Nokea
An older adult with a recent history of mixed hearing loss has been diagnosed with a cholesteatoma. What should this patient be taught about this diagnosis? Select all that apply
- A. Cholesteatomas are benign and self-limiting, and hearing loss will resolve spontaneously.
- B. Cholesteatomas are usually the result of metastasis from a distant tumor site.
- C. Cholesteatomas are often the result of chronic otitis media.
- D. Cholesteatomas, if left untreated, result in intractable neuropathic pain.
- E. Cholesteatomas usually must be removed surgically.
Correct Answer: C,E
Rationale: Cholesteatomas, often caused by chronic otitis media, require surgical removal to prevent complications like bone erosion. They are not self-limiting, metastatic, or typically painful.
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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.
A nurse is teaching preventative measures for otitis externa to a group of older adults. What action should the nurse encourage?
- A. Rinsing the ears with normal saline after swimming
- B. Avoiding loud environmental noises
- C. Instilling antibiotic ointments on a regular basis
- D. Avoiding the use of cotton swabs
Correct Answer: D
Rationale: Avoiding cotton swabs prevents trauma to the ear canal, reducing otitis externa risk. Rinsing ears, noise avoidance, or routine antibiotics are not effective preventive measures.
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.
The nurse is planning the care of a patient who is adapting to the use of a hearing aid for the first time. What is the most significant challenge experienced by a patient with hearing loss who is adapting to using a hearing aid for the first time?
- A. Regulating the tone and volume
- B. Learning to cope with amplification of background noise
- C. Constant irritation of the external auditory canal
- D. Challenges in keeping the hearing aid clean while minimizing exposure to moisture
Correct Answer: B
Rationale: Amplification of background noise is the primary challenge for new hearing aid users, often leading to discontinuation. Tone/volume adjustment, canal irritation, and cleaning are secondary concerns.
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.