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.

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Correct Answer is C

Explanation

A. Insert a nasal tube into each nostril to ensure no blockage is present: Inserting a nasal tube is an invasive procedure that is not necessary for assessing nostril patency. This method can cause discomfort and does not provide a simple or effective assessment of airflow through the nostrils.

B. Refer patient to a nasal specialist to ensure there is not any blockage in the nasal cavity: Referral to a specialist is unnecessary for a basic assessment of nostril patency. The nurse can perform a simple, non-invasive test before considering a referral for further evaluation.

C. Press each nostril shut and have the patient sniff to ensure air passage through each nostril: This method effectively assesses nostril patency. By occluding one nostril at a time, the nurse can evaluate airflow and determine if there is any blockage or obstruction in the nasal passages. It is a quick and straightforward assessment technique.

D. Have the patient blow their nose into a tissue forcefully: Asking the patient to blow their nose can provide information about mucus presence or drainage but does not specifically assess nostril patency. This action may also cause discomfort and is not the best initial assessment for airflow through the nostrils.

A. Rubella B. Leukoplakia C. Rheumatic fever D. Scarlet fever

Correct Answer is C

Explanation

A. Rubella: Rubella is a viral infection caused by the rubella virus, not a complication of untreated strep throat. It is unrelated to Group A Streptococcus (GAS) infection and is prevented through vaccination.

B. Leukoplakia: Leukoplakia is a condition characterized by white patches on the mucous membranes, often associated with chronic irritation or tobacco use. It is not a complication of streptococcal pharyngitis.

C. Rheumatic fever: Untreated streptococcal throat infections caused by Group A Streptococcus can lead to rheumatic fever, an inflammatory disease affecting the heart, joints, skin, and brain. This autoimmune response can result in rheumatic heart disease, which may cause permanent cardiac damage.

D. Scarlet fever: While scarlet fever can develop from strep throat, it is not a long-term complication but rather an acute reaction to the streptococcal toxin. The more serious complication of untreated strep throat is rheumatic fever, which can have lasting consequences, particularly for the heart.

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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

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