A 3-year-old child is diagnosed with otitis media.
What is a key sign the nurse might expect the caregiver to report?
The child stares blankly for prolonged periods.
The child rubs or pulls at the affected ear.
The child shows hyperactivity.
The child sleeps excessively.
The Correct Answer is B
Choice A rationale
Blank staring for prolonged periods is not a typical sign of otitis media. While changes in behavior can occur with illness, this specific symptom is more indicative of neurological issues like absence seizures rather than an ear infection. Neurological assessments would be necessary to evaluate this finding, which is outside the typical presentation of otitis media.
Choice B rationale
Rubbing or pulling at the affected ear is a common behavioral manifestation of otitis media in young children. The inflammation and pressure within the middle ear cause pain and discomfort, leading the child to touch or tug at their ear in an attempt to alleviate the sensation. This localized physical sign strongly suggests an issue within the ear itself.
Choice C rationale
Hyperactivity is not a primary indicator of otitis media. While a child experiencing discomfort might be irritable or restless, true hyperactivity is a distinct behavioral pattern often associated with other conditions like attention-deficit/hyperactivity disorder (ADHD) and is not directly linked to a middle ear infection.
Choice D rationale
Excessive sleepiness is not a typical presenting symptom of otitis media. While a child might be slightly more tired due to the general discomfort of an infection, excessive somnolence would be more concerning for a systemic illness or a neurological issue, rather than a localized ear infection.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["B","C","E","G"]
Explanation
Choice A rationale
Nephrotic syndrome typically has a gradual onset of symptoms, developing over days to weeks, as protein loss in the urine accumulates. An abrupt onset is less characteristic.
Choice B rationale
Proteinuria, the presence of abnormally high levels of protein in the urine (normal range is less than 150 mg/24 hours), is a defining characteristic of nephrotic syndrome. Damage to the glomeruli in the kidneys leads to increased permeability and leakage of protein into the urine.
Choice C rationale
Hypoalbuminemia in the blood (normal range is 3.5 to 5.5 g/dL) is a key feature of nephrotic syndrome. The excessive loss of protein in the urine leads to a decrease in serum albumin levels.
Choice D rationale
Fever is not typically a primary symptom of nephrotic syndrome. While children with nephrotic syndrome can develop infections, fever is not a direct consequence of the underlying kidney dysfunction.
Choice E rationale
Hyperlipidemia, an elevated level of lipids (fats) in the blood (normal total cholesterol is less than 200 mg/dL), is commonly associated with nephrotic syndrome. The liver increases lipoprotein synthesis in response to the decreased serum albumin levels.
Choice F rationale
While a positive Group A beta-hemolytic streptococcal infection can lead to post-streptococcal glomerulonephritis, which can sometimes present with nephrotic features, it is not a common finding directly associated with the primary diagnosis of nephrotic syndrome itself.
Choice G rationale
Anasarca, which is severe generalized edema characterized by widespread swelling due to fluid retention, is a common finding in nephrotic syndrome. The low serum albumin levels reduce oncotic pressure in the blood vessels, leading to fluid shifting into the interstitial spaces. .
Correct Answer is C
Explanation
Choice A rationale
Washing bedding and recently worn clothing in hot water (above 54°C or 130°F) helps to kill lice and their nits (eggs) that may be present on these items, preventing re-infestation or spread to others. The heat denatures the proteins essential for the lice's survival.
Choice B rationale
Sealing non-washable items in a plastic bag for 2 weeks suffocates any lice and allows any hatched nymphs to die due to lack of a blood meal. Lice cannot survive for extended periods away from a human host.
Choice C rationale
Both washing bedding and clothing in hot water and sealing non-washable items are crucial steps in eliminating head lice and preventing recurrence or transmission. Therefore, all of the above instructions should be provided to parents.
Choice D rationale
Notifying the school allows for screening of other children and implementation of appropriate measures to prevent further spread of the head lice within the school environment. While important for public health, it is an action separate from the direct treatment and environmental control measures that parents should undertake at home.
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