A nurse on an outpatient unit is assisting in caring for an adolescent who sustained an eye injury 1 month ago. Which of the following findings indicates the child's condition has not improved?

Choice A rationale Visual acuity measuring 20/70 previously compared to a current reading of 20/30 indicates a significant improvement in the child's ability to see objects clearly from a distance. The Snellen chart interpretation shows the child can now see at 20 feet what a person with normal vision sees at 30 feet, whereas before they needed to be at 20 feet to see what others see at 70 feet. This recovery of function suggests healing of the ocular structures. Choice B rationale When the injury site area is congruent with the child's natural skin tone, it suggests that the inflammatory response has subsided and bruising or erythema has resolved. Normal skin color indicates adequate perfusion and the absence of active infection or chronic inflammation in the periorbital tissues. If the condition were not improving, one would expect to see persistent discoloration, swelling, or even purulent drainage from the initial site of the traumatic eye injury. Choice C rationale A pain rating of 7 on a scale of 1 to 10 indicates severe persistent discomfort one month after the initial injury occurred. Chronic or worsening pain in an injured eye can signal complications such as increased intraocular pressure, secondary infection, or internal structural damage that has not healed correctly. Normal pain levels one month post-injury should be minimal or zero. This finding is a clear clinical indicator that the child's physiological condition is not improving. Choice D rationale An oral temperature of 37.1 degrees Celsius (98.8 degrees Fahrenheit) and a radial pulse of 74 beats per minute are both within the expected reference ranges for an adolescent. Normal body temperature typically ranges from 36.4 to 37.6 degrees Celsius, and a resting pulse for this age group is usually between 60 and 90 beats per minute. These stable vital signs suggest the absence of a systemic inflammatory response or a generalized infection related to the eye.