On a health history, a client reports no visual disturbances, last eye exam being 2 years ago, and not wearing glasses. The nurse notices that the client squints when signing the consent for treatment form and holds the paper close to the face. What should the nurse do next?

a. document the findings in the client's record
b. perform both the distant and near visual acuity tests
c. test the pupils for direct and consensual reaction to light
d. obtain a referral to the ophthalmologist for a complete eye exam