During an auditory screening of third graders, the school nurse ...

[codyclark]

During an auditory screening of third graders, the school nurse identifies a hearing deficit for one of the students. When the parents ask the nurse about the findings, the nurse should respond:
 
  1. Hearing acuity is not fully developed in your child. Let's recheck next year.
  2. I'd like to recheck at the clinic. Then we may have to have your child seen by an auditory specialist.
  3. It was too noisy when we were testing, so I wouldn't be concerned if I were you.
  4. Your child will probably need a hearing aid.

Question 2

A kindergarten class is being screened by a group of nursing students using a Snellen E chart. Few of the children have 20/20 vision. Most have 20/30, and some have 20/40. What observation would the nursing students make to their instructor?
 
  1. These children have normal vision abilities.
  2. We should check into the health of these children. Maybe their diet is lacking in essential vitamins since they all have poor eyesight.
  3. These kids will all be wearing glasses when we come back next year.
  4. We should use a different eye chart. Maybe the kids would understand it better.

[annierak]

Answer to Question 1

Correct Answer: 2
Rationale 1: The follow up for these findings should not be postponed.
Rationale 2: Auditory perception is fully developed in school-age children, who are able to identify fine differences in voices, both in sound and pitch. Rechecking the results with a possible referral would be appropriate at this level.
Rationale 3: Auditory testing should be done in a quiet environment or none of the testing is accurate.
Rationale 4: The child's hearing test could be affected by a number of physiological variables (recent respiratory illness or excess cerumen in the ears), and telling the parents their child needs a hearing aid is both premature and not within the nurse's realm of practice.

Answer to Question 2

Correct Answer: 1
Rationale 1: Preschool children are generally farsighted and not able to focus on near objects. By the end of the preschool years, visual ability has improved. Normal vision for the 5-year-old is 20/30.
Rationale 2: Unless there are other concerns, these findings should be considered normal and further investigation would be unnecessary.
Rationale 3: This option does not reflect an understanding of normal physical development of a child.
Rationale 4: The Snellen E chart should be used to assess the preschooler's vision.