NCLEX CH 17 eyes,ear

The nurse is educating the parents of a 7-year-old boy who has hearing loss due to otitis media with effusion. Which of the following statements by the parents indicates that further education is needed? Using hand gestures as visual cues should help our child understand a little better." "We need to raise the volume of our voices significantly so he can hear us." "We need to face our son when we are speaking." "We need to make sure we are speaking clearly."

"We need to raise the volume of our voices significantly so he can hear us." It is not necessary for the parents to raise their voices more than slightly in order to be heard.

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 of the following interventions would the nurse expect to implement? Obtaining a culture of fluid from the middle ear Administering antivirals to ensure broad coverage of all organisms Determining if the girl's balance is shaky when walking Administering antibiotics as soon as they're available

Administering antibiotics as soon as they're available Because of the severity of the symptoms, the child will be treated with antibiotics immediately. This decision is based on the clinical practice guideline developed by the American Academy of Pediatrics and American Academy of Family Physicians. This clinical practice guideline helps to eliminate the need for obtaining middle ear fluid for culture.

The nurse is screening a 4-year-old girl for vision problems. Which of the following problems could result in loss of vision? Amblyopia Nystagmus Exotropia Diplopia

Amblyopia, if untreated, will get worse in the poorer eye and will cause strain on the better eye, which may also lead to worsening of acuity in that eye. Eventually blindness will result in one or both eyes.

After conducting vision screening and examination of a preschooler, the nurse suspects amblyopia based on which of the following? Crossing of the eyes Irregular rapid eye movement Absent red reflex Asymmetric corneal light reflex

Asymmetric corneal light reflex Asymmetry of the corneal light reflex may be the only sign of amblyopia in a preverbal child. Eyes not facing in the same direction suggest strabismus. Very rapid, irregular eye movement suggests nystagmus. An absent red reflex is suggestive of congenital cataract.

A child is being prepared for discharge after sustaining a simple contusion of the eye. Which instruction would the nurse expect to include in the discharge instructions to the parents? Tell the parents that although the condition is frightening, no intervention is needed. Inform the parents to call their pediatrician if the bruising persists for more than 2 days. Teach the parents how to apply ophthalmologic antibiotic ointment properly. Encourage parents to apply ice to the area for 20 minutes at a time for the first 24 hours.

Encourage parents to apply ice to the area for 20 minutes at a time for the first 24 hours. To decrease the edema of a simple contusion, the parents should be instructed to apply an ice pack to the area for 20 minutes, then remove it for 20 minutes, continuing to repeat this cycle as often as possible during the first 24 hours.

When developing the plan of care for a child with a visual impairment, which of the following would the nurse include? Select all that apply. Encouraging activities to stimulate development Using touch and tone of voice to demonstrate affection Referring the child to early intervention after the age of 5 years Encouraging the use of self-stimulatory behaviors Ensuring that the child's environment is familiar and secure

Encouraging activities to stimulate development Using touch and tone of voice to demonstrate affection Ensuring that the child's environment is familiar and secure When caring for a child with a visual impairment, the nurse would ensure that the child's environment provides familiarity and security. The nurse would also encourage the parents to use activities to stimulate the child's development and use touch and tone of voice to demonstrate affection. The nurse would work with the parents to plan a strategy for the development of alternative behaviors specific to the child to minimize the use of self-stimulatory behaviors. Children younger than 3 years of age should be referred to early intervention to establish case management services for the child's developmental needs.

The nurse is teaching the family of a 6-year-old boy with allergic conjunctivitis how to minimize his exposure to allergens. Which of the following would the nurse anticipate as being most difficult for the family to implement? Washing the child's hands and face when returning from outdoors Making sure the child showers and shampoos before bedtime Encouraging the child to keep his hands away from his eyes Rinsing the child's eyelids with a clean washcloth and cool water

Encouraging the child to keep his hands away from his eyes Keeping a 6-year-old child's hands away from his face is a difficult task, particularly when he is playing by himself or is at school.

The nurse is providing immediate postoperative care for a 3-month-old who had a cataract removed. Which of the following interventions would be the priority? Ensuring the protective eye patch is securely in place teaching the family how to use antibiotic eye drops Explaining to the parents about patching the eye as therapy Instructing parents about using protective sunglasses

Ensuring the protective eye patch is securely in place The priority intervention is to protect the operative site with an eye patch

The nurse is caring for an 11-year-old with otalgia and fever. When reviewing the child's medical record, which of the following would the nurse identify as a risk factor for acute otitis media? Her mother has had recurrent otitis media. She lives with her parents and older sister. She had a first episode of acute otitis media 3 months ago. Child was breastfed, not bottle-fed.

Her mother has had recurrent otitis media. A positive family history of acute otitis media, as evidenced by the report that her mother has had recurrent otitis media, is a risk factor.

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? "His eye doesn't seem to tear much." "It seems like bright lights really bother him." "His eye looks about the same size as his other eye." "He opens his eyes quite frequently when he's awake."

It seems like bright lights really bother him." Photophobia occurs with infantile glaucoma, so bright light may bother the infant.

Vision screening reveals that a child has myopia. The nurse interprets this as which of the following? Eye and brain are not working together properly Light rays being bent unevenly Light rays being focused in front of the retina Farsightedness

Light rays being focused in front of the retina When the light entering the eye focuses in front of the retina, it results in myopia or nearsightedness. Amblyopia results when the vision in one eye is reduced because the eye and brain are not working together properly.Astigmatism involves light rays being refracted or bent unevenly due to an uneven curvature of the cornea.Farsightedness or hyperopia involves light rays being focused behind the retina.

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? Teaching children safety around the home Supervising children during play Limiting time and volume when using earphones listening to music Requiring the use of safety gear for sports activities

Limiting time and volume when using earphones listening to music Parents will have the most difficulty getting their child to comply with an appropriate volume and exposure time when they listen to music with earphones. Often the child will engage in this activity alone, without adult supervision.

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 assessment of which of the following? Select all that apply. Loss of appetite Red bulging tympanic membrane Low-grade fever Mobile eardrum Upper respiratory infection 3 months ago

Loss of appetite Red bulging tympanic membrane Low-grade fever Manifestations of acute otitis media include fever (low-grade or higher); dull or opaque, bulging or red tympanic membrane; loss of appetite or poor feeding; immobile eardrum; and recent upper respiratory infection.

The nurse is assessing a child with a hordeolum. Which of the following would the nurse be least likely to observe? Eyelid edema Pain Reddened conjunctiva Lesion along the lid margin

Reddened conjunctiva The conjunctiva is clear with a hordeolum. Eyelid edema is present with a hordeolum. A hordeolum is usually painful. A hordeolum may be visible as an enlarged lesion along the lid margin.

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 which of the following? Scleral hemorrhage Foreign body Simple contusion Corneal abrasion

Scleral hemorrhage appears as erythema in the sclera and can be quite large initially, but vision is unaffected by it.

A nurse is preparing a presentation for a group of parents who have children with significant visual impairment. Which of the following would the nurse be least likely to include as an example of compensatory self-stimulatory behaviors? SPINNING SHOUTING HEAD BANGING ROCKING

Shouting would not be considered an example of a self-stimulatory behavior or blindism. ALL THE OTHERS ARE

A group of students are reviewing the various causes of bacterial conjunctivitis in children. The students demonstrate understanding of this condition when they identify which of the following as the most common cause? Haemophilus influenzae Chlamydia trachomatis Streptococcus pneumoniae Staphylococcus aureus

Staphylococcus aureus S. aureus is the most common bacterial cause of conjunctivitis.

The nurse is discussing communication options with the parents of a 2-year-old girl with congenital hearing loss. The nurse integrates knowledge of which of the following as having no verbal component? Cued speech Total communication American Sign Language Oral deaf education

aNSWER: American Sign Language is entirely communicated through hand signs, gestures, and facial expression. It has its own grammar and syntax. Cued speech is a system using hand signs to clarify lip-reading. It gives the person clues about the sounds the speaker is making.Total communication combines auditory training and teaching spoken language with signing exact English, which corresponds to the words and syntax of English.Oral deaf education uses technology to boost auditory potential and teaches children to notice sound and give it meaning. It helps develops oral speech.

A nurse is preparing a presentation for a parent group about ear infections. The nurse would identify the highest incidence of acute otitis media as occurring during which time? summer fall spring winter

winter Acute otitis media occurs mostly in the fall through the spring, with the highest incidence in the winter.

The nurse is caring for a 6-year-old boy with sensorineural hearing loss. Which of the following would the nurse be least likely to identify as the cause of the child's hearing loss? Excess noise exposure Intrauterine exposure to rubella Ototoxic medication use Acute otitis media

Answer : Acute otitis media can cause damage to the middle ear, bringing about conductive hearing loss. Excess noise exposure causes damage to the hair cells in the cochlea or along the auditory pathway, which in turn causes sensorineural hearing loss.Intrauterine infection with rubella causes damage to the hair cells in the cochlea or along the auditory pathway, which in turn causes sensorineural hearing loss.Ototoxic medications can damage the hair cells of the cochlea or along the auditory pathway, in turn causing sensorineural hearing loss.

A child returns to the clinic after an episode of otitis externa, which has resolved. Which of the following would the nurse emphasize as the priority for preventing future episodes? Adhering to regular follow-up to assess for hearing loss Keeping ear canals dry' Avoiding upper respiratory tract infections Performing hand washing

Since moisture contributes to otitis externa, the priority is to keep the ear canals dry.

A nurse is preparing a presentation for a group of parents about vision impairment. When describing the causes, which of the following would the nurse include as a common cause? Select all that apply. Refractive error Amblyopia Retinopathy of prematurity Conjunctivitis Trauma Infantile glaucoma

Refractive error Amblyopia Retinopathy of prematurity Infantile glaucoma In the United States, visual impairment and blindness are most often caused by refractive error, astigmatism, strabismus, amblyopia, nystagmus, infantile glaucoma, congenital cataract, retinopathy of prematurity, and retinoblastoma.