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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.
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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.
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.
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.
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.
A patient has been diagnosed with hearing loss related to damage of the end organ for hearing or cranial nerve VIII. What term is used to describe this condition?
- A. Exostoses
- B. Otalgia
- C. Sensorineural hearing loss
- D. Presbycusis
Correct Answer: C
Rationale: Sensorineural hearing loss results from damage to the cochlea or cranial nerve VIII. Exostoses are bony growths, otalgia is ear pain, and presbycusis is age-related hearing loss.