Lippincott Certification Review Medical-Surgical Nursing

321

Retinal Detachment

Question 11. A pediatric patient reports unilateral ear pain since yesterday. The ear canal is inflamed, edematous and filled with debris. Which of the following instructions is correct? A. “You have a middle ear infection. We need to place a tube in your ear drum to drain the fluid from your middle ear.” B. “Use a cotton swab to clear out your ears after swimming. It will prevent future ear infections.” C. “When you put in the antibiotic drops, lay down on your left side and leave the drops in for 3 to 5 minutes before getting up.” D. “The pharmacist can flavor your liquid antibiotic and will let you choose if you prefer grape or cherry.” Answers and Rationales Question 1. Correct answer: D Otosclerosis can cause vertigo, which increases fall risk. Assisting with ambulation and transfers to the chair will help prevent falls. Option A is incorrect because the background noise makes it more difficult for patients with hearing loss to understand the nurse. Ask the patient if it is better to have the sound on or off. Option B is incorrect because independent ambulation can put the patient at risk for falls. Option C is incorrect because speaking slowly does not ensure the volume of the nurse’s voice was appropriate for the patient to hear. Question 2. Correct answer: B In mild cases of acute otitis media, many cases will resolve without antibiotic treatment. A watch and wait approach for up to 48 hours is appropriate, with parents knowing they can follow-up if no better in 48 hours or any time the illness gets worse. Options A and C are incorrect because over the counter antihistamines, intranasal steroids, and/or decongestants are not recommended. Option D is incorrect because only acetaminophen or ibuprofen are recommended for pain in children under 18 years old due to the risk of Reyes syndrome that can result with aspirin use. Question 3. Correct answer: B Otosclerosis has a familial tendency and usually has an onset between the ages of 15 to 50 years old, and women are twice as likely as men to developing otosclerosis. Additionally, pregnancy may trigger the onset. Option A is a symptom of otitis media or otitis externa. Option C may indicate otitis media with effusion or eustachian tube dysfunction. Option D is a negative indicator for the familial disease.

Question 12. A patient has recently been diagnosed with otosclerosis. Which medication is most appropriate for this patient? A. A third-generation bisphosphonate B. Long-term steroids C. Loop diuretics D. Cephalosporins for up to 3 months

Question 4. Correct answer: C Frequent swallowing indicates something is in the posterior oropharynx that needs to be cleared. Use a penlight to assess the back of the throat for bleeding. Options A and C are expected and unless worsening, are not indicative of a bleed. Option B is not related. Question 5. Correct answer: B Fluorescein angiography can reveal leaking blood vessels in the subretinal neovascular net. Options A and C are tests used for glaucoma. Option D is a surgical procedure. Question 6. Correct answer: A The wick is used to transport antibiotic eardrops into the ear canal when severe edema occurs. Option B is incorrect because it can take about 3 weeks for otitis media to resolve with treatment. Option C is incorrect because inserting foreign objects in the ear canals, including cotton-tipped applicators, fingers, and hair pins risk injuring the epithelial tissue of the ear canal and introducing bacteria. Option D is incorrect because the wick will fall out as edema resolves, leaving enough space for the antibiotic drops to permeate the ear canal.

Question 7. Correct answer: C Mouth breathing does not moisturize inhaled air like breathing through the nose does, and this can lead to dry oral mucosa. Option A is incorrect because oral secretions should be expectorated to help monitor bleeding. Option B is incorrect because activities that increase blood pressure can increase bleeding at the surgical site. Option D is incorrect because the patient should keep the head elevated at least 30 degrees to promote drainage, reduce edema, and maintain a patent airway. Copyright © 2025 Wolters Kluwer, Inc. Unauthorized reproduction of the content is prohibited.