The nurse is performing an otoscopic examination on a client with acute otitis media. On examination of the tympanic membrane, which finding should the nurse expect to observe?
A red, dull, thick, and immobile tympanic membrane
A transparent and dear tympanic membrane
A pink-colored tympanic membrane
A pearly colored tympanic membrane
The Correct Answer is A
a) A red, dull, thick, and immobile tympanic membrane: In acute otitis media, the tympanic membrane typically appears red, dull, thickened, and may be immobile due to fluid and infection in the middle ear.
b) A transparent and clear tympanic membrane: This would suggest a healthy, non-infected ear, which is not expected in acute otitis media.
c) A pink-colored tympanic membrane: This is not a typical finding in acute otitis media; a pink membrane is more characteristic of a healthy ear.
d) A pearly colored tympanic membrane: A pearly color is normal for the tympanic membrane, indicating a healthy ear with no infection.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
a) Encourage increased fluid intake: In acute glomerulonephritis, fluid retention is common due to kidney dysfunction, so increasing fluid intake can exacerbate symptoms like edema and hypertension.
b) Encourage frequent ambulation: While ambulation is important for overall health, excessive activity may worsen symptoms such as fatigue or edema in clients with acute glomerulonephritis. Rest and limited activity are often recommended initially.
c) Obtain weekly weight: For a client with acute glomerulonephritis, weight monitoring should ideally be done daily. This allows for more precise tracking of fluid balance and early detection of fluid retention or weight gain, which could indicate worsening of the condition.
d) Place the client on a low-sodium diet: A low-sodium diet helps reduce fluid retention and lower blood pressure, which are important in managing acute glomerulonephritis and preventing complications such as edema or hypertension.
Correct Answer is A
Explanation
a) "I should call the clinic before taking any over-the-counter medications.": Over-the-counter medications, especially decongestants and antihistamines, can increase intraocular pressure and should be used with caution in glaucoma patients.
b) "Every two years I will need to have my vision checked by an eye doctor.": This is incorrect because glaucoma patients need more frequent eye exams, typically every 6 to 12 months.
c) "If I forget to take my eye drops, I should wait until the next time they are due.": The client should take the missed dose as soon as remembered, unless it is close to the next scheduled dose. Waiting could result in elevated intraocular pressure.
d) "When my vision improves, I will be able to stop taking the eye drops.": Vision may not improve with glaucoma treatment, and medications should be taken consistently to manage intraocular pressure, even if symptoms are controlled.
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