Ear and Nose Foreign Body Removal in Pediatric Patients

TEST INSTRUCTIONS

• Read the article. The test for this nursing continuing professional development (NCPD) activity is to be taken online at www.nursingcenter.com/CE/AENJ. Tests can no longer be mailed or faxed.
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• There's only one correct answer for each question. A passing score for this test is 7 correct answers. If you pass, you can print your certificate of earned contact hours and access the answer key. If you fail, you have the option of taking the test again at no additional cost.
• For questions, contact Lippincott Professional Development: 1-800-787-8985.
• Registration deadline is December 5, 2025.

PROVIDER ACCREDITATION

Lippincott Professional Development will award 2.0 contact hours and 0 pharmacology contact hours for this nursing continuing professional development activity.

Lippincott Professional Development is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center's Commission on Accreditation.

This activity is also provider approved by the California Board of Registered Nursing, Provider Number CEP 11749 for 2.0 contact hours. Lippincott Professional Development is also an approved provider of continuing nursing education by the District of Columbia, Georgia, West Virginia, New Mexico, South Carolina, and Florida, CE Broker #50-1223. Your certificate is valid in all states.

Payment: The registration fee for this test is $21.95.

CE TEST QUESTIONS

AENJ0123B

Learning Outcome: Seventy-five percent of participants will demonstrate competency in clinical reasoning regarding ear and nose foreign bodies in pediatric patients by achieving a minimum score of 70% on the outcomes-based posttest.

Learning Objectives: After completing this continuing professional development activity, the participant will apply knowledge gained to a case scenario to

1. Identify general steps in the removal of a foreign body from a child's ear or nose.
2. Explain options that may be used in the removal of a foreign body from the nose.
3. Explain special considerations for removing a foreign body from the ear.
4. Select potential complications from foreign bodies in the ear or nose.

• 1. If you see a foreign body in a child's ear or nose where it appears that it will be difficult to remove and the child is not cooperative, the most appropriate course of action would be to
1. attempt removal of the object with the child swaddled and being held securely by one or more persons.
2. sedate the child before attempting to remove the object.
3. refer the child for care by an Ear, Nose, and Throat (ENT) specialist.
• 2. As noted in the article, before removing nasal foreign bodies (excluding button batteries), you can consider applying which of the following intranasal medications?
1. a corticosteroid
2. a vasoconstrictor
3. a benzodiazepine
• 3. Which statement regarding the use of suction to remove a foreign body from the nose is accurate?
1. Suction may be more successful in removing compressible objects than noncompressible objects.
2. The standard tool to use in most cases is a flexible suction catheter.
3. When attempting to remove noncompressible objects, suction is most likely to be successful if the object is wedged in the nasal cavity.
• 4. You should not use irrigation to remove which of the following foreign objects in the ear?
1. beads
2. paper
3. rocks
• 5. What is the proper procedure for removing a full post earring, including earring back, that is embedded in a child's ear lobe?
1. Grasp the ear lobe while applying pressure to the anterior side, pushing posteriorly.
2. Have an assistant squeeze the ear lobe while you pry the front and back pieces of the earring apart.
3. Make a small incision to the anterior pinna and remove the earring with hemostats.
• 6. A lack of success in removing which of the following foreign bodies in the emergency department would necessitate an emergent ENT referral?
1. sponges
2. popcorn kernels
3. button batteries
• 7. What is an appropriate intervention for your patient who has purulent nasal discharge and signs and symptoms consistent with bacterial sinusitis from a foreign body in the nose?
1. a mucolytic
2. gentle irrigation
3. oral antibiotics
• 8. As noted in the article, what is the most concerning complication of attempted nasal foreign body removal?
1. posterior displacement
2. swelling
3. epistaxis

Case-based assessment: Placing yourself in the role of the advanced practice nurse, use the following scenario to apply the knowledge and skills you learned in the attached article.

Questions 9 and 10 are based on this case scenario:

P.S. is an 11-year-old girl who presents to the emergency department with her mother. She states, “A bug flew in my ear, and I can feel it flapping around! It's awful!” Her mother states that this occurred within the past hour while the family was having a picnic at the park. P.S. has no significant past medical history. Her vital signs are within normal limits.

• 9. After looking in both ears, you determine that P.S. has a small moth in her right ear that is not pressing against the tympanic membrane. Your first step in caring for P.S. is to
1. quickly remove the moth with alligator forceps.
2. administer acetaminophen for discomfort.
3. explain in age-appropriate language what will happen during the procedure.
• 10. After showing P.S. the alligator forceps that you will use and prior to removal attempts, what is an appropriate solution to use to kill the moth?
1. mineral oil
2. docusate sodium
3. saline