2026/2027 Jersey College
Q1. A toddler with acute otitis media is crying, pulling at one ear,
and has a fever. Which additional finding would the nurse expect?
A) Painless bilateral eye drainage
B) Bulging erythematous tympanic membrane
C) Fixed dilated pupils
D) Absent bowel sounds
Correct Answer: B) Bulging erythematous tympanic membrane
Rationale: Acute otitis media commonly causes middle-ear inflammation
with pain, fever, and a bulging or erythematous tympanic membrane.
Q2. Which parent statement about prescribed antibiotics for acute
otitis media requires additional teaching?
A) “I will give doses at the scheduled times.”
B) “I will monitor for worsening symptoms.”
C) “I will use the measuring device supplied with the medication.”
D) “I can stop the antibiotic as soon as my child feels better.”
Correct Answer: D) “I can stop the antibiotic as soon as my child feels
better.”
Rationale: When an antibiotic is prescribed, it should be administered for
the prescribed course unless the healthcare provider changes the plan.
Q3. Which finding in a child with otitis media should prompt urgent
reassessment for a possible complication?
A) Swelling, redness, and tenderness behind the ear
B) Mild irritability at bedtime
C) Temporary decrease in appetite
D) Ear discomfort that improves with analgesia
Correct Answer: A) Swelling, redness, and tenderness behind the ear
Rationale: Postauricular swelling and tenderness can indicate mastoid
involvement and require prompt evaluation.
Q4. A preschooler has recurrent middle-ear effusions and delayed
speech development. Which concern is most appropriate?
,A) Permanent intellectual disability is certain
B) The child will inevitably require cochlear implantation
C) Reduced hearing may interfere with speech and language development
D) Speech development is unrelated to hearing
Correct Answer: C) Reduced hearing may interfere with speech and language
development
Rationale: Persistent conductive hearing loss during periods of rapid
language acquisition can interfere with speech and communication
development.
Q5. Which communication strategy is most appropriate for a child
with significant hearing impairment?
A) Speak from another room
B) Face the child and use clear visual and verbal communication according to
the child's preferred method
C) Cover the mouth while speaking
D) Exaggerate every word loudly
Correct Answer: B) Face the child and use clear visual and verbal
communication according to the child's preferred method
Rationale: Facing the child supports lip-reading, facial cues, sign language,
and other visual communication strategies.
Q6. A child with bacterial conjunctivitis is being discharged. Which
instruction helps prevent transmission?
A) Perform frequent hand hygiene and avoid sharing towels or washcloths
B) Share eye drops with siblings who develop redness
C) Cover both eyes continuously
D) Stop treatment after the first dose
Correct Answer: A) Perform frequent hand hygiene and avoid sharing towels
or washcloths
Rationale: Infectious conjunctivitis spreads readily through hand-to-eye
contact and contaminated personal items.
Q7. Which finding is most consistent with strabismus?
A) Persistent misalignment of the eyes
B) Clouding of the tympanic membrane
, C) Absence of tears during crying
D) Purulent nasal discharge
Correct Answer: D) Persistent misalignment of the eyes
Rationale: Strabismus is abnormal ocular alignment and can interfere with
normal binocular vision if not appropriately managed.
Q8. Why is early treatment of significant strabismus important?
A) It prevents otitis media
B) It prevents all refractive errors
C) Untreated misalignment can contribute to amblyopia and impaired visual
development
D) It eliminates the need for future vision screening
Correct Answer: C) Untreated misalignment can contribute to amblyopia and
impaired visual development
Rationale: During childhood, persistent unequal visual input can cause the
brain to suppress the image from one eye, leading to amblyopia.
CHAPTER 2 — NEUROMUSCULAR AND MUSCULOSKELETAL DISORDERS
Q9. Which finding is commonly associated with Duchenne muscular
dystrophy?
A) Gowers maneuver when rising from the floor
B) Sudden unilateral facial paralysis only
C) Hyperactive muscle strength
D) Rapid spontaneous recovery
Correct Answer: A) Gowers maneuver when rising from the floor
Rationale: Proximal muscle weakness causes affected children to use their
hands to push against the legs while rising from the floor.
Q10. A child with Duchenne muscular dystrophy develops increasing
morning headaches and daytime sleepiness. Which complication
should the nurse consider?
A) Acute appendicitis
B) Progressive respiratory muscle weakness with nocturnal hypoventilation
C) Hyperthyroidism
D) Otitis externa