NLE/PRC Test about Pediatric Nurse Education (1-4)

Pediatric Nurse Education Practice Test 1-4

1. When determining the parent’s compliance with treatment for their toddler who has recurrent otitis media, which of the following measures would the nurse expect the parents to describe?

a. Cleansing the child’s ear canals with hydrogen peroxide.
b. Administering continuous, small dose antibiotic therapy.
c. Instilling ear drops regularly to prevent cerumen accumulation.
d. Holding the child upright when feeding with a bottle.

2. After insertion of bilateral tympanostomy tubes, which of the following instructions by Pediatric Nurse Education would the nurse include in a child’s discharge plan for the parents?

a. Insert ear plugs into the canals when the child bathes.
b. Blow the nose forcibly during a cold.
c. Administer the prescribed antibiotic while the tubes are in place.
d. Disregard any drainage from the ear after 1 week.

3. Following a myringotomy for the treatment of otitis media, the nurse should expect the child to have:

a. Symptoms of CNS irritation.
b. Irrigations to the lacrimal glands.
c. Difficulty voiding and slight hematuria.
d. Purulent drainage into the external auditory canal.

4. The nurse judges that more teaching is necessary for the father of a child with conjunctivitis on hearing the father say which of the following?

a. “Use your brother’s towel until I can get the others washed.”
b. “Remember to wash your hands after touching your eyes.”
c. “It will not take long for your eye infection to get better.”
d. “Use a tissue to clean your eyes and then throw it away.”



Pediatric Nurse Education
ANSWERS AND RATIONALE

1) D
- Sitting or holding a child upright for formula feedings help prevents pooling of formula in the pharyngeal area. When the vaccum in the middle ear opens in the pharyngeal area, formula (along with bacteria) is drawn into the middle ear. A- Cleansing the ear does not reduce the incidence of otitis media because the pathogenic bacteria are in the nasopharynx, not the external area of the ears. B- Continuous low-dose antibiotic therapy is used only in cases of recurrent otitis media, when the child finishes a course of antibiotics but then develops another ear infection a few days later. C- Although accumulation of cerumen makes it difficult to visualize the tympanic membrane, it does not promote inner ear infection.

2) A
- Placing ear plugs in the ears will prevent contaminated bathwater from entering the middle ear through the tympanostomy tube and causing an infection. B- Blowing the nose forcibly during a cold causes organisms to ascend through the Eustachian tube, possibly causing otitis media. C- It is not necessary to administer antibiotics continuously to a child with tympanostomy tube. Antibiotics are appropriate only when an ear infection is present.D- Drainage from the ear may be a sign of middle ear infection and should be reported to the health care provider.

3) D
- According to Pediatric Nurse Education Books, a myringotomy relieves pressure and prevents spontaneous rupture of the eardrum by allowing pus and fluid to escape from the middle ear into the external auditory canal, from which the exudates drain.A, B & C-The CNS, lacrimal glands, and the urinary sytem are not involved in myringotomy.

4) A
- Conjunctivitis is very contagious, so using a sibling’s towel is not recommended because the danger of spreading the infection. Careful and frequent handwashing is necessary to reduce risk of transmission. Typically, the child can return to school 24 hours after starting treatment. Medication for conjunctivitis is used for approximately 5 days. Teaching for the parents and the child with conjunctivitis should also include instructions to wash hands after touching the eyes, dispose of tissue used to clean the eyes after use, and launder washcloths and towels in hot water.

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