Question

question 9
1 pts
a school - age child has a history of chronic otitis media and is seen in the clinic with vertigo. the primary care nurse practitioner notes profuse purulent otorrhea from both pressure - equalizing tubes and a pearly - white lesion on one tympanic membrane. which condition is most likely?

• cholesteatoma
• otitis media with effusion
• mastoiditis
• otitis externa

question 10
1 pts
a child is bitten on one arm by a neighbor’s dog. the dog is immunized against rabies and the child’s last tetanus immunization was 4 years prior. the wound edges are gaping and avulsed. what is an important initial intervention when treating this injury?

• administration of rabies prophylaxis and a tetanus booster
• irrigation of the wounds with high - pressure normal saline
• reporting the animal bite to the local animal control authority
• debriding and suturing the wound to prevent infection

Explanation:

Question 9

• Cholesteatoma: Associated with chronic otitis media, presents with purulent otorrhea, vertigo, and a pearly - white lesion on the tympanic membrane.
• Otitis media with effusion: Mainly has fluid in the middle ear without the purulent otorrhea and pearly - white lesion.
• Mastoiditis: Involves the mastoid bone, symptoms are more related to mastoid pain and swelling, not the tympanic membrane lesion described.
• Otitis externa: Affects the outer ear canal, not related to pressure - equalizing tubes or tympanic membrane lesions.

• For a dog - bite wound with gaping and avulsed edges, initial irrigation with high - pressure normal saline is crucial to clean the wound and reduce infection risk.
• Rabies prophylaxis is not needed as the dog is immunized.
• Tetanus booster is not the initial intervention (wound cleaning first).
• Reporting the animal is not the initial treatment for the wound.

Answer:

A. Cholesteatoma

Question 10