Correct Answer: C

Rationale: The correct answer is C: Perform an otoscopic examination of the left naris. The rationale for this is that the child presenting with purulent, malodorous drainage from one naris may indicate a foreign body lodged in the left naris causing infection. By performing an otoscopic examination, the nurse can visualize inside the naris to identify any foreign body or signs of infection. This step is crucial for determining the appropriate treatment plan. Choices A, B, and D are incorrect: A: Referring the child for an antibiotic prescription without further assessment is premature and may not address the underlying cause. B: Having the mother bring the child back in 1 week delays the necessary examination and potential treatment. D: Telling the mother that this is normal without proper assessment could lead to overlooking a potential health issue that requires intervention.

Correct Answer: C

Rationale: The correct answer is C: myxedema. This is a classic presentation of hypothyroidism, specifically myxedema, characterized by puffy eyes, coarse hair, and dry skin. The thyroid hormone deficiency leads to decreased metabolic activity, causing these symptoms. Cachexia (A) is severe muscle wasting seen in conditions like cancer. Cretinism (B) is congenital hypothyroidism leading to mental retardation. Scleroderma (D) is a connective tissue disorder causing skin thickening, not typically associated with these symptoms.

Correct Answer: B

Rationale: Step 1: Jaundice is characterized by a yellow skin color due to elevated bilirubin levels. Step 2: Yellow color extending up to the iris indicates systemic jaundice, involving the whole body. Step 3: Yellow patches throughout the sclera (Choice A) may not indicate systemic jaundice. Step 4: Skin appearing yellow under low light (Choice C) may not be specific to jaundice. Step 5: Yellow deposits on palms and soles (Choice D) are not typical signs of jaundice. Therefore, Choice B is correct as it reflects systemic jaundice, while the other choices do not fully align with the manifestation of true jaundice.

Correct Answer: C

Rationale: The correct answer is C: A thin, translucent membrane. In elderly patients, the tympanic membrane tends to become thinner and more translucent due to age-related changes. This is considered a normal finding as it is a common occurrence in older individuals. The other choices are incorrect because: A) Loss of high-tone frequency hearing is not a normal finding in an ear examination of an elderly patient, as age-related hearing loss typically affects high frequencies. B) Increased elasticity of the pinna is not a common age-related change and may indicate a different issue. D) A shiny pink tympanic membrane is not a typical finding in an elderly patient and could suggest inflammation or infection instead of a normal age-related change.

Correct Answer: D

Rationale: The correct answer is D because intraocular pressure is primarily determined by the amount of aqueous humor produced and the resistance to its outflow at the angle of the anterior chamber. When there is an imbalance in the production and outflow of aqueous humor, it can lead to an increase in intraocular pressure, which can result in conditions like glaucoma. Choices A, B, and C are incorrect because they do not directly influence intraocular pressure. The thickness or bulging of the lens (A) is related to accommodation for near vision, the posterior chamber accommodating fluid (B) is not a primary factor in determining intraocular pressure, and the contraction of the ciliary body (C) affects the shape of the lens for focusing rather than intraocular pressure regulation.