Nokea
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.
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The nurse in the ED is caring for a 4 year-old brought in by his parents who state that the child will not stop crying and pulling at his ear. Based on information collected by the nurse, which of the following statements applies to a diagnosis of external otitis?
- A. External otitis is characterized by aural tenderness.
- B. External otitis is usually accompanied by a high fever.
- C. External otitis is usually related to an upper respiratory infection.
- D. External otitis can be prevented by using cotton-tipped applicators to clean the ear.
Correct Answer: A
Rationale: Aural tenderness is a key feature of otitis externa due to canal inflammation. High fever and upper respiratory infections are more typical of otitis media, and cotton-tipped applicators can cause otitis externa.
Which of the following nurses actions carries the greatest potential to prevent hearing loss due to ototoxicity?
- A. Ensure that patients understand the differences between sensory hearing loss and conductive hearing loss.
- B. Educate patients about expected age-related changes in hearing perception.
- C. Educate patients about the risks associated with prolonged exposure to environmental noise.
- D. Be aware of patients medication regimens and collaborate with other professionals accordingly.
Correct Answer: D
Rationale: Monitoring and collaborating on medication regimens prevent ototoxicity from drugs like aspirin, which can cause hearing loss. Education on hearing types or noise is less relevant.
A nurse is planning preoperative teaching for a patient with hearing loss due to otosclerosis. The patient is scheduled for a stapedectomy with insertion of a prosthesis. What information is most crucial to include in the patients preoperative teaching?
- A. The procedure is an effective, time-tested treatment for sensory hearing loss.
- B. The patient is likely to experience resolution of conductive hearing loss after the procedure.
- C. Several months of post-procedure rehabilitation will be needed to maximize benefits.
- D. The procedure is experimental, but early indications suggest great therapeutic benefits.
Correct Answer: B
Rationale: Stapedectomy corrects conductive hearing loss caused by otosclerosis by replacing the fixed stapes with a prosthesis, restoring sound conduction. It is not for sensory hearing loss, not experimental, and does not require lengthy rehabilitation.
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.
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.