Nokea
A patient diagnosed with arthritis has been taking aspirin and now reports experiencing tinnitus and hearing loss. What should the nurse teach this patient?
- A. The hearing loss will likely resolve with time after the drug is discontinued.
- B. The patients hearing loss and tinnitus are irreversible at this point.
- C. The patients tinnitus is likely multifactorial, and not directly related to aspirin use.
- D. The patients tinnitus will abate as tolerance to aspirin develops.
Correct Answer: A
Rationale: Aspirin-induced ototoxicity, causing tinnitus and hearing loss, is typically reversible upon discontinuation. It is directly related to aspirin, not multifactorial, and tolerance does not resolve it.
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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 advanced practice nurse is attempting to examine the patients ear with an otoscope. Because of impacted cerumen, the tympanic membrane cannot be visualized. The nurse irrigates the patients ear with a solution of hydrogen peroxide and water to remove the impacted cerumen. What nursing intervention is most important to minimize nausea and vertigo during the procedure?
- A. Maintain the irrigation fluid at a warm temperature.
- B. Instill short, sharp bursts of fluid into the ear canal.
- C. Follow the procedure with insertion of a cerumen curette to extract missed ear wax.
- D. Have the patient stand during the procedure.
Correct Answer: A
Rationale: Warm irrigation fluid prevents vertigo and nausea, which cold fluid can trigger. Forceful irrigation risks perforation, curettes require special training, and standing is unnecessary.
The nurse and a colleague are performing the Epley maneuver with a patient who has a diagnosis of benign paroxysmal positional vertigo. The nurses should begin this maneuver by performing what action?
- A. Placing the patient in a prone position
- B. Assisting the patient into a sitting position
- C. Instilling 15 mL of warm normal saline into one of the patients ears
- D. Assessing the patients baseline hearing by performing the whisper test
Correct Answer: B
Rationale: The Epley maneuver starts with the patient sitting, followed by specific head positioning to reposition canaliths. Prone positioning, saline instillation, or hearing tests are not part of the procedure.
The nurse is providing discharge education for a patient with a new diagnosis of Mnires disease. What food should the patient be instructed to limit or avoid?
- A. Sweet pickles
- B. Frozen yogurt
- C. Shellfish
- D. Red meat
Correct Answer: A
Rationale: Mnires disease is exacerbated by high salt and sugar intake, which sweet pickles contain. Dairy, shellfish, and red meat are not contraindicated unless processed or canned.
A patient is being discharged home after mastoid surgery. What topic should the nurse include in discharge teaching?
- A. Expected changes in facial nerve function
- B. The need for audiometry testing every 6 months following recovery
- C. Safe use of analgesics and antivertiginous agents
- D. Appropriate use of OTC ear drops
Correct Answer: C
Rationale: Teaching about analgesics and antivertiginous agents supports safe management of pain and vertigo post-mastoidectomy. Facial nerve changes are complications, audiometry is not routine, and OTC ear drops are not recommended.