Nokea
A patient has benefited from a cochlear implant. The nurse should understand that this patients health history likely includes which of the following? Select all that apply.
- A. The patient was diagnosed with sensorineural hearing loss.
- B. The patients hearing did not improve appreciably with the use of hearing aids.
- C. The patient has deficits in peripheral nervous function.
- D. The patients hearing deficit is likely accompanied by a cognitive deficit.
- E. The patient is unable to lip-read.
Correct Answer: A,B
Rationale: Cochlear implants are used for profound bilateral sensorineural hearing loss unresponsive to hearing aids. Peripheral nerve deficits, cognitive issues, or inability to lip-read are not prerequisites.
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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.
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 patient with mastoiditis is admitted to the post-surgical unit after undergoing a radical mastoidectomy. The nurse should identify what priority of postoperative care?
- A. Assessing for mouth droop and decreased lateral eye gaze
- B. Assessing for increased middle ear pressure and perforated ear drum
- C. Assessing for gradual onset of conductive hearing loss and nystagmus
- D. Assessing for scar tissue and cerumen obstructing the auditory canal
Correct Answer: A
Rationale: Facial nerve injury during mastoidectomy can cause mouth droop and decreased lateral gaze, making this a priority assessment. Middle ear pressure, hearing loss, or scar tissue are not immediate postoperative concerns.
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.
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.