PEDS EXAM 4 TEST PAPER QUESTIONS
AND SOLUTIONS VERIFIED ANSWERS
GRADED A+
●● amblyopia
Answer: "lazy eye" from strabismus
lead to blindness eventually, brain rejects image from weaker eye
●● otitis externa manifestations
Answer: infection/inflammation of ear canal from water remaining in ear
sx: pruritis, erythema, discomfort (worse with pulling down!), clear
odorless drainage, muffled hearing
●● otitis externa tx
Answer: otic drops: antibiotic and anti fungal with potential wick
acetaminophen, ibuprofen for discomfort
●● otitis media types
Answer: -acute: inflammation with rapid onset and s/s acute infection
,-with effusion: fluid remains after infection cleared
-chronic with effusion
either related to respiratory infection/allergy or noninfectious (blocked)
●● acute otitis media clinical manifestations
Answer: otalgia (earache) after URI, possible fever, purulent, bulging
and red tympanic membrane
if chronic: hearing loss, speech issues, tinnitus or vertigo, feeling of
fullness
●● acute otitis media infant vs. older child sx
Answer: infant: restless, irritable when laying down, pull on affected ear
(!!), hard to comfort, refuse to eat
older children: verbalize discomfort, irritable, lethargy, loss of appetite
●● acute otitis media treatment
Answer: -analgesics and antipyretics - priority to tx pain
-abx: if sx for > 48-72hrs, watchful waiting before to see if sx resolve
-severe: myringotomy and tympanoplasty tubes if severe pain, chronic
infection, hearing loss, scarring
,●● acute otitis media nursing care
Answer: comfort measures for pain/fever
feed upright
educate abt abx and prevention
tubes: limit activity for a few days, notify provider if tubes come out
●● acute streptococcal pharyngitis sx
Answer: GABHS infection of upper airway
abrupt onset of pharyngitis (red, shore throat), h/a, fever, abd pain,
enlarge tonsils with possible white exudate, anterior cervical
lymphadenopathy
●● strep diagnosis/therapeutic mgmt
Answer: get test if sore throat!! rapid antigen testing - culture if neg
abx, IM penicillin
●● strep nursing care
Answer: get throat swap for culture
abx education
, warm/cold compress
warm saline gargles
ibuprophen (> 6mo), acetaminopehn
fluids essential! dont force food
cool liquids
rest
change toothbrush after 24hrs on abx
●● tonsilitis nursing care/mgmt
Answer: antipyretic/analgesic
abx - oral, 10 days
I & Os
tonsillectomy or adenoidectomy if recurrent tosillitis, obstructed airway,
abscess
●● tonsillectomy post-op care
Answer: -hemorrhage risk: assess, discourage coughing/clearing throat,
observe frequent swallowing
-pain control: Tylenol with codeine prn
-I&Os: anti-emetics, clears -> soft diet
-airway: cool mist vaporizer, check throat before d/c
AND SOLUTIONS VERIFIED ANSWERS
GRADED A+
●● amblyopia
Answer: "lazy eye" from strabismus
lead to blindness eventually, brain rejects image from weaker eye
●● otitis externa manifestations
Answer: infection/inflammation of ear canal from water remaining in ear
sx: pruritis, erythema, discomfort (worse with pulling down!), clear
odorless drainage, muffled hearing
●● otitis externa tx
Answer: otic drops: antibiotic and anti fungal with potential wick
acetaminophen, ibuprofen for discomfort
●● otitis media types
Answer: -acute: inflammation with rapid onset and s/s acute infection
,-with effusion: fluid remains after infection cleared
-chronic with effusion
either related to respiratory infection/allergy or noninfectious (blocked)
●● acute otitis media clinical manifestations
Answer: otalgia (earache) after URI, possible fever, purulent, bulging
and red tympanic membrane
if chronic: hearing loss, speech issues, tinnitus or vertigo, feeling of
fullness
●● acute otitis media infant vs. older child sx
Answer: infant: restless, irritable when laying down, pull on affected ear
(!!), hard to comfort, refuse to eat
older children: verbalize discomfort, irritable, lethargy, loss of appetite
●● acute otitis media treatment
Answer: -analgesics and antipyretics - priority to tx pain
-abx: if sx for > 48-72hrs, watchful waiting before to see if sx resolve
-severe: myringotomy and tympanoplasty tubes if severe pain, chronic
infection, hearing loss, scarring
,●● acute otitis media nursing care
Answer: comfort measures for pain/fever
feed upright
educate abt abx and prevention
tubes: limit activity for a few days, notify provider if tubes come out
●● acute streptococcal pharyngitis sx
Answer: GABHS infection of upper airway
abrupt onset of pharyngitis (red, shore throat), h/a, fever, abd pain,
enlarge tonsils with possible white exudate, anterior cervical
lymphadenopathy
●● strep diagnosis/therapeutic mgmt
Answer: get test if sore throat!! rapid antigen testing - culture if neg
abx, IM penicillin
●● strep nursing care
Answer: get throat swap for culture
abx education
, warm/cold compress
warm saline gargles
ibuprophen (> 6mo), acetaminopehn
fluids essential! dont force food
cool liquids
rest
change toothbrush after 24hrs on abx
●● tonsilitis nursing care/mgmt
Answer: antipyretic/analgesic
abx - oral, 10 days
I & Os
tonsillectomy or adenoidectomy if recurrent tosillitis, obstructed airway,
abscess
●● tonsillectomy post-op care
Answer: -hemorrhage risk: assess, discourage coughing/clearing throat,
observe frequent swallowing
-pain control: Tylenol with codeine prn
-I&Os: anti-emetics, clears -> soft diet
-airway: cool mist vaporizer, check throat before d/c
