Test 3 - Otitis media and conjunctivitis
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 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 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.
A) Her mother has had recurrent otitis media.
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 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
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 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."
B: "Children's vision is not completely developed by this age. Your child might outgrow this nearsightedness."
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
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
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 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 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.
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
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
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
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
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.
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
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 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
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." - When mucopurulent drainage is no longer present (usually after 24 to 48 hours of treatment with a topical antibiotic), the child with bacterial conjunctivitis may safely return to day care or school. - Avoid the use of vasoconstricting eye drops such as Visine to rid the eyes of redness. Rebound vasodilation may occur, and with it the redness returns. This leads to repeated frequent use of the drops to keep the eyes from being red but does not treat the actual cause of 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 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
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."
B: "We need to raise the volume of our voices significantly so he can hear us."
