Medical Tests Medical Tests Certifications CEN Questions & Answers

• Question 181:

  You are caring for a child who will have a tonsillectomy. Which of the following would increase the child's risk of aspiration during surgery?

  A. Difficulty swallowing

  B. Loose teeth

  C. Bleeding

  D. Exudate in the throat

  Correct Answer: B

  If the child has loose teeth it increases the risk of aspiration. A and D are symptoms that indicate the need for surgery. C will be taken care of during surgery with suctioning and packing. Therefore it is important that the nurse check the child for loose teeth prior to surgery to prevent aspiration.

• Question 182:

  You are caring for a child who is going to have a tonsillectomy. Which of the following laboratory results would you want to check preoperatively?

  A. Prothrombin time

  B. Sedimentation rate

  C. Blood urea nitrogen

  D. Creatinine

  Correct Answer: A

  The nurse would want to check the prothrombin time preoperatively and report any abnormal results to the surgeon. The tonsillar area is very vascular, which can increase the patient's chance of bleeding. If the prothrombin time is not adequate, the patient could bleed to death.

• Question 183:

  You are caring for a child with chlamydial conjunctivitis. What would you want to investigate if you had a patient with this diagnosis?

  A. Presence of an allergy

  B. Possible trauma

  C. Possible sexual abuse

  D. Presence of a respiratory infection

  Correct Answer: C

  The nurse would want to investigate possible sexual abuse. This diagnosis in a child who is not sexually active should trigger suspicions in the nurse. Allergy, trauma and infection can all cause conjunctivitis, but chlamydia is a sexually transmitted disease.

• Question 184:

  Which of the following assessments would make the nurse suspect that a child has strabismus?

  A. Tilts head to see

  B. Turns head to see

  C. Does not respond when spoken to

  D. Has difficulty hearing

  Correct Answer: A

  A child with strabismus will tilt head to see. Strabismus is when the extraocular muscles have a lack of coordination so the eyes do not align. The patient may complain of frequent headaches and squint to see and may need to go to surgery to realign the weak muscles if nonsurgical interventions do not work.

• Question 185:

  The most appropriate action by the nurse who is preparing to communicate with an older patient who has hearing loss is:

  A. Stand in front of the patient.

  B. Exaggerate lip movements.

  C. Obtain a sign language interpreter.

  D. Pantomime and write the patient notes.

  Correct Answer: A

  The nurse should stand in front of the patient with hearing loss while trying to communicate with them. By standing in front of the patient and providing adequate lighting, the nurse insures that the patient can see the nurse clearly. If there is still difficulty communicating, then notes and pantomime can be used.

• Question 186:

  You have delegated the care of an older patient with hearing loss to a nursing assistant. You tell the nursing assistant that patients with this diagnosis:

  A. Are often distracted.

  B. Respond better to low pitched sounds.

  C. Have middle ear changes.

  D. Develop moist cerumen production.

  Correct Answer: B

  Older patients with hearing loss respond better to low pitch sounds. Age-related changes of the inner ear are called presbycusis. As a result of these changes the patient often loses the ability to hear high-pitched sounds.

• Question 187:

  You are caring for a patient who has had a right eye cataract removal. What discharge instruction would you want to include in the plan of care?

  A. Do not sleep on right side.

  B. Do not sleep on left side.

  C. Do not sleep with head elevated.

  D. Do wear glasses until physician says it is okay.

  Correct Answer: A

  The patient should not sleep on the right side following surgery. The patient should be placed in a semi-Fowler position to minimize edema and intraocular pressure. The patient should wear glasses and a protective shield over the affected eye.

• Question 188:

  You are caring for a patient who complains of tinnitus. What part of the ear do you suspect is the most likely cause of the patient's complaint?

  A. External ear

  B. Middle ear

  C. Inner ear

  D. Auricle

  Correct Answer: C

  Tinnitus is the most common complaint of patients with disorders of the inner ear. Tinnitus is a ringing in the ear that can be loud intolerable ringing or mild ringing that can be unnoticed during the day.

• Question 189:

  When caring for a patient what sign would indicate that he might have a basal skull fracture?

  A. The auditory canal has purulent drainage.

  B. The auditory canal has bloody or clear drainage.

  C. Epistaxis

  D. Periorbital edema

  Correct Answer: B

  A basal skull fracture would be indicated by bloody or clear drainage from the auditory canal. This indicates a cerebrospinal fluid leak from the fracture. This is a medical emergency and needs to be addressed by the physician immediately.

• Question 190:

  You are caring for a patient who has come into the emergency department with a foreign body in his right ear. After further investigation you determine that the foreign object is an insect. What intervention would the physician order first for this client?

  A. Sterile normal saline irrigation

  B. Diluted alcohol irrigation

  C. Antibiotic ear drops

  D. Corticosteroids ointment

  Correct Answer: B

  The nurse would know that the physician will order diluted alcohol irrigation of the affected ear. This will suffocate the insect so it can be removed from the ear with forceps. If the foreign object were vegetable matter, irrigation would not be performed due to the enlargement of the object when it is hydrated, which would make the impaction worse.