CMN-568 Ears Exam Questions And Answers
Otitis Externa (Swimmer's Ear) - ANS Inflammation of the outer ear and ear canal due to infection
Cellulitis of the soft tissues of the external auditory canal - ANS Otitis Externa
What pathogens are responsible for Otitis Externa? - ANS Pseud...
Otitis Externa (Swimmer's Ear) - ANS Inflammation of the outer ear and ear canal due to infection
Cellulitis of the soft tissues of the external auditory canal - ANS Otitis Externa
K
What pathogens are responsible for Otitis Externa? - ANS Pseudomonas aeruginosa
Staphylococcus aureus
Aspergillus or other fungi
C
Which of the following is considered a risk factor for Otitis Externa?
LO
A. A mother that repeatedly cleans her child's ears.
B. Swimming
C. Doing back flips on the trampoline.
D. A & B - ANS D
YC
How does keeping the ears too clean contribute to Otitis Externa? - ANS Removes protective cerumen
and increases pH which promotes bacterial growth
Hallmark Sign of Otitis Externa - ANS Severe ear pain made worse by moving pinna or tragus
What type of discharge would the provider expect to see when caring for a patient with a diagnosis of
D
Otitis Externa? - ANS Purulent discharge
Differential Diagnosis of Otitis Externa - ANS AOM w/ TM rupture
U
Patent PE tubes
Furunculosis of the ear canal
Mastoiditis
ST
If debris is visualized and the TM is visualized what should the next action be? - ANS The NP can
gently remove the debris using warm water and a bulb syringe?
What is a negative response that can occur if the NP irrigates with cold water? - ANS Vestibular
response and can cause an episode of dizziness and possible vomiting.
What is the first-line treatment for a patient with Otitis Externa? - ANS Fluoroquinolone drops
Ciprofloxacin/dexamethasone (Ciprodex)
What drops cover both pseudomonas and Staph? - ANS Ciprodex
, Can Neomycin/Polymyxin B/Hydrocortisone be used if the TM is perforated or PE Tubes in place/ -
ANS No
Patient comes in and the provider tells the patient that they have otitis externa. The patient asks, "What
can I do differently to prevent this from ocurring again?
Select All That Apply - ANS A. Avoid use of Q-Tips
B. Do not dry ears out, moisture keeps the ears healthy.
C. Avoid vigorous ear cleaning.
D. Use drying agents after swimming such as 2-3 drops of 1:1 solution of white vinegar/70% ethyl
K
alcohol.
A-C-D
C
Acute Otitis Media (AOM) - ANS inflammation of the middle ear
bulging tympanic membrane
LO
middle ear effusion as demonstrated by pneumatic otoscopy - ANS Acute Otitis Media
acute otitis media Pathogens Mnemonic - ANS She Hit Me
Streptococcus Pneumoniae
Haemophilus influenzae
Moraxella Catarrhalis
D
Why are children more prone to AOM? - ANS Eustachian tube dysfunction: equalizes pressure and
allows drainage from middle ear. Tubes in infants are shorter, wider, floppier and more horizontal that in
U
adults, making them prone to dysfunction
What are risk factors for AOM? - ANS A. Eustachian tube dysfunction: equalizes pressure and allows
ST
drainage from middle ear.
B. Bacterial colonization of the nasopharynx with AOM pathogens
C. Viral URI: inflammation of eustachian tubes impairs function leading to middle ear effusion
D. Smoke exposure: inflamed eustachian tubes, impeded drainage, and increases pathogen colonization
Impaired immune defense: children with disorders that cause immunocompromised are at increased risk
E. Bottle feeding: Breastfeeding has been shown to decrease risk of AOM. Bottle feeding, especially if
the bottle is propped, increases the risk
Craniofacial disorders such as Down's Syndrome and cleft palate
Daycare attendance: children in daycare have more exposure to URI and more AOM
Time of year: AOM increases in winter months along with viral URI
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