A nurse is preparing to assess a 4-year-old child's visual acuity. Which of the following actions should the nurse plan to take?

A. The Tumbling E chart is a suitable tool for assessing visual acuity in young children who may not yet know their letters. It uses the letter "E" in various orientations (up, down, left, right), and the child is asked to identify the direction the "E" is facing. This method is appropriate for children who are at least 3 years old and can follow simple directions. B. In a visual acuity assessment, it is typically standard to test each eye separately after assessing both eyes together. Testing both eyes together initially can help gauge how the child performs with their full visual capability, but it’s essential to test each eye individually to accurately determine if there is a difference in visual acuity between the two eyes. C. For a visual acuity test using a standard Snellen chart, positioning the child 4.6 meters (15 feet) away from the chart is correct. However, younger children, especially those who might not be able to focus or remain still at that distance, may sometimes be tested from a shorter distance. For preschool-aged children, the testing distance can be adapted to accommodate their ability to focus and understand the task. D. Testing visual acuity without glasses first is not the recommended approach if the child already wears corrective lenses. If the child uses glasses or other corrective lenses, you should assess their visual acuity with the glasses on, as this provides the most accurate representation of their vision with their current correction.