Peds - Chapter 17: Nursing Care of the Child With a Disorder of the Eyes or Ears
A 7-year-old girl who recently immigrated to the United States from India as a refugee is suffering from night blindness. The nurse recognizes that this condition is caused by a deficiency in which of the following vitamins? a) Vitamin B12 b) Vitamin A c) Vitamin K d) Vitamin C
Vitamin A
The nurse is educating the parents of a 5-year-old girl with infectious conjunctivitis about the disorder. Which information is most important to provide to prevent the spread of the disorder? a) Properly applying the prescribed antibiotic b) Washing hands frequently c) Keeping hands away from eyes d) Staying home from school
Washing hands frequently
When teaching a mother about amblyopia, it would be most important to explain that: a) if the child is not treated, he or she is likely to resent it later on. b) amblyopia can result from a refractive error in one eye. c) amblyopia is correctable if the child is properly treated before 6 years of age. d) amblyopia is a rapid irregular movement of the eye.
amblyopia is correctable if the child is properly treated before 6 years of age.
After conducting vision screening and examination of a preschooler, the nurse suspects amblyopia based on: a) irregular rapid eye movement. b) asymmetric corneal light reflex. c) crossing of the eyes. d) absent red reflex.
asymmetric corneal light reflex.
An infant with poor eye alignment cannot establish single binocular vision but has double vision. The nurse knows that another term for this disorder is: a) diplopia. b) myopia. c) stereopsis. d) hyperopia.
diplopia Diplopia is another name for double vision. Stereopsis is depth perception or the ability to locate an object in space relative to other objects. Myopia is nearsightedness. Hyperopia is farsightedness
The nurse is educating the parents of a 4-year-old boy with strabismus. Teaching for the parents would include the: a) possibility that multiple operations may be necessary. b) importance of patching as prescribed. c) importance of completing the full course of oral antibiotics. d) need for ultraviolet-protective glasses postoperatively.
importance of patching as prescribed.
Vision screening reveals that a child has myopia. The nurse interprets this as: a) light rays being bent unevenly. b) eye and brain are not working together properly. c) farsightedness. d) light rays being focused in front of the retina.
light rays being focused in front of the retina.
The mother of a child with conjunctivitis asks you if her son will develop amblyopia later in childhood because of the infection. You would teach her that amblyopia results from a condition such as: a) conjunctivitis. b) prematurity. c) ptosis. d) eye strain.
ptosis
The nurse is assessing a 13-year-old boy with an eye injury. The nurse determines that evaluating pupillary response to light and accommodation is not appropriate based on the suspicion of a: a) corneal abrasion. b) simple contusion. c) foreign body. d) scleral hemorrhage.
scleral hemorrhage
A child has been diagnosed with bacterial conjunctivitis. Which statements by the child's parent indicate the need for further education? Select all that apply. a) "All of us at home need to wash our hands really well." b) "He can go back to school in 4 hours after that thick yellow drainage is gone." c) "We should not use a towel that he has used." d) "I'll continue to use eye drops to help with the redness." e) "This is really contagious."
• "He can go back to school in 4 hours after that thick yellow drainage is gone." • "I'll continue to use eye drops to help with the redness."
The nurse works in a pediatrician office. Which children, who have been diagnosed with acute otitis media, does the nurse expect the physician to treat with antibiotics? Select all that apply. a) 12-year-old child who reports he has some mild ear pain with a temperature of 101.4° F (38.6° C) b) 2-month-old child who is having difficulty sleeping and has a fever of 102.6° F (39.2° C) c) 22-month-old child who is irritable with the presence of purulent drainage from her right ear d) 5-month-old child who is fussy and pulling at her ears e) 8-year-old child who is crying due to ear pain and has a temperature of 103° F (39.4° C)
• 8-year-old child who is crying due to ear pain and has a temperature of 103° F (39.4° C) • 2-month-old child who is having difficulty sleeping and has a fever of 102.6° F (39.2° C) • 5-month-old child who is fussy and pulling at her ears • 22-month-old child who is irritable with the presence of purulent drainage from her right ear
A 5-year-old girl is diagnosed with amblyopia. What treatment options are available for this child? Select all that apply. a) Covering the bad eye with a patch b) Covering the good eye with a patch c) Administration of levodopa d) Orthoptics e) Lasik surgery to the eye with the refractive error f) Use of correcting lenses (glasses)
• Covering the good eye with a patch • Use of correcting lenses (glasses) • Lasik surgery to the eye with the refractive error • Administration of levodopa
When developing the plan of care for a child with a visual impairment, what would the nurse include? Select all that apply. a) Encouraging the use of self-stimulatory behaviors b) Encouraging activities to stimulate development c) Ensuring that the child's environment is familiar and secure d) Referring the child to early intervention after the age of 5 years e) Using touch and tone of voice to demonstrate affection
• Ensuring that the child's environment is familiar and secure • Encouraging activities to stimulate development • Using touch and tone of voice to demonstrate affection
A nursing student is doing a clinical rotation on a pediatric floor and is learning about normal growth and development. What can impact normal growth and development? Select all that apply. a) Interference with hearing b) Interference with vision c) Education of the father d) Education of the mother e) Number of siblings
• Interference with hearing • Interference with vision
A child diagnosed with conjunctivitis is being seen in the pediatric clinic. Which statements are correct regarding conjunctivitis? Select all that apply. a) It is highly contagious. b) Treatment is symptomatic. c) Warm compresses are used to remove crusts that form on the eyes. d) It is most often caused by a virus. e) Purulent drainage is a common symptom.
• It is highly contagious. • Warm compresses are used to remove crusts that form on the eyes. • Purulent drainage is a common symptom.
A nurse is assessing a toddler who is brought to the clinic by his mother. The mother states, "He's been so irritable lately and I've noticed him frequently pulling on his right ear." The nurse suspects acute otitis media based on which assessment findings? Select all that apply. a) Loss of appetite b) Upper respiratory infection 3 months ago c) Red bulging tympanic membrane d) Low-grade fever e) Mobile eardrum
• Loss of appetite • Red bulging tympanic membrane • Low-grade fever
The pediatric office nurse notes that several of the young children that are waiting to see the physician may have conjunctivitis. Which findings are consistent with bacterial conjunctivitis? Select all that apply. a) There is clear, watery drainage from both eyes. b) The drainage is white. c) Only the right eye is involved. d) The child suffers from seasonal allergies. e) The drainage is yellow and thick.
• Only the right eye is involved. • The drainage is yellow and thick
A nurse is preparing a presentation for a group of parents about vision impairment. When describing the causes, what would the nurse include as a common cause? Select all that apply. a) Amblyopia b) Trauma c) Infantile glaucoma d) Retinopathy of prematurity e) Conjunctivitis f) Refractive error
• Refractive error • Infantile glaucoma • Amblyopia • Retinopathy of prematurity
The young child has been diagnosed with a corneal abrasion. Which findings are most consistent with this diagnosis? Select all that apply. a) The child's pupils are equal, round, reactive to light and accommodation. b) The child has a large purple bruise over the eye and edema on the eyelid. c) The child reports that it hurts to look towards bright light. d) The child's eye is draining clear fluid and the child says it feels like it is full of tears. e) The child denies any eye pain.
• The child's pupils are equal, round, reactive to light and accommodation. • The child reports that it hurts to look towards bright light. • The child's eye is draining clear fluid and the child says it feels like it is full of tears.
A nursing instructor is teaching about eye disorders in childhood. Which statement made by a student indicates a need for further instruction? a) "A cataract is a marked opacity of the lens." b) "Cataracts are only present in adults." c) "Cataracts can be present at birth." d) "Glaucoma is caused by increased intraocular pressure."
"Cataracts are only present in adults."
The nurse is talking with the mother of a 4-year-old son who will soon be going to a prekindergarten program. The child has had the Snellen vision test done at home, and he was unable to distinguish the pictures at the distance that would indicate his vision is normal. The child's mother asks the nurse if he will need glasses. Which statement made by the nurse would be most appropriate regarding the child's vision? a) "He is likely to have a slight astigmatism, which almost always needs to be corrected by glasses." b) "Children's vision is not completely developed by this age. Your child might outgrow this nearsightedness." c) "His vision problem will get in the way of his learning, so he will probably have to have glasses before he starts school." d) "He might be suffering from hyperopia and probably will need glasses now."
"Children's vision is not completely developed by this age. Your child might outgrow this nearsightedness."
The school nurse is educating the parents of a child with infectious conjunctivitis. Which comment provides the most value for prevention? a) "This could have started with a head cold." b) "Don't use anything that touches her face." c) "Place the ointment inside the lower eyelid." d) "Use all the medication as directed."
"Don't use anything that touches her face."
The nurse is obtaining the history from the parents of an infant who is suspected of having infantile glaucoma. Which statement by the parents would help to confirm this suspicion? a) "He opens his eyes quite frequently when he's awake." b) "It seems like bright lights really bother him." c) "His eye looks about the same size as his other eye." d) "His eye doesn't seem to tear much."
"It seems like bright lights really bother him."
The nurse is educating the parents of a premature newborn diagnosed with retinopathy of prematurity. Which comment will be part of the information provided? a) "This can be genetic or acquired." b) "It's an overgrowth of retinal blood vessels." c) "The liquid inside the eye can't drain." d) "This is caused by silver nitrate."
"It's an overgrowth of retinal blood vessels."
The caregiver of a 2 1/2-year-old child tells the nurse, "They told me my daughter has an eye disorder called hyperopia." Which statement made by the mother indicates she has an understanding of this child's current condition? a) "Now I know why when she is working on puzzles she says her eye is sleepy." b) "She has to have glasses right away." c) "She can see better close up than at a distance." d) "At least by the time she gets married maybe she can have contacts."
"Now I know why when she is working on puzzles she says her eye is sleepy."
The nurse is educating a 13-year-old paintball enthusiast about sports-related injuries. Which comments is most likely to be accepted by the child? a) "Play rough, but wear protective gear." b) "56% of paintball eye injuries have poor outcomes." c) "Most sports injuries happen to guys your age." d) "Paintball eye injuries have doubled in the past two years."
"Play rough, but wear protective gear."
The mother of a child having myringotomy tubes placed asks, "Will my son lose his hearing while the tubes are in place?" What is the nurse's best answer? a) "Have you asked your son's physician about that?" b) "There is some risk of permanent deafness, but the benefit of decreasing the infection is worth it." c) "Your son's hearing will decrease while the tubes are in place." d) "The tubes are inserted into a section of eardrum in which the hearing is not affected."
"The tubes are inserted into a section of eardrum in which the hearing is not affected."
A child having myringotomy tubes placed asks, "How and when will the tubes be removed?" What is your best response? a) "The tubes remain in place for 6 months and then are dissolved by vinegar." b) "You will have them replaced every 2 months until you reach age 18." c) "The tubes remain in place for 6 to 12 months until they come out by themselves." d) "The tubes are not removed; they grow permanently into place."
"The tubes remain in place for 6 to 12 months until they come out by themselves."
The nurse is educating the parents of a 7-year-old boy who has hearing loss due to otitis media with effusion. Which statement by the parents indicates that further education is needed? a) "We need to make sure we are speaking clearly." b) "We need to raise the volume of our voices significantly so he can hear us." c) "Using hand gestures as visual cues should help our child understand a little better." d) "We need to face our son when we are speaking."
"We need to raise the volume of our voices significantly so he can hear us."
A 9-year-old boy who is blind is admitted to the hospital. When serving him a meal in bed, which statement would be most appropriate to increase his self-esteem? a) "You have a sandwich on your plate, a glass of milk to your right, and an apple to your left." b) "I have cut your meat for you. Do you need any other help?" c) "Here is your tray; if you need help just call me." d) "I'll have to feed you lunch; spaghetti is very messy."
"You have a sandwich on your plate, a glass of milk to your right, and an apple to your left."
An infant is born with congenital glaucoma. She is scheduled for surgery to relieve this condition at age 2 days. Which preoperative order would you question for her? a) A preoperative antibiotic b) A preoperative injection of atropine c) Nothing by mouth (with intravenous therapy) prior to surgery d) Arm restraints to be applied after surgery
A preoperative injection of atropine
During physical assessment of a 2-year-old child, the nurse becomes concerned that the child may have a cataract in one eye. Which sign or symptom suggests the child has a cataract? a) Absence of the red reflex b) Sclera appears to be blue c) Edema of the eyelids d) Excess watering of the eyes
Absence of the red reflex
The nurse is caring for a 6-year-old boy with sensorineural hearing loss. Which is the least likely cause of the child's hearing loss? a) Acute otitis media b) Ototoxic medication use c) Excess noise exposure d) Intrauterine exposure to rubella
Acute otitis media
The nurse is caring for a 10-year-old girl with acute periorbital cellulitis. Which nursing intervention (therapy) is primary for this disorder? a) Monitoring for increased intracranial pressure b) Administering morphine sulfate as ordered c) Administering antibiotics IV as ordered d) Applying heated aqua pad to site
Administering antibiotics IV as ordered
The nurse is caring for a 20-month-old girl with equivocal bacterial otitis media, a severe earache, and a temperature of 39° C (102.2° F). Which intervention would the nurse expect to implement? a) Obtaining a culture of fluid from the middle ear b) Administering antivirals to ensure broad coverage of all organisms c) Administering antibiotics as soon as they're available d) Determining if the girl's balance is shaky when walking
Administering antibiotics as soon as they're available
A mother brings her school-age child to the clinic for a check-up. She precedes to tell the nurse that the patient is getting bad grades in school and has trouble focusing on what is on the page while reading. Upon performing an eye examination, the nurse notices that the patient has one eye that wanders. What does the nurse suspect that this patient may have? a) Coloboma b) Amblyopia c) Nystagmus d) Color blindness
Amblyopia
The nurse is screening a 4-year-old girl for vision problems. What problem could result in loss of vision? a) Amblyopia b) Exotropia c) Nystagmus d) Diplopia
Amblyopia
The nurse is discussing communication options with the parents of a 2-year-old girl with congenital hearing loss. The nurse integrates knowledge of what form of communication as having no verbal component? a) Oral deaf education b) Cued speech c) Total communication d) American Sign Language
American Sign Language
Which situation would cause the nurse to become concerned about possible hearing loss? 1. A 12-month-old who babbles incessantly, making no sense. 2. An 8-month-old who says only "da". 3. A 3-month-old who startles easily to sound. 4. A 3-year-old who drops the letter "s".
An 8-month-old who says only "da".
The nurse is preparing a nursing care plan for a 2-year-old child with hearing impairment. Which intervention will be part of the plan? a) Teach parents to make vinegar and alcohol eardrops. b) Assess vision to determine functional capability. c) Assess the child's ability to convey information. d) Explain botulinum injection procedure and risks.
Assess the child's ability to convey information.
The nurse is caring for a 24-month-old boy with regressed retinopathy of prematurity. Which intervention is priority for this child? a) Observing for rubbing, shutting the eyes, or squinting b) Assessing the child for asymmetric corneal light reflex c) Referring the child to the local district of early intervention d) Teaching the parents to check how the child's glasses fit
Assessing the child for asymmetric corneal light reflex
The nurse is caring for a 24-month-old boy with regressed retinopathy of prematurity. Which intervention is priority for this child? a) Teaching the parents to check how the child's glasses fit b) Assessing the child for asymmetric corneal light reflex c) Observing for rubbing, shutting the eyes, or squinting d) Referring the child to the local district of early intervention
Assessing the child for asymmetric corneal light reflex
The nurse is assessing the vision of 9-year-old boy. His vision appears normal on a vision screening test, although the nurse notices that he has to tilt his head occasionally as he is reading the chart. His mother tells the nurse that he has trouble reading and reports having a headache after doing his homework. Which condition should the nurse suspect in this boy? a) Amblyopia b) Nystagmus c) Myopia d) Astigmatism
Astigmatism
The nurse is teaching a group of parents about eyes and eye concerns. The nurse tells these caregivers about a condition that occurs when unequal curvatures in the cornea bend the light rays in different directions and this causes images to be blurred. The condition the nurse is referring to is: a) Hyperopia b) Myopia c) Astigmatism d) Refraction
Astigmatism
The nurse is teaching parents of a 6-year-old child about otitis media (OM). What predisposes the child to OM infections? a) The use of cotton swabs, which can damage the eardrum b) Eustachian tubes that are long and narrow in children c) Bacteria entering through the eustachian tube d) Swimming and other water activities
Bacteria entering through the eustachian tube
If the child is following a normal development process, visual acuity gradually increases from birth. What is most accurate regarding the age children develop 20/20 vision? a) Children usually develop 20/20 vision by 7 years of age. b) Most children do not develop 20/20 vision until about 18 years of age. c) Most children develop 20/20 vision by 2 years of age. d) A few children develop 20/20 vision by 4 years of age.
Children usually develop 20/20 vision by 7 years of age.
A 12-year-old boy with color blindness asks his nurse what causes this condition. The nurse should explain to him that which of the following eye structures are genetically absent? a) Retinas b) Rods c) Lenses d) Cones
Cones It occurs in 4-8% of boys because one of the sets of cones of the retina that perceive red, green, or blue is absent.
A young child in the clinic has watery eyes and reddened conjunctiva. The child keeps the eyes closed a lot, because it hurts to have them open. Which problem does the nurse suspect for this client? a) Chalazion b) Stye c) Blepharitis marginalis d) Conjunctivitis
Conjunctivitis
The nurse is explaining information to the parents of a 3-year-old boy who may have strabismus. The nurse should explain that which examinations will be performed first to find out if he has strabismus? a) Visual acuity test b) Ophthalmologic examination c) Corneal light reflex test d) Refractive examination
Corneal light reflex test
The nurse is performing a physical assessment of a 9-month-old child who has been rubbing his eyes. Which of the following findings suggests the possibility of glaucoma? a) White, opaque appearance of the lens b) Copious, purulent drainage c) Absence of the red reflex d) Different pupil sizes
Different pupil sizes
In children with otitis media, a procedure known as a myringotomy may be performed. Which statement is most accurate regarding this procedure? a) During this procedure, small tubes are inserted into the typmpanic membrane. b) The purpose of this procedure is to decrease or stop the drainage. c) This procedure is performed as soon as otitis media is diagnosed. d) A small incision is made in the earlobe during this procedure.
During this procedure, small tubes are inserted into the typmpanic membrane.
The nurse is caring for a 7-year-old girl in an outpatient clinic diagnosed with amblyopia that is unrelated to any other disorder. Which intervention should be most helpful at this time? a) Ensuring follow-up visits with the ophthalmologist b) Educating parents on how to use prescribed atropine drops c) Discouraging the child from roughhousing d) Explaining postsurgical treatment of the eye
Educating parents on how to use prescribed atropine drops
A child is being prepared for discharge after sustaining a simple contusion of the eye. Which advice would the nurse expect to include in the discharge instructions? a) Tell the parents that although the condition is frightening, no intervention is needed. b) Teach the parents how to apply ophthalmologic antibiotic ointment properly. c) Inform the parents to call their pediatrician if the bruising persists for more than 2 days. d) Encourage the parents to apply ice to the area for 20 minutes at a time for the first 24 hours.
Encourage the parents to apply ice to the area for 20 minutes at a time for the first 24 hours.
The nurse is teaching the family of a 6-year-old boy with allergic conjunctivitis how to minimize his exposure to allergens. What action would the nurse anticipate as being most difficult for the family to implement? a) Making sure the child showers and shampoos before bedtime b) Encouraging the child to keep his hands away from his eyes c) Rinsing the child's eyelids with a clean washcloth and cool water d) Washing the child's hands and face when returning from outdoors
Encouraging the child to keep his hands away from his eyes
The nurse is teaching parents of a 9-year-old girl about the importance of wearing the prescribed glasses. Which subject is least important to promoting compliance? a) Encouraging the use of eye protection for sports b) Checking condition and fit of glasses monthly c) Getting scheduled eye examinations on time d) Watching for signs that prescription needs changing
Encouraging the use of eye protection for sports
The nurse is providing immediate postoperative care for a 3-month-old who had a cataract removed. Which intervention would be the priority? a) Explaining to the parents about patching the eye as therapy b) Instructing parents about using protective sunglasses c) Ensuring the protective eye patch is securely in place d) Teaching the family how to use antibiotic eye drops
Ensuring the protective eye patch is securely in place
Hearing aids can improve hearing for children who have inner ear or nerve deafness. a) True b) False
False
Regular use of cotton-tipped applicators to clean the ears is recommended. a) False b) True
False
The nurse is caring for an 8-year-old boy with otitis media with effusion. Which situation may have caused this disorder? a) He frequently goes swimming. b) He has good attendance at school. c) He had recent bacterial conjunctivitis. d) He is experiencing recurrent nasal congestion.
He is experiencing recurrent nasal congestion.
The nurse is caring for an 11-year-old with otalgia and fever. When reviewing the child's medical record, which factor would place the client at risk for acute otitis media? a) She lives with her parents and older sister. b) She had a first episode of acute otitis media 3 months ago. c) Child was breastfed, not bottle-fed. d) Her mother has had recurrent otitis media.
Her mother has had recurrent otitis media.
A 1-year-old comes to the clinic for a routine visit. The eye examination reveals an enlarged, edematous, and hazy cornea. The child appears sensitive to light. What should the nurse suspect? a) Cataract b) Stye c) Conjunctivitis d) Infantile glaucoma
Infantile glaucoma
An 8-year-old boy comes to the emergency room with an eye injury after having a glass bottle shatter near his face. Which intervention should the nurse do first while assisting this client? a) Press firmly on the lower lid with the fingertip until it turns out b) Grasp the eyelashes of the upper eyelid and evert it c) Instill a few drops of a topical anesthetic into the affected eye d) Touch the glass fragment in the eye with a moistened, sterile, cotton-tipped applicator
Instill a few drops of a topical anesthetic into the affected eye
The nurse is caring for a child who has conductive hearing loss. What is true regarding this type of hearing loss? a) It is often undetected until the child goes to school. b) It is generally severe and unresponsive to medical treatment. c) It is caused by maternal rubella. d) It is caused by chronic otitis media or another infection
It is caused by chronic otitis media or another infection
A child returns to the clinic after an episode of otitis externa, which has resolved. What would the nurse emphasize as the priority for preventing future episodes? a) Avoiding upper respiratory tract infections b) Performing hand washing c) Keeping ear canals dry d) Adhering to regular follow-up to assess for hearing loss
Keeping ear canals dry
In examining the vision of a 9-year-old girl, the nurse notices that she frequently reaches either too far or not far enough when attempting to take an object from the nurse's hand. Which conditions does the nurse suspect in this child? a) Refractive error b) Lack of depth perception (stereopsis) c) Diplopia d) Lack of accommodation
Lack of depth perception (stereopsis)
The nurse is teaching the parents of a visually impaired baby about development potential for their child. Which learning function is unique to sight-impaired children? a) Learning how to participate in a group b) Learning to dress, feed, and bathe themselves c) Learning physical fitness skills d) Learning to use facial expressions
Learning to use facial expressions
The nurse is teaching a class on children's eye and ear safety to a group of parents. Which of the following would the nurse describe as most likely causing the greatest difficulty related to child compliance? a) Requiring the use of safety gear for sports activities b) Limiting time and volume when using earphones listening to music c) Teaching children safety around the home d) Supervising children during play
Limiting time and volume when using earphones listening to music
A nurse is assessing a child's vision. Which test should the nurse use to test for accommodation? a) Performing a Weber test b) Having the child touch the fly's wings in an image constructed of colored dots c) Performing Hirshberg's test d) Moving a penlight toward the client's nose and observing whether his eyes can follow it
Moving a penlight toward the client's nose and observing whether his eyes can follow it
The vision impairment seen in a child in which the child can see objects at close range but not at a distance is known as: a) Myopia b) Hyperopia c) Estropia d) Exotropia
Myopia
A nurse is giving instructions to the parents of a girl with otitis media with effusion who has just undergone placement of myringotomy tubes in her ears. Which of the following should she mention to the parents? a) Encourage the child to swim for exercise b) Notify the school nurse of the child's condition c) Have the child shower rather than bathe d) Use cotton-tipped applicators to clean around the tubes
Notify the school nurse of the child's condition
The nurse is preparing an ongoing assessment plan for a child with multiple sensory disorders. What will best contribute to the detection and intervention of problems? a) Behavioral assessments as scheduled by the school b) Behavioral assessments when problems occur c) Ongoing parental assessments of their child's capabilities d) Physical assessments when the child is sick or hurt
Ongoing parental assessments of their child's capabilities
A 4-year-old complains of extreme pain when the tragus is touched. Though not diagnostic, this sign is most indicative of which disorder? 1. Acute otitis media. 2. Acute tympanic effusion. 3. Otitis interna. 4. Otitis externa.
Otitis externa.
A 2-year-old has been prescribed eye patching for strabismus 6 hours per day. What teaching does the nurse provide for the mother? 1. Try to patch 6 hours per day, but if you miss some it is OK. 2. Patching is necessary to strengthen vision in the weaker eye. 3. Patching will keep the eye from turning in. 4. Since the child is so young, patching can be delayed until school age.
Patching is necessary to strengthen vision in the weaker eye.
The nurse is caring for an infant who has undergone surgery for infantile glaucoma. What is the priority nursing intervention? 1. Place the child prone postoperatively for comfort. 2. Teach the family use of the contact lens. 3. Place elbow restraints on the infant. 4. Provide a mobile for optical stimulation.
Place elbow restraints on the infant.
The nurse is educating the parents of a 6-year-old child about preventing hearing loss. Which will be included in the discussion? a) Tendency to act silly in the classroom b) Prevention and treatment of otitis media c) Playing the radio loudly d) Suddenly doing poorly in school
Prevention and treatment of otitis media
The nurse is caring for a 2-year-old girl with persistent otitis media with effusion. Which intervention is most important to the developmental health of the child? a) Informing the parents to avoid nonprescription drugs b) Telling parents not to smoke in the house c) Educating the parents about proper antibiotic use d) Reassessing for language acquisition
Reassessing for language acquisition
The nurse is taking a health history for a 9-year-old with conjunctivitis. Which finding would suggest that this is allergic conjunctivitis? a) Exposure to infective agents b) Recently helped clean the basement c) Recent upper respiratory infection d) Family history of conjunctivitis
Recently helped clean the basement
The nurse is assessing a child with a hordeolum. Which finding would the nurse be least likely to observe? a) Eyelid edema b) Lesion along the lid margin c) Pain d) Reddened conjunctiva
Reddened conjunctiva
A 5-year-old is diagnosed with acute otitis media. Which nursing intervention would be primary? a) Cautioning the child not to pull on the ear b) Administration of a mydriatic c) Cautioning the child not to blow the nose d) Relief of pain
Relief of pain
The nurse is caring for a 6-month-old infant diagnosed with otitis media. Which clinical manifestation would likely have been noted in this child? a) Body stiffening and loss of consciousness b) Shaking the head and pulling the ear c) Severe vomiting and confusion d) High-pitched cry and nuchal rigidity
Shaking the head and pulling the ear
A nurse is preparing a presentation for a group of parents who have children with significant visual impairment. Which action would the nurse be least likely to include as an example of a self-stimulatory action? a) Head banging b) Rocking c) Spinning d) Shouting
Shouting
A group of students are reviewing the various causes of bacterial conjunctivitis in children. The students demonstrate understanding of this condition when they identify what as the most common cause? a) Staphylococcus aureus b) Haemophilus influenzae c) Chlamydia trachomatis d) Streptococcus pneumoniae
Staphylococcus aureus
A young child in the clinic reports pain and has redness on the lid of the right eye. Upon further examination, the nurse notices swelling in the preauricular lymph node along with tenderness. What should the nurse suspect? a) Chalazion b) Conjunctivitis c) Stye d) Cellulitis
Stye
A child has recently been diagnosed with cataracts. The treatment for cataracts is: a) Eye drops to lower the pressure b) Surgery c) Wearing a patch until the cloudiness clears d) There is no treatment for childhood cataracts
Surgery
The nurse is performing a physical assessment for an 8-year-old with an earache. Which sign or symptom indicates acute otitis externa? a) The child cries out when the ear is grasped. b) Symptoms of upper respiratory infection are present. c) The ear canal is devoid of cerumen. d) The tympanic membrane reacts to a puff of air.
The child cries out when the ear is grasped.
The nurse is discussing the ears and hearing in a child with a group of peers. Which statement is most accurate related to this topic? a) The eardrum is located between the middle and the internal ear. b) Most children do not have acutely developed hearing until the age of 5 years. c) The eustachian tube in the infant is straighter and wider than in the adult. d) The infant usually responds to sounds around the age of 6 months.
The eustachian tube in the infant is straighter and wider than in the adult.
A mother asks you if there is any way to prevent acute otitis media. What would the nurse state to the mother? a) The frequency of otitis media is reduced in breastfed infants. b) Prophylactic acetic acid instillations may be helpful. c) Prophylactic myringotomy tubes can be inserted at birth. d) Beginning immunizations at birth rather than age 2 months might help.
The frequency of otitis media is reduced in breastfed infants.
The nurse is teaching a parent how to medicate her 1-year-old child with corticosteroid eye drops. Which of the following instructions will be included? a) Visual therapy will begin in one week. b) Give the medication on an empty stomach. c) The ophthalmologist must be seen as scheduled. d) Elbow restraints are needed until healing is complete.
The ophthalmologist must be seen as scheduled.
The nurse is performing a physical assessment on a 6-week-old infant. Which sign or symptom suggests glaucoma? a) The eyes are red and watering b) Edema is present in the eyelids c) There is no red reflex d) The right eye appears larger than the left
The right eye appears larger than the left
The nurse recognizes that if the infant is following normal development, the infant will be able to focus and follow an object with the eyes by what age? a) Seven days of age b) One month of age c) Twenty-one days of age d) Two months of age
Two months of age
A 10-year-old boy has just been treated for otitis externa and now the nurse is teaching the boy and his parents about prevention. Which recommendation should the nurse include? a) Using cotton swabs to keep the inner ear dry b) Washing the hair only when necessary c) Using a hair dryer on cool to dry the ears d) Using alcohol and vinegar for soreness
Using a hair dryer on cool to dry the ears
