A 35-year-old lawn maintenance worker reports "something in my eye." What should the nurse practitioner do first?

In the scenario presented, the most immediate and appropriate action for the nurse practitioner would be to assess the patient's visual acuity and test the visual field. This step is critical to determine the extent of any visual impairment and identify potential damage to the eye caused by the foreign object.

Testing the visual field helps to establish a baseline of the patient's vision before further interventions or referrals are made. Given that the patient is reporting "something in my eye," it’s essential to first ascertain whether there is any compromise to their vision and to rule out serious conditions, such as corneal abrasions or more severe ocular injuries. Understanding the nature and the severity of the visual field impact is crucial in guiding subsequent management steps, such as whether fluorescein staining or referral to an ophthalmologist is warranted.

Following the assessment of visual fields, appropriate interventions can be made based on the findings. This rationale supports the rationale that evaluating visual function is paramount when dealing with possible ocular trauma.