EENT MCQs

A 7-year-old male presents with loud snoring for one year and associated hyperactivity and poor school performance. His parents also snore loudly. His BMI is in the 99th percentile, and adenotonsillar hypertrophy is noted on exam. Polysomnography shows an apnea-hypopnea index (AHI) of 20. Which of the following is the most common complication after surgery for this patient's condition? A. Bleeding B. Poor oral intake C. Postoperative nausea and vomiting D. Velopharyngeal insufficiency

A Tonsillectomy is a surgical procedure performed with or without adenoidectomy that completely removes the tonsil. The most common complication after adenotonsillectomy is bleeding.

The parent of a child having tympanoplasty tubes placed asks, "Will my child lose hearing while the tubes are in place?" What is the nurse's best answer? A. "The tubes are inserted into a section of eardrum in which the hearing is not affected." B. "There is some risk of permanent deafness, but the benefit of decreasing the infection is worth it." C. "Your child's hearing will decrease while the tubes are in place." D. "Have you asked your child's surgeon about that?"

A Tymanostomy tubes help to ventilate the cavities of the middle ear and balance the pressure on each side of the tympanic membrane..Tympanoplasty tubes do not interfere with hearing because they are inserted into a portion of the tympanic membrane that is not instrumental to hearing. There is no risk of permanent deafness and hearing will be increased while the tubes are in place, not decreased.

Screening for and treating for amblyopia is critical to appropriate visual acuity development. A. True B. False

True Visual development must be balanced between the eyes in the early years in order to achieve proper and equal visual acuity in both eyes. Eye patch can be used to achieve balance in both eyes.

Strabismus will lead to visual impairment if not treated. A. True B. False

True Strabismus results in unequal visual acuity between the eyes and may lead to lifelong visual impairment.

The nurse is assessing a 5-month-old infant. What would cause the nurse to be concerned about a possible visual impairment? A. The infant can "fix and follow." B. The infant does not imitate facial expressions. C. The infant makes eye contact. D. The infant blinks quickly when a bright light is shone in the eyes.

B Infants who have visual impairments may not "fix and follow," do not make eye contact, are unaffected by bright light, and do not imitate facial expressions.

The nurse is performing a physical assessment for an 8-year-old child with an earache. Which sign or symptom indicates external otitis (acute otitis externa or swimmer's ear)? A. Symptoms of upper respiratory infection are present. B. The child cries out when the ear is grasped. C. The ear canal is devoid of cerumen. D. The tympanic membrane reacts to a puff of air.

B The most notable symptom of acute otitis externa is throbbing and severe pain. The child often will not even allow the examiner to touch the ear.

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. Refraction B. Myopia C. Astigmatism D. Hyperopia

C Astigmatism is caused by unequal curvatures in the cornea that bend the light rays in different directions and produce a blurred image. Refraction is the way light rays bend as they pass through the lens to the retina. Myopia is nearsightedness; hyperopia is farsightedness.

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. Conjunctivitis D. Blepharitis marginalis

C Conjunctivitis is inflammation of the conjunctiva and is demonstrated by watery eyes with reddened conjunctiva and sensitivity to light. Sticking of eyelids with pustular drainage is also a sign. It is very contagious

A 5-year-old child is diagnosed with acute otitis media. Which nursing intervention would be priority? A. Relieving the child's pain B. Administering a mydriatic C. Cautioning the child not to pull on the ear D. Cautioning the child not to blow the nose

A Acute otitis media is caused by a bacterial or viral infection of fluid in the middle ear. The fluid behind the eardrum has difficulty draining back out because of the horizontal positioning of the eustachian tube. This causes increased pain. Antibiotics are prescribed to cure the infection. Children need pain relief until the antibiotic prescribed reduces the inflammation and pressure. Children pull on the ear as an attempt to reduce the pain and equalize the pressure. Pulling on the ears, especially in an infant, is one of the first signs the parent sees to warn of the ear infection. Blowing the nose is also an attempt by the child to equalize the pressure in the ear and help reduce the pain. A mydriatic is a drug that induces dilation of the pupils.

The vision impairment in which the child can see objects at close range but not at a distance is known as: A. Myopia B. Hyperopia C. Esotropia D. Exotropia

A Myopia is nearsightedness, which means that the child can see objects clearly at close range but not at a distance. It occurs because the light entering the eye focuses in front of the retina. Hyperopia is farsightedness. Esotropia is better known as "cross-eyed." It is a form of strabismus in which one or both eyes focus inward. Exotropia is a form of strabismus where the eyes are deviated outward.

The nurse is performing a physical assessment for an 8-year-old child with an earache. Which sign or symptom indicates external otitis (acute otitis externa or swimmer's ear)? A. The tympanic membrane reacts to a puff of air. B. Symptoms of upper respiratory infection are present. C. The ear canal is devoid of cerumen. D. The child cries out when the ear is grasped.

D External otitis (acute otitis externa or swimmer's ear) is an infection and inflammation of the skin of the external ear canal. The classic sign of external otitis is pain on movement of the pinna or pain on pressure over the tragus. Upon examination, the ear canal is red and swollen. Many times the tympanic membrane cannot be visualized because the swelling does not allow the insertion of an otoscope.

The longer, more downward-directed position of the Eustachian tube places younger children at higher risk for ear infections. A. True B. False

False Opposite! It's shorter and more straight, which places younger children at higher risk for ear infections.

Recurrent otitis media does not affect language development in infants and toddlers. A. True B. False

False Untreated otitis media can lead to conductive hearing loss, which may lead to delayed language development, especially in the younger children.

Chronic otitis media may require treatment with pressure-equalizing tube (tympanostomy) placement. A. True B. False

True Frequent or unresolved otitis media may require tympanostomy tube (pressure equalizing tube) to remove excess drainage.