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 A
Explanation
Choice A rationale
Immersing a first-degree burn in cool tap water for at least 10 minutes helps to cool the burned tissue, reducing pain, inflammation, and the extent of tissue damage. The cool water dissipates the heat absorbed by the skin, preventing further injury to the epidermal cells and underlying tissues.
Choice B rationale
Covering a fresh burn with a dry, sterile gauze bandage is important to protect it from contamination and further injury after it has been adequately cooled. However, the immediate initial action should focus on stopping the burning process and cooling the affected area to minimize tissue damage.
Choice C rationale
Applying a topical antibiotic ointment is generally recommended for burns to prevent infection, but this is not the most appropriate initial action immediately after the burn occurs. Cooling the burn takes precedence to reduce heat damage. Antibiotic ointment is usually applied after the initial cooling and cleaning of the wound.
Choice D rationale
Applying an ice pack directly to a burn can cause further tissue damage due to vasoconstriction and potential frostbite. While cooling is beneficial, it should be done gently with cool running water or immersion in cool tap water, not with intense cold like an ice pack directly on the skin.
Correct Answer is A
Explanation
Choice A rationale
Urinary tract infections can cause bladder irritation and dysfunction, leading to symptoms such as frequency, urgency, and nocturia, which can manifest as enuresis, especially secondary enuresis (bedwetting that starts after a period of dryness). Therefore, assessing for a UTI is a crucial first step to rule out a treatable medical cause. Normal urine specific gravity ranges from 1.005 to 1.030, and a urinalysis can detect the presence of bacteria, white blood cells, or nitrites indicative of infection.
Choice B rationale
Psychological stressors can contribute to enuresis, particularly secondary enuresis. Anxiety, family changes, or school-related stress can manifest physically. While important to explore, medical causes like UTIs should be ruled out first.
Choice C rationale
Sleep patterns are relevant in the context of enuresis, as bedwetting occurs during sleep. However, assessing for a medical cause like a UTI should precede a detailed evaluation of sleep habits.
Choice D rationale
A family history of enuresis can suggest a genetic predisposition. However, the immediate nursing priority is to assess for and rule out treatable underlying medical conditions, such as a urinary tract infection.
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