Nokea
A patient has undergone diagnostic testing and has been diagnosed with otosclerosis? What ear structure is primarily affected by this diagnosis?
- A. Malleus
- B. Stapes
- C. Incus
- D. Tympanic membrane
Correct Answer: B
Rationale: Otosclerosis causes abnormal bone growth around the stapes, fixing it and impairing sound conduction. Other ear structures are not primarily affected.
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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 patient has been diagnosed with serous otitis media for the third time in the past year. How should the nurse best interpret this patients health status?
- A. For some patients, these recurrent infections constitute an age-related physiologic change.
- B. The patient would benefit from a temporary mobility restriction to facilitate healing.
- C. The patient needs to be assessed for nasopharyngeal cancer.
- D. Blood cultures should be drawn to rule out a systemic infection.
Correct Answer: C
Rationale: Recurrent unilateral serous otitis media in adults may indicate nasopharyngeal cancer obstructing the eustachian tube, requiring evaluation. It is not age-related, does not require mobility restriction, and is not systemic.
An advanced practice nurse has performed a Rinne test on a new patient. During the test, the patient reports that air-conducted sound is louder than bone-conducted sound. How should the nurse best interpret this assessment finding?
- A. The patients hearing is likely normal.
- B. The patient is at risk for tinnitus.
- C. The patient likely has otosclerosis.
- D. The patient likely has sensorineural hearing loss.
Correct Answer: A
Rationale: A Rinne test showing louder air-conducted sound indicates normal hearing or sensorineural loss, but in context, normal hearing is most likely. Tinnitus and otosclerosis are not directly assessed by this test.
Following a motorcycle accident, a 17-year-old man is brought to the ED. What physical assessment findings related to the ear should be reported by the nurse immediately?
- A. The malleus can be visualized during otoscopic examination.
- B. The tympanic membrane is pearly gray.
- C. Tenderness is reported by the patient when the mastoid area is palpated.
- D. Clear, watery fluid is draining from the patients ear.
Correct Answer: D
Rationale: Clear, watery ear drainage post-trauma suggests cerebrospinal fluid leak from a skull fracture, requiring immediate reporting. Visualizing the malleus or a pearly gray tympanic membrane is normal, and mastoid tenderness, while notable, is less urgent.
The nurse is planning the care of a patient with a diagnosis of vertigo. What nursing diagnosis risk should the nurse prioritize in this patients care?
- A. Risk for disturbed sensory perception
- B. Risk for unilateral neglect
- C. Risk for falls
- D. Risk for ineffective health maintenance
Correct Answer: C
Rationale: Vertigo increases fall risk due to impaired balance, making this the priority nursing diagnosis. Other risks are less immediate.