Nokea
A nurse is teaching preventative measures for otitis externa to a group of older adults. What action should the nurse encourage?
- A. Rinsing the ears with normal saline after swimming
- B. Avoiding loud environmental noises
- C. Instilling antibiotic ointments on a regular basis
- D. Avoiding the use of cotton swabs
Correct Answer: D
Rationale: Avoiding cotton swabs prevents trauma to the ear canal, reducing otitis externa risk. Rinsing ears, noise avoidance, or routine antibiotics are not effective preventive measures.
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The nurse is planning the care of a patient who is adapting to the use of a hearing aid for the first time. What is the most significant challenge experienced by a patient with hearing loss who is adapting to using a hearing aid for the first time?
- A. Regulating the tone and volume
- B. Learning to cope with amplification of background noise
- C. Constant irritation of the external auditory canal
- D. Challenges in keeping the hearing aid clean while minimizing exposure to moisture
Correct Answer: B
Rationale: Amplification of background noise is the primary challenge for new hearing aid users, often leading to discontinuation. Tone/volume adjustment, canal irritation, and cleaning are secondary concerns.
While reviewing the health history of an older adult experiencing hearing loss the nurse notes the patient has had no trauma or loss of balance. What aspect of this patients health history is most likely to be linked to the patients hearing deficit?
- A. Recent completion of radiation therapy for treatment of thyroid cancer
- B. Routine use of quinine for management of leg cramps
- C. Allergy to hair coloring and hair spray
- D. Previous perforation of the eardrum
Correct Answer: B
Rationale: Quinine is ototoxic and its long-term use is associated with hearing loss. Radiation therapy, hair product allergies, and a single healed eardrum perforation are less likely to cause hearing deficits.
The clinic nurse is assessing a child who has been brought to the clinic with signs and symptoms that are suggestive of otitis externa. What assessment finding is characteristic of otitis externa?
- A. Tophi on the pinna and ear lobe
- B. Dark yellow cerumen in the external auditory canal
- C. Pain on manipulation of the auricle
- D. Air bubbles visible in the middle ear
Correct Answer: C
Rationale: Pain when manipulating the auricle is a hallmark of otitis externa due to inflammation of the external ear canal. Tophi are related to gout, cerumen is a normal finding, and air bubbles suggest middle ear issues, not otitis externa.
A group of high school students is attending a concert, which will be at a volume of 80 to 90 dB. What is a health consequence of this sound level?
- A. Hearing will not be affected by a decibel level in this range.
- B. Hearing loss may occur with a decibel level in this range.
- C. Sounds in this decibel level are not perceived to be harsh to the ear.
- D. Ear plugs will have no effect on these decibel levels.
Correct Answer: B
Rationale: Sound levels above 80 dB can damage the inner ear, potentially causing hearing loss. These levels are perceived as harsh, and ear plugs can mitigate the risk.
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.