A nurse is caring for a child who has otitis media.
Which of the following assessment findings should the nurse expect?
Tugging on the affected ear lobe.
Erythema and edema of the affected ear.
Pain when manipulating the affected ear lobe.
Clear drainage from the affected ear.
The Correct Answer is A
The correct answer is A. Tugging on the affected ear lobe.
Choice A rationale
Tugging on the affected ear lobe is a common sign of otitis media in children. This behavior is often observed because the child is experiencing discomfort or pain in the ear, and tugging or pulling on the ear lobe is a way to express or alleviate that discomfort.
Choice B rationale
Erythema and edema of the affected ear are not typical findings in otitis media. These symptoms are more commonly associated with external ear infections, such as otitis externa.
Choice C rationale
Pain when manipulating the affected ear lobe is more indicative of otitis externa rather than otitis media. Otitis media involves the middle ear, and manipulation of the ear lobe does not typically cause pain.
Choice D rationale
Clear drainage from the affected ear is not a typical finding in otitis media. If there is drainage, it is usually purulent (pus-like) and indicates a more severe infection or a ruptured eardrum.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
The correct answer is Choice A.
Choice A rationale
The apex of the heart (apical pulse) is the preferred site for assessing the heart rate in infants. It is located at the point of maximal impulse (PMI) and provides the most accurate measurement of the heart rate in this age group.
Choice B rationale
The brachial artery is not the preferred site for assessing the heart rate in infants. While it can be used for blood pressure measurement, it is not as accurate as the apical pulse for heart rate assessment.
Choice C rationale
The radial artery is not typically used for assessing the heart rate in infants. It is more commonly used in older children and adults.
Choice D rationale
The carotid artery is not recommended for assessing the heart rate in infants due to the risk of compressing the airway and causing discomfort.
Correct Answer is C
Explanation
The correct answer is Choice C.
Choice A rationale
Budesonide via dry-powder inhaler is a corticosteroid used for long-term control of asthma. It is not effective for immediate relief of acute asthma exacerbations.
Choice B rationale
Cromolyn via metered-dose inhaler is a mast cell stabilizer used for long-term control of asthma. It is not effective for immediate relief of acute asthma exacerbations.
Choice C rationale
Albuterol via jet nebulizer is a short-acting beta-adrenergic agonist that provides rapid bronchodilation. It is the medication of choice for immediate relief of acute asthma exacerbations.
Choice D rationale
Montelukast orally is a leukotriene receptor antagonist used for long-term control of asthma. It is not effective for immediate relief of acute asthma exacerbations. .
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