesion on the oculomotor nerve. As this infant is 1 month old, it may be a normal finding. After the nurse offers reassurance, she can then proceed to the eye exam and if any abnormalities are noted, these would be reported to the pediatrician. It is inappropriate to tell new parents not to overreact, as this may make them reluctant to report future findings.

Answer to Question 2

C
A change in nail shape may indicate underlying disease. Spoon-shaped nails may result from iron deficiency. In chronic lung disease, clubbing of the nails may be present due to chronic hypoxia. In heart disease, changes occur with delayed capillary refill time. Spoon-shaped nails are not part of a normal aging process and should be evaluated in the older adult.

[aabwk4]

Thanks for the timely response, appreciate it

[FergA]

Excellent