When screening a 5-year-old for strabismus, which action should the nurse take?

A. Observe the child for blank, sunken eyes. Blank, sunken eyes are not associated with strabismus. These could be signs of other conditions, such as dehydration or severe malnutrition, but they are not relevant for assessing strabismus. B. Inspect the child for the setting-sun sign. The setting-sun sign is more commonly associated with increased intracranial pressure in infants and is not a relevant observation for detecting strabismus in a 5-year-old child. C. Have the child identify colored patterns on polychromatic cards. Identifying colored patterns on polychromatic cards is a test for color vision, not for strabismus. Strabismus involves misalignment of the eyes rather than a problem with color perception. D. Direct the child through the six cardinal positions of gaze. The six cardinal positions of gaze test the alignment and movement of the eyes. The nurse asks the child to follow an object with their eyes as it is moved through these six positions. Any inability of the eyes to maintain proper alignment or any deviation from the expected movement can indicate strabismus. This is an effective and commonly used method to screen for strabismus in children.