When positioning a young child for an ear exam it is safest to:
Have parent lie across the child on the table.
Pretend nurse is looking for "Mickey Mouse" in child's ear.
Lying down with parent holding hand.
Have parent hold child against chest with one hand immobilizing head.
The Correct Answer is D
Safe pediatric examination techniques require behavioral control, parental involvement, and head stabilization to prevent sudden movement during otoscopic assessment. Young children have limited impulse control, requiring secure positioning to reduce risk of canal injury and ensure accurate visualization of the tympanic membrane.
Rationale:
A. Having a parent lie across the child may provide physical restraint but is not a controlled or recommended technique. It can increase psychological distress and does not ensure precise head immobilization, raising risk of injury during otoscopic insertion.
B. Using play therapy distraction such as pretending to look for Mickey Mouse may reduce anxiety but does not provide physical stabilization. Without proper immobilization, sudden movement can still occur during ear examination, risking trauma to the external auditory canal.
C. Lying down while holding a parent’s hand offers emotional comfort but insufficient head control. The child’s head can still move unpredictably during the procedure, making otoscopic examination unsafe and potentially inaccurate due to lack of immobilization.
D. Holding the child against the parent’s chest with one hand immobilizing the head provides optimal stabilization. This position ensures both emotional reassurance and effective physical restraint, minimizing sudden movement and allowing safe visualization of the ear canal and tympanic membrane.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Infant cardiovascular physiology is characterized by increased metabolic demand, higher cardiac output, rapid heart rate variability, and immature autonomic regulation. Normal pulse rates decline progressively with age as myocardial efficiency improves and resting oxygen consumption decreases during pediatric growth and development.
Rationale:
A. A pulse rate of 210 beats/minute is significantly elevated for a 6-month-old infant and suggests severe tachycardia. Such rates may indicate fever, dehydration, supraventricular tachycardia, or cardiovascular instability requiring urgent evaluation.
B. A heart rate of 198 beats/minute exceeds the expected resting range for infancy and is considered abnormal cardiac acceleration. Persistent rates at this level may impair ventricular filling and reduce effective cardiac output.
C. A pulse rate of 85 beats/minute is abnormally low for a 6-month-old infant. Infant physiology requires higher resting heart rates to maintain adequate tissue perfusion and oxygen delivery due to elevated metabolic needs.
D. A pulse rate of 126 beats/minute falls within the normal infant physiologic range, typically between 100 and 160 beats/minute. This reflects appropriate cardiac output and normal autonomic regulation for a healthy 6-month-old child.
Correct Answer is B
Explanation
Otic medication administration in young children requires anatomical straightening of the external auditory canal to ensure optimal drug delivery to the tympanic membrane. In toddlers, the ear canal is shorter and more horizontally oriented, requiring specific auricle manipulation for effective instillation.
Rationale:
A. Pulling the auricle up and back is appropriate for adults and older children whose ear canal has a more inferior and posterior angulation. In a 2-year-old, this technique misaligns the canal, reducing medication penetration and therapeutic effectiveness.
B. Pulling the auricle down and back is the correct technique for children under 3 years. It straightens the more horizontal external auditory canal, allowing optimal flow of medication to the tympanic membrane and improving absorption of otic antibiotics like gentamicin.
C. Pulling the auricle down and out does not effectively straighten the pediatric ear canal. This positioning fails to align the external auditory canal properly, resulting in poor drug distribution and potential leakage of medication from the ear canal.
D. Pulling the auricle up and out is anatomically incorrect for all age groups. It distorts the ear canal rather than straightening it, leading to inadequate medication delivery and possible discomfort during administration of otic preparations.
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