Exam 1 study guide for pediatric
nursing (NUR 101)
,Question 1: A 8 year old, 60 lb child diagnosed with left otits externa can be managed with
a. Ciprodex otic, 4 drops to the affected ear bid X 7 days
b. Children's Ibuprofen liquid 10 mls q 6-8h prn for discomfortC. Avoidance of
swimming/underwater baths until resolved
d. All of the above
**Correct Answer:
d. All of the above
Explanation:
Management of otitis externa (swimmer’s ear) in an 8-year-old child includes:
1. Topical antibiotic drops:
o Ciprodex (Ciprofloxacin-Dexamethasone) otic drops o Dosage: 4 drops in the
affected ear twice daily for 7 days
o Ciprodex provides antibiotic coverage (ciprofloxacin) and reduces inflammation
(dexamethasone).
2. Pain management:
o Ibuprofen (Children’s liquid) is appropriate for pain relief. o Dosage: Ibuprofen
10 mg/kg/dose every 6-8 hours as needed.
o The child weighs 60 lbs (~27 kg), so 10 mL of Children's Ibuprofen (100 mg/5 mL
concentration) provides adequate pain relief.
3. Avoidance of water exposure:
o Swimming and underwater baths should be avoided to prevent further irritation
and promote healing.
Question 2: A 1 month old female is brought to the office for a follow-up visit due to feeding
issues. She was a NSVD at 39 weeks gestation, no complications. Was discharged to home on
,day 2 after delivery. The mother states she had a hepatits B vaccine in the hospital prior to
being discharged. In reviewing the chart the NP would anticipate ordering which immunization
at this visit?
a. DTaP, IPV, and Hepatitis B
b. DTaP, IPV, HIB, and Prevnar
c. Hepatitis B
d. DTaP, IPV, HIB, Prevnar, Hepatitis B, Rototeq
**Correct Answer:
c. Hepatitis B
Explanation:
• At birth: Hepatitis B vaccine (1st dose)
• 1-month visit: Hepatitis B vaccine (2nd dose)
• 2-month visit: DTaP, IPV, Hib, PCV13 (Prevnar), Rotavirus, and possibly Hepatitis B (if
not given at 1 month).
Question 3: A 5 year old comes to the office with right ear pain X 3 days. Today mom states that
she is feeling a little better. She has had a fever of 100 to 101 X2 days. On otoscopic exam of
her ear you note a perforation in the TM. What treatment would you recommend?
a. Amoxicillin 90 mg/kg/day X 10 days
b. Cefdinir 14 mg/kg/day X 10 days
c. Ciprodex otic drops 4 drops to affected are bid X 7 days
d. Treat with both oral and topical antibioticsCorrect Answer:
d. Treat with both oral and topical antibiotics
Explanation:
, A 5-year-old child with acute otitis media (AOM) with TM perforation should be treated with
both oral and topical antibiotics to cover for common pathogens (Streptococcus pneumoniae,
Haemophilus influenzae, Moraxella catarrhalis).
Oral Antibiotic:
• First-line: Amoxicillin 90 mg/kg/day divided BID for 10 days
• If the child has a penicillin allergy (non-severe reaction): Cefdinir 14 mg/kg/day is a
good alternative.
• If severe beta-lactam allergy: Clindamycin or macrolides (like azithromycin) may be
used, though they have less coverage.
Topical Antibiotic:
• Ciprodex otic (Ciprofloxacin-Dexamethasone) drops o Dosage: 4 drops to the affected
ear twice daily for 7 days o Helps treat the infection locally and reduces inflammation.
Why Both Oral and Topical?
• Oral antibiotics are necessary because middle ear infections often have a bacterial
etiology and require systemic treatment.
• Topical fluoroquinolone ear drops (like Ciprodex) are safe with TM perforation and
help prevent otorrhea and secondary infection
Question 4: All are findings consistent with peritonsillar abscess EXCEPT:
a. muffled voice
b. unilateral enlargement of tonsil
C. trismus
d. exudate on tonsils
Correct Answer:
d. Exudate on tonsils
Explanation:
A peritonsillar abscess (PTA) is a deep neck space infection that typically presents with:
nursing (NUR 101)
,Question 1: A 8 year old, 60 lb child diagnosed with left otits externa can be managed with
a. Ciprodex otic, 4 drops to the affected ear bid X 7 days
b. Children's Ibuprofen liquid 10 mls q 6-8h prn for discomfortC. Avoidance of
swimming/underwater baths until resolved
d. All of the above
**Correct Answer:
d. All of the above
Explanation:
Management of otitis externa (swimmer’s ear) in an 8-year-old child includes:
1. Topical antibiotic drops:
o Ciprodex (Ciprofloxacin-Dexamethasone) otic drops o Dosage: 4 drops in the
affected ear twice daily for 7 days
o Ciprodex provides antibiotic coverage (ciprofloxacin) and reduces inflammation
(dexamethasone).
2. Pain management:
o Ibuprofen (Children’s liquid) is appropriate for pain relief. o Dosage: Ibuprofen
10 mg/kg/dose every 6-8 hours as needed.
o The child weighs 60 lbs (~27 kg), so 10 mL of Children's Ibuprofen (100 mg/5 mL
concentration) provides adequate pain relief.
3. Avoidance of water exposure:
o Swimming and underwater baths should be avoided to prevent further irritation
and promote healing.
Question 2: A 1 month old female is brought to the office for a follow-up visit due to feeding
issues. She was a NSVD at 39 weeks gestation, no complications. Was discharged to home on
,day 2 after delivery. The mother states she had a hepatits B vaccine in the hospital prior to
being discharged. In reviewing the chart the NP would anticipate ordering which immunization
at this visit?
a. DTaP, IPV, and Hepatitis B
b. DTaP, IPV, HIB, and Prevnar
c. Hepatitis B
d. DTaP, IPV, HIB, Prevnar, Hepatitis B, Rototeq
**Correct Answer:
c. Hepatitis B
Explanation:
• At birth: Hepatitis B vaccine (1st dose)
• 1-month visit: Hepatitis B vaccine (2nd dose)
• 2-month visit: DTaP, IPV, Hib, PCV13 (Prevnar), Rotavirus, and possibly Hepatitis B (if
not given at 1 month).
Question 3: A 5 year old comes to the office with right ear pain X 3 days. Today mom states that
she is feeling a little better. She has had a fever of 100 to 101 X2 days. On otoscopic exam of
her ear you note a perforation in the TM. What treatment would you recommend?
a. Amoxicillin 90 mg/kg/day X 10 days
b. Cefdinir 14 mg/kg/day X 10 days
c. Ciprodex otic drops 4 drops to affected are bid X 7 days
d. Treat with both oral and topical antibioticsCorrect Answer:
d. Treat with both oral and topical antibiotics
Explanation:
, A 5-year-old child with acute otitis media (AOM) with TM perforation should be treated with
both oral and topical antibiotics to cover for common pathogens (Streptococcus pneumoniae,
Haemophilus influenzae, Moraxella catarrhalis).
Oral Antibiotic:
• First-line: Amoxicillin 90 mg/kg/day divided BID for 10 days
• If the child has a penicillin allergy (non-severe reaction): Cefdinir 14 mg/kg/day is a
good alternative.
• If severe beta-lactam allergy: Clindamycin or macrolides (like azithromycin) may be
used, though they have less coverage.
Topical Antibiotic:
• Ciprodex otic (Ciprofloxacin-Dexamethasone) drops o Dosage: 4 drops to the affected
ear twice daily for 7 days o Helps treat the infection locally and reduces inflammation.
Why Both Oral and Topical?
• Oral antibiotics are necessary because middle ear infections often have a bacterial
etiology and require systemic treatment.
• Topical fluoroquinolone ear drops (like Ciprodex) are safe with TM perforation and
help prevent otorrhea and secondary infection
Question 4: All are findings consistent with peritonsillar abscess EXCEPT:
a. muffled voice
b. unilateral enlargement of tonsil
C. trismus
d. exudate on tonsils
Correct Answer:
d. Exudate on tonsils
Explanation:
A peritonsillar abscess (PTA) is a deep neck space infection that typically presents with:
