Nokea
On otoscopy, a red blemish behind the tympanic membrane is suggestive of what diagnosis?
- A. Acoustic tumor
- B. Cholesteatoma
- C. Facial nerve neuroma
- D. Glomus tympanicum
Correct Answer: D
Rationale: A red blemish behind the tympanic membrane is characteristic of glomus tympanicum, a vascular tumor. Acoustic tumors, cholesteatomas, and neuromas do not typically present this way.
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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.
Following a motorcycle accident, a 17-year-old man is brought to the ED. What physical assessment findings related to the ear should be reported by the nurse immediately?
- A. The malleus can be visualized during otoscopic examination.
- B. The tympanic membrane is pearly gray.
- C. Tenderness is reported by the patient when the mastoid area is palpated.
- D. Clear, watery fluid is draining from the patients ear.
Correct Answer: D
Rationale: Clear, watery ear drainage post-trauma suggests cerebrospinal fluid leak from a skull fracture, requiring immediate reporting. Visualizing the malleus or a pearly gray tympanic membrane is normal, and mastoid tenderness, while notable, is less urgent.
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.
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 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.