A nurse is caring for a 3-year-old client who has persistent otitis media. To help identify contributing factors, the nurse should ask the parents which of the following questions?

"Does anyone smoke in the same house as your daughter?"

"Has your daughter had a lot of earwax in her ears over the last month?"

"Has your daughter been king glass of water day?"

"Does your daughter get water in her ears when you bath her?

Answer and Explanation

The Correct Answer is A

A. Exposure to environmental tobacco smoke (passive smoking) is a known risk factor for otitis media, as it can irritate the upper respiratory tract and increase susceptibility to respiratory infections, including those affecting the ears.

B. Excessive earwax buildup can sometimes contribute to ear discomfort or hearing problems but it is not a common cause of persistent otitis media. However, it's still important for the nurse to assess for any earwax issues as part of the overall assessment of the child's ear health.

C. Drinking water is generally beneficial for overall health but is not directly linked to otitis media unless there are specific concerns about hydration status or exposure to contaminated water sources.

D. Water entering the ears during bathing is not generally considered a significant risk factor for otitis media, but it can be associated with otitis externa, which is an infection of the outer ear canal.

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Correct Answer is D

Explanation

D. Tugging or pulling on the affected ear lobe is a classic sign of otitis media in infants. The discomfort or pain caused by inflammation and pressure in the middle ear may lead the infant to tug or rub the affected ear in an attempt to alleviate discomfort.

A. Bluish-green discharge from the ear canal is not a typical finding in otitis media. Otitis media is characterized by inflammation and fluid accumulation in the middle ear, which may not result in discharge unless there is a secondary bacterial infection or perforation of the eardrum.

B. An increase in appetite is not a typical finding in otitis media. In fact, many children with otitis media may experience a decrease in appetite due to discomfort, pain, and difficulty swallowing or chewing.

C. Erythema (redness) and edema (swelling) of the affected auricle (outer ear) are not typically associated with otitis media. Otitis media primarily affects the middle ear, where inflammation and fluid accumulation occur behind the eardrum.

A. Blood glucose 140 mg/dL B. Serum sodium 156 mEq/L C. RBC 3.2 million/ul D. Oxygen saturation 85%

Correct Answer is D

Explanation

D. An oxygen saturation level of 85% is significantly below the normal range and indicates hypoxemia (low blood oxygen levels). This finding is concerning, especially in a child with cystic fibrosis, which can lead to respiratory complications such as airway obstruction, infection, or mucus plugging.

A. A blood glucose level of 140 mg/dL is within the normal range for children, so this finding would not typically require immediate reporting to the provider.

B. A serum sodium level of 156 mEq/L is significantly elevated and above the normal range. However, hypoxia is the priority.

C. A red blood cell (RBC) count of 3.2 million/µL falls within the normal range for children, so this finding would not typically require immediate reporting to the provider.

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A nurse is caring for a 3-year-old client who has persistent otitis media. To help identify contributing factors, the nurse should ask the parents which of the following questions?

Nursing Test Bank

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Correct Answer is D

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