Nokea
The clinic nurse is assessing a child who has been brought to the clinic with signs and symptoms that are suggestive of otitis externa. What assessment finding is characteristic of otitis externa?
- A. Tophi on the pinna and ear lobe
- B. Dark yellow cerumen in the external auditory canal
- C. Pain on manipulation of the auricle
- D. Air bubbles visible in the middle ear
Correct Answer: C
Rationale: Pain when manipulating the auricle is a hallmark of otitis externa due to inflammation of the external ear canal. Tophi are related to gout, cerumen is a normal finding, and air bubbles suggest middle ear issues, not otitis externa.
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A patient diagnosed with arthritis has been taking aspirin and now reports experiencing tinnitus and hearing loss. What should the nurse teach this patient?
- A. The hearing loss will likely resolve with time after the drug is discontinued.
- B. The patients hearing loss and tinnitus are irreversible at this point.
- C. The patients tinnitus is likely multifactorial, and not directly related to aspirin use.
- D. The patients tinnitus will abate as tolerance to aspirin develops.
Correct Answer: A
Rationale: Aspirin-induced ototoxicity, causing tinnitus and hearing loss, is typically reversible upon discontinuation. It is directly related to aspirin, not multifactorial, and tolerance does not resolve it.
A patient has benefited from a cochlear implant. The nurse should understand that this patients health history likely includes which of the following? Select all that apply.
- A. The patient was diagnosed with sensorineural hearing loss.
- B. The patients hearing did not improve appreciably with the use of hearing aids.
- C. The patient has deficits in peripheral nervous function.
- D. The patients hearing deficit is likely accompanied by a cognitive deficit.
- E. The patient is unable to lip-read.
Correct Answer: A,B
Rationale: Cochlear implants are used for profound bilateral sensorineural hearing loss unresponsive to hearing aids. Peripheral nerve deficits, cognitive issues, or inability to lip-read are not prerequisites.
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 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.
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.