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Chronic otitis media with effusion (OME) differs from acute otitis media (AOM) because it is usually characterized by which signs or symptoms?
- A. Severe pain in the ear
- B. Anorexia and vomiting
- C. A feeling of fullness in the ear
- D. Fever as high as 40 C (104 F)
Correct Answer: C
Rationale: Chronic otitis media with effusion (OME) typically presents with a feeling of fullness in the ear and nonspecific symptoms, unlike acute otitis media (AOM), which involves severe pain, fever, and systemic symptoms like anorexia or vomiting.
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A toddler has a unilateral foul-smelling nasal discharge and frequent sneezing. The nurse should suspect what condition?
- A. Allergies
- B. Acute pharyngitis
- C. Foreign body in the nose
- D. Acute nasopharyngitis
Correct Answer: C
Rationale: A unilateral foul-smelling nasal discharge with sneezing suggests a foreign body causing local irritation and obstruction. Allergies cause bilateral clear discharge, pharyngitis lacks nasal discharge, and nasopharyngitis produces bilateral mucous discharge.
When caring for a child after a tonsillectomy, what intervention should the nurse do?
- A. Watch for continuous swallowing.
- B. Encourage gargling to reduce discomfort.
- C. Apply warm compresses to the throat.
- D. Position the child on the back for sleeping.
Correct Answer: A
Rationale: Continuous swallowing, especially during sleep, signals bleeding from the tonsillectomy site, requiring immediate attention. Gargling may irritate the site, ice compresses are preferred to reduce inflammation, and side or abdominal positioning aids drainage, not back sleeping.
Parents bring their 15-month-old infant to the emergency department at 3:00 AM because the toddler has a temperature of 39 C (102.2 F), is crying inconsolably, and is tugging at the ears. A diagnosis of otitis media (OM) is made. In addition to antibiotic therapy, the nurse practitioner should instruct the parents to use what medication?
- A. Decongestants to ease stuffy nose
- B. Antihistamines to help the child sleep
- C. Aspirin for pain and fever management
- D. Benzocaine ear drops for topical pain relief
Correct Answer: D
Rationale: Benzocaine ear drops provide topical relief for otitis media pain. Decongestants and antihistamines are not recommended, and aspirin is contraindicated in children due to Reye syndrome risk.
The nurse is caring for a child with carbon monoxide (CO) poisoning associated with smoke inhalation. What intervention is essential in this childs care?
- A. Monitor pulse oximetry.
- B. Monitor arterial blood gases.
- C. Administer oxygen if respiratory distress develops.
- D. Administer oxygen if childs lips become bright, cherry-red in color.
Correct Answer: B
Rationale: Monitoring arterial blood gases is essential for CO poisoning, as pulse oximetry is unreliable due to normal PaO2 levels. High-flow oxygen should be administered immediately, not only if distress or cherry-red lips (a late sign) appear, to displace CO from hemoglobin.
The nurse encourages the mother of a toddler with acute laryngotracheobronchitis to stay at the bedside as much as possible. What is the primary rationale for this action?
- A. Mothers of hospitalized toddlers often experience guilt.
- B. The mothers presence will reduce anxiety and ease the childs respiratory efforts.
- C. Separation from the mother is a major developmental threat at this age.
- D. The mother can provide constant observations of the childs respiratory efforts.
Correct Answer: B
Rationale: The mother?s presence reduces the toddler?s anxiety, easing respiratory efforts in acute laryngotracheobronchitis. While guilt and separation are concerns, the primary benefit is decreased distress improving breathing, and constant observation is secondary to emotional support.