Chapter 45

Question 1

Which is the rationale for why young children are more prone to otitis media that the nurse should include in the teaching session with a parent?

1. The eustachian tube is shorter, wider, and horizontal in younger children.
2. The eustachian tube is shorter, more narrow, and horizontal in younger children.
3. The eustachian tube is longer, wider, and vertical in younger children.
4. The eustachian tube is longer, more narrow, and vertical in younger children.

Answer 1

1

Question 2

Which neonate requires a close nursing assessment for the development of retinopathy of prematurity (ROP)?

1. 28-weeks’-gestation infant who has been on long-term oxygen and weighed 1400 g
2. 32-weeks’-gestation infant of African heritage with a congenital heart defect who needed no oxygen and weighed 1850 g
3. 28-weeks’-gestation female infant who was on short-term oxygen, weighed 1420 g, and was treated with phototherapy
4. 36-weeks’-gestation, small-for-gestational-age infant who was in an oxyhood for 12 hours and weighed 1800 g

Answer 2

1

Question 3

Which is the priority nursing assessment for a pediatric client who is postoperative for tonsillectomy?

1. Arrhythmias
2. Dehydration
3. Increased blood sugar
4. Increased urinary output

Answer 3

2

Question 4

A neonate is diagnosed with a herpes simplex viral infection of the eye. Which medication should the nurse prepare to administer?

1. Oral erythromycin
2. Fluoroquinolone eyedrops or ointment
3. Parenteral acyclovir (Zovirax) and vidarabine (VIRA-A) ophthalmic ointment
4. Intravenous penicillin

Answer 4

3

Question 5

A nurse is caring for a visually impaired 20-month-old client who has not begun to walk. Which nursing diagnosis would be appropriate for this child?

1. Self-care Deficit
2. Impaired Physical Mobility
3. Impaired Home Maintenance
4. Delayed Development

Answer 5

4

Question 6

A nurse is caring for a visually impaired school-age child. Which is the priority nursing intervention during the admission process to the hospital?

1. Explaining playroom policies
2. Orienting the child to where furniture is placed in the room
3. Taking the child on a tour of the unit
4. Letting the child touch equipment that will be used during the child’s hospitalization

Answer 6

2

Question 7

Which should the nurse include in the discharge instructions for the parents of an infant who is diagnosed with acute otitis media?

1. Keep the baby in a flat position during sleep.
2. Administer a decongestant.
3. Place the baby to sleep with a pacifier.
4. Administer acetaminophen (Tylenol) to relieve discomfort.

Answer 7

4

Question 8

Which parental statements indicate correct understanding of the care that is needed for a pediatric client after the insertion of tympanostomy tubes? Select all that apply.

1. “It is important to limit my child’s diet after surgery and only allow soft, bland foods.”
2. “I should restrict my child to quiet activities after surgery.”
3. “I should plan to administer a decongestant to my child for 1 to 2 weeks following surgery.”
4. “It is important for my child to drink plenty of fluids after the procedure.”
5. “I will remind my child to use ear plugs prior to showering and swimming.”

Answer 8

2,4,5

Question 9

Which nursing action is appropriate when providing care to a child with a mild hearing loss who reads lips to enhance adaptation during hospitalization?

1. Touching the child lightly before speaking
2. Using a picture board as the main means of communication
3. Speaking in a loud voice while facing the child
4. Speaking directly to the parents for communication

Answer 9

1

Question 10

Which is an appropriate nursing intervention for a child who experiences epistaxis?

1. Laying the child down and applying a warm pack.
2. Tilting the child’s head back, squeezing the bridge of the nose, and applying a warm moist pack to the nose.
3. Tilting the child’s head forward, squeezing the nares below the nasal bone, and applying ice to the nose.
4. Immediately packing the nares with a cotton ball soaked with phenylephrine (Neo-Synephrine).

Answer 10

3

Question 11

Which parental statement indicates correct understanding of discharge instructions for a pediatric client after a tonsillectomy?

1. “We will call the healthcare provider for any indication of ear pain.”
2. “We will be sure to give our child adequate amounts of citrus juices.”
3. “We will plan on administering acetaminophen (Tylenol) for pain.”
4. “We will keep our child on bed rest for 10 days after the surgery.”

Answer 11

3

Question 12

Which information should the nurse include in a teaching session regarding treatment for the common cold in the pediatric population?

1. Aspirin should be taken for alleviation of fever if the common cold is contracted.
2. Antibiotics will eliminate the nasopharyngitis virus.
3. Vaccinations can prevent contraction of a nasopharyngitis virus.
4. Proper hand washing can prevent the spread of the common cold.

Answer 12

4

Question 13

Which assessment finding is considered normal for a school-age client?

1. Tonsils are large and seem to fill the throat.
2. Child is complaining of sore throat and drooling
3. White patches are observed on the tonsils.
4. Throat appears red, and child has a low-grade fever

Answer 13

1

Question 14

Which topics should the nurse include in a teaching session to the parents of a 10-month-old infant who experiences frequent ear infections? Select all that apply.

1. Prohibiting tobacco smoke in the home
2. Avoiding use of a pacifier while the child is sleeping
3. Breastfeeding the infant
4. Cleaning the child’s ears nightly with peroxide
5. Avoiding use of wood-burning stoves

Answer 14

1,2,5

Question 15

Which is the reason for a healthcare provider to recommend that a preschool-age male client with a documented hearing loss should attend preschool at least 2 days per week?

1. Help the child recognize his hearing deficit.
2. Increase the child’s socialization skills.
3. Improve the child’s immunity by increased exposure to organisms.
4. Teach other children that children are different.

Answer 15

2

Question 16

Which screening tool should the nurse use to screen a pediatric client for esotropia?

1. Examine the eye with an otoscope.
2. Check for the “red reflex” in the eyes.
3. Perform the cover–uncover test.
4. Use a tonometer to evaluate the eyes.

Answer 16

3

Question 17

Which is a priority nursing assessment the nurse includes in the plan of care for a pediatric client who has received a cochlear implant?

1. Ringing in the ears
2. Pharyngitis
3. Hearing loss
4. Bacterial meningitis

Answer 17

4

Question 18

Which nursing actions are appropriate when providing care to a 12-year-old client who has lost several teeth as a result of a facial injury? Select all that apply.

1. Not worrying about the tooth loss, as children this age still have their “baby” teeth
2. Only handling the lost tooth by the roots and avoiding touching the crown of the tooth
3. Rinsing the lost tooth with sterile saline
4. Placing the tooth back into its socket and taking the child to an emergency dental facility
5. Keeping the tooth clean and dry during transport to an emergency dental facility

Answer 18

3,4

Question 19

Which parental statements indicate correct understanding of the anatomy and physiology of the infant’s mouth, nose, and throat? Select all that apply.

1. “My baby will breathe through her mouth during the first 3 months of life.”
2. “When my baby has a cold she may have trouble with bottle feedings.”
3. “My baby’s tonsils will be largest during infancy.”
4. “I should expect my baby’s first tooth to erupt during the first 6 months of life.”
5. “I should expect my baby to lose her first tooth during the first year of life.”

Answer 19

2,4

Question 20

Which common eye disorders should the nurse include in a teaching session for the parents of pediatric clients? Select all that apply.

1. Hyperopia
2. Myopia
3. Astigmatism
4. Strabismus
5. Cataracts

Answer 20

1,2,3

Question 21

Which visual screenings should the school nurse conduct when conducting annual assessments for school-age children? Select all that apply.

1. Light reflex assessment
2. Cover–uncover test
3. Acuity testing
4. Visualization of the tympanic membrane
5. Cranial nerve VIII testing

Answer 21

1,2,3

Question 22

Which should the nurse include in the plan of care for a pediatric client who is diagnosed with periorbital ecchymosis? Select all that apply.

1. Apply ice to the site for 5 to 15 minutes every hour for the first 1 to 2 days.
2. Apply warm compresses beginning on day 3.
3. Apply antibiotic ointment to the conjunctiva for 7 to 10 days.
4. Apply a patch to the affected eye for 5 to 7 days.
5. Apply antibiotic drops to the conjunctiva for 7 to 10 days.

Answer 22

1,2

Question 23

Which should the nurse include in the plan of care for a pediatric client diagnosed with otitis media with effusion? Select all that apply.

1. Administration of antibiotic drops per order
2. Administration of pain relief measures
3. Assessment of hearing acuity over several months
4. Assessment of speech
5. Assessment of development

Answer 23

2,3,4,5