A nurse is collecting data from a school-age child who reports difficulty seeing the chalk board in the front of the classroom. Which of the following tests should the nurse assist with performing?

A. Ask the child to find numbers on Ishihara plates is incorrect because Ishihara plates are used to screen for color vision deficiencies, not visual acuity. Difficulty seeing the chalkboard relates to distance vision, which Ishihara testing does not assess. B. Ask the child to identify items in a book is incorrect because identifying items in a book evaluates near vision. The child’s difficulty is with seeing distant objects (the chalkboard), so this test would not address the reported problem. C. Instruct the child to track items in the room is incorrect because tracking items assesses eye coordination, smooth pursuit, and visual-motor integration. While important for overall vision assessment, it does not measure distance visual acuity, which is the likely cause of the child’s difficulty seeing the chalkboard. D. Instruct the child to identify letters on a Snellen eye chart is correct because the Snellen chart is the standard tool for assessing distance visual acuity. Difficulty seeing the chalkboard suggests a refractive error, such as myopia (nearsightedness), which would be detected using the Snellen chart. The nurse can assist by ensuring proper chart placement (20 feet away), having the child cover one eye at a time, and recording the smallest line of letters the child can read accurately.