Nokea
A patient presents to the ED complaining of a sudden onset of incapacitating vertigo, with nausea and vomiting and tinnitus. The patient mentions to the nurse that she suddenly cannot hear very well. What would the nurse suspect the patients diagnosis will be?
- A. Ossiculitis
- B. Mnires disease
- C. Ototoxicity
- D. Labyrinthitis
Correct Answer: D
Rationale: Labyrinthitis causes sudden vertigo, nausea, vomiting, tinnitus, and hearing loss due to inner ear inflammation. Mnires disease has similar symptoms but is chronic, not sudden. Ossiculitis and ototoxicity do not match this presentation.
You may also like to solve these questions
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.
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 with a sudden onset of hearing loss tells the nurse that he would like to begin using hearing aids. The nurse understands that the health professional dispensing hearing aids would have what responsibility?
- A. Test the patients hearing promptly.
- B. Perform an otoscopy.
- C. Measure the width of the patients ear canal.
- D. Refer the patient to his primary care physician.
Correct Answer: D
Rationale: Sudden hearing loss requires medical evaluation to rule out pathology, so referral to a physician is mandatory before dispensing hearing aids. Other actions are secondary.
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 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.