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A patient is scheduled to have an electronystagmography as part of a diagnostic workup for Mnires disease. What question is it most important for the nurse to ask the patient in preparation for this test?
- A. Have you ever experienced claustrophobia or feelings of anxiety while in enclosed spaces?
- B. Do you currently take any tranquilizers or stimulants on a regular basis?
- C. Do you have a history of falls or problems with loss of balance?
- D. Do you have a history of either high or low blood pressure?
Correct Answer: B
Rationale: Electronystagmography requires withholding medications like tranquilizers or stimulants that affect nystagmus, ensuring accurate results. Claustrophobia, falls, or blood pressure are less relevant to test preparation.
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The nurse is assessing a patient with multiple sclerosis who is demonstrating involuntary, rhythmic eye movements. What term will the nurse use when documenting these eye movements?
- A. Vertigo
- B. Tinnitus
- C. Nystagmus
- D. Astigmatism
Correct Answer: C
Rationale: Nystagmus is involuntary, rhythmic eye movement, common in multiple sclerosis. Vertigo is a sensation of movement, tinnitus is auditory, and astigmatism affects vision.
The nurse is discharging a patient home after mastoid surgery. What should the nurse include in discharge teaching?
- A. Try to induce a sneeze every 4 hours to equalize pressure.
- B. Be sure to exercise to reduce fatigue.
- C. Avoid sleeping in a side-lying position.
- D. Dont blow your nose for 2 to 3 weeks.
Correct Answer: D
Rationale: Avoiding nose blowing for 2-3 weeks prevents pressure changes that could dislodge grafts or prostheses. Sneezing, exercise, or side-lying are not contraindicated.
The nurse is discussing the results of a patients diagnostic testing with the nurse practitioner. What Weber test result would indicate the presence of a sensorineural loss?
- A. The sound is heard better in the ear in which hearing is better.
- B. The sound is heard equally in both ears.
- C. The sound is heard better in the ear in which hearing is poorer.
- D. The sound is heard longer in the ear in which hearing is better.
Correct Answer: A
Rationale: In sensorineural hearing loss, the Weber test shows sound lateralizing to the better-hearing ear, as the affected ear has impaired nerve function. Equal hearing or sound in the poorer ear suggests normal hearing or conductive loss.
A patient with otosclerosis has significant hearing loss. What should the nurse do to best facilitate communication with the patient?
- A. Sit or stand in front of the patient when speaking.
- B. Use exaggerated lip and mouth movements when talking.
- C. Stand in front of a light or window when speaking.
- D. Say the patients name loudly before starting to talk.
Correct Answer: A
Rationale: Standing in front allows the patient to see facial expressions and potentially lip-read, aiding communication. Exaggerated movements distort speech, backlighting causes glare, and shouting may not help.
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.