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A child goes to the school nurse and complains of not being able to hear the teacher. What test could the school nurse perform that would preliminarily indicate hearing loss?
- A. Audiometry
- B. Rinne test
- C. Whisper test
- D. Weber test
Correct Answer: C
Rationale: The whisper test, assessing the ability to hear a whispered phrase, is a simple screening tool for hearing loss that a nurse can perform. Audiometry, Rinne, and Weber tests require specialized training or equipment.
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A nurse is planning preoperative teaching for a patient with hearing loss due to otosclerosis. The patient is scheduled for a stapedectomy with insertion of a prosthesis. What information is most crucial to include in the patients preoperative teaching?
- A. The procedure is an effective, time-tested treatment for sensory hearing loss.
- B. The patient is likely to experience resolution of conductive hearing loss after the procedure.
- C. Several months of post-procedure rehabilitation will be needed to maximize benefits.
- D. The procedure is experimental, but early indications suggest great therapeutic benefits.
Correct Answer: B
Rationale: Stapedectomy corrects conductive hearing loss caused by otosclerosis by replacing the fixed stapes with a prosthesis, restoring sound conduction. It is not for sensory hearing loss, not experimental, and does not require lengthy rehabilitation.
A patient is postoperative day 6 following tympanoplasty and mastoidectomy. The patient has phoned the surgical unit and states that she is experiencing occasional sharp, shooting pains in her affected ear. How should the nurse best interpret this patients complaint?
- A. These pains are an expected finding during the first few weeks of recovery.
- B. The patients complaints are suggestive of a postoperative infection.
- C. The patient may have experienced a spontaneous rupture of the tympanic membrane.
- D. The patients surgery may have been unsuccessful.
Correct Answer: A
Rationale: Sharp, shooting pains are normal post-tympanoplasty/mastoidectomy as the eustachian tube adjusts, typically resolving in 2-3 weeks. Infection would involve constant pain and fever, and there's no evidence of rupture or surgical failure.
A child has been experiencing recurrent episodes of acute otitis media (AOM). The nurse should anticipate that what intervention is likely to be ordered?
- A. Ossiculoplasty
- B. Insertion of a cochlear implant
- C. Stapedectomy
- D. Insertion of a ventilation tube
Correct Answer: D
Rationale: Ventilation tubes are commonly used for recurrent AOM to equalize pressure and drain fluid, preventing further infections. Ossiculoplasty, cochlear implants, and stapedectomy address other conditions.
An older adult with a recent history of mixed hearing loss has been diagnosed with a cholesteatoma. What should this patient be taught about this diagnosis? Select all that apply
- A. Cholesteatomas are benign and self-limiting, and hearing loss will resolve spontaneously.
- B. Cholesteatomas are usually the result of metastasis from a distant tumor site.
- C. Cholesteatomas are often the result of chronic otitis media.
- D. Cholesteatomas, if left untreated, result in intractable neuropathic pain.
- E. Cholesteatomas usually must be removed surgically.
Correct Answer: C,E
Rationale: Cholesteatomas, often caused by chronic otitis media, require surgical removal to prevent complications like bone erosion. They are not self-limiting, metastatic, or typically painful.
Which of the following nursing interventions would most likely facilitate effective communication with a hearing-impaired patient?
- A. Ask the patient to repeat what was said in order to evaluate understanding.
- B. Stand directly in front of the patient to facilitate lip reading.
- C. Reduce environmental noise and distractions before communicating.
- D. Raise the voice to project sound at a higher frequency.
Correct Answer: C
Rationale: Reducing environmental noise enhances the patient's ability to hear and focus, improving communication. Asking to repeat may frustrate, raising the voice distorts sound, and not all patients lip-read effectively.