While performing the otoscopic examination of a 3-year-old boy who has been pulling on his left ear, the nurse finds that his left tympanic membrane is bright red and that the light reflex is abnormal. What do these findings indicate?

An otitis media

Cholesteatoma

A fungal infection

A perforation of the eardrum

Answer and Explanation

The Correct Answer is A

A. An otitis media: A bright red tympanic membrane with an abnormal light reflex suggests inflammation and infection of the middle ear, characteristic of otitis media. Young children are particularly susceptible due to their shorter and more horizontal eustachian tubes, which facilitate bacterial or viral entry. Symptoms such as ear pulling, irritability, and fever often accompany the condition.

B. Cholesteatoma: Cholesteatoma is an abnormal skin growth in the middle ear that may result from chronic infections. It typically presents with a foul-smelling discharge, conductive hearing loss, and a white or pearly mass on the tympanic membrane rather than generalized redness.

C. A fungal infection: Fungal infections (otomycosis) usually present as black or white spots on the tympanic membrane or ear canal rather than diffuse redness. The condition often causes itching and mild discomfort rather than acute pain and fever.

D. A perforation of the eardrum: A perforation would likely present with a visible tear or hole in the tympanic membrane, often accompanied by drainage. While infections like otitis media can lead to perforation, the findings described in the question suggest inflammation rather than rupture.

Nursing Test Bank

Quiz #1: RN Exams Pharmacology Exams Quiz #2: RN Exams Medical-Surgical Exams Quiz #3: RN Exams Fundamentals Exams Quiz #4: RN Exams Maternal-Newborn Exams Quiz #5: RN Exams Anatomy and Physiology Exams Quiz #6: RN Exams Obstetrics and Pediatrics Exams Quiz #7: RN Exams Fluid and Electrolytes Exams Quiz #8: RN Exams Community Health Exams Quiz #9: RN Exams Promoting Health across the lifespan Exams Quiz #10: RN Exams Multidimensional care Exams

Get 100+ Naxlex Exit Exams for $79 Try Naxlex NCLEX-RN (14 Day Free-Trial)

Naxlex Comprehensive Predictor Exams

Quiz #1: Naxlex RN Comprehensive online practice 2019 B with NGN Quiz #2: Naxlex RN Comprehensive Predictor 2023 Quiz #3: Naxlex RN Comprehensive Predictor 2023 Exit Exam A Quiz #4: Naxlex HESI Exit LPN Exam Quiz #5: Naxlex PN Comprehensive Predictor PN 2020 Quiz #6: Naxlex VATI PN Comprehensive Predictor 2020 Quiz #8: Naxlex PN Comprehensive Predictor 2023 - Exam 1 Quiz #10: Naxlex HESI PN Exit exam Quiz #11: Naxlex HESI PN EXIT Exam 2

Free Nursing Study Resources

Correct Answer is B

Explanation

A. Maxillary sinuses reach full size after puberty: While maxillary sinuses continue to grow throughout childhood, they are present at birth and reach adult size during late adolescence. The frontal and sphenoid sinuses, rather than the maxillary, experience more significant postnatal development.

B. Maxillary and ethmoid sinuses are the only sinuses present at birth: At birth, only the maxillary and ethmoid sinuses are developed. The frontal and sphenoid sinuses begin to develop later in infancy and childhood, with full maturation occurring in adolescence.

C. Frontal sinuses are fairly well developed at birth: Frontal sinuses do not develop until around 7 to 8 years of age and continue growing into adolescence. They are absent or rudimentary in newborns.

D. Sphenoid sinuses are full size at birth: The sphenoid sinuses begin developing around 2 to 3 years of age and continue growing into late childhood and adolescence. They are not present at birth.

A. Once the speculum is in the ear, releasing the traction. B. Pulling the pinna up and back before inserting the speculum. C. Tilt the person's head forward during the examination. D. Using the smallest speculum to decrease the amount of discomfort.

Correct Answer is B

Explanation

A. Once the speculum is in the ear, releasing the traction: Releasing traction too soon can lead to collapse of the ear canal, obstructing the view of the tympanic membrane. Maintaining traction throughout the examination ensures a clear view and prevents discomfort.

B. Pulling the pinna up and back before inserting the speculum: The correct technique for an adult involves pulling the pinna up and back to straighten the external auditory canal, allowing for an unobstructed view of the tympanic membrane. In children under three, the pinna is pulled down and back due to the more horizontal orientation of the ear canal.

C. Tilt the person's head forward during the examination: The head should remain upright or slightly tilted away from the examiner to provide better access to the ear canal. Tilting forward is unnecessary and may not improve visualization.

D. Using the smallest speculum to decrease the amount of discomfort: A speculum that is too small may not provide a sufficient view of the tympanic membrane. The largest speculum that comfortably fits should be used to allow for optimal visualization.

View Question and Answer

Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.

Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today

While performing the otoscopic examination of a 3-year-old boy who has been pulling on his left ear, the nurse finds that his left tympanic membrane is bright red and that the light reflex is abnormal. What do these findings indicate?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is reviewing the development of the newborn infant. Regarding the sinuses, which statement is true in relation to a newborn infant?

Correct Answer is B

Explanation

The nurse is performing an otoscopic examination on an adult. Which of these actions is correct?

Correct Answer is B

Explanation

During an assessment, where would the nurse best auscultate for a tricuspid valve murmur?

A mother brings her 2-month-old daughter in for an examination and says, "My daughter rolled over against the wall, and now I have noticed that she has this spot that is soft on the top of her head. Is something terribly wrong?" How should the nurse respond?

Which of the following are the PRIMARY muscles of respiration? (Select All that Apply.)

The mother of a 2-year-old toddler is concerned about the upcoming placement of tympanostomy tubes in her son's ears. The nurse would include which of these statements in the teaching plan?

A patient has been admitted to the emergency department for a suspected drug overdose. His respirations are shallow, with an irregular pattern, at a rate of 12 respirations per minute. The nurse interprets this respiration pattern as which of the following?

When assessing a patient's lungs, what should the nurse recall about the left lung?

In performing a voice test to assess hearing, which of these actions would the nurse perform?

During auscultation of breath sounds, the nurse should correctly use the stethoscope in which of the following ways?