Nokea
The nurse and a colleague are performing the Epley maneuver with a patient who has a diagnosis of benign paroxysmal positional vertigo. The nurses should begin this maneuver by performing what action?
- A. Placing the patient in a prone position
- B. Assisting the patient into a sitting position
- C. Instilling 15 mL of warm normal saline into one of the patients ears
- D. Assessing the patients baseline hearing by performing the whisper test
Correct Answer: B
Rationale: The Epley maneuver starts with the patient sitting, followed by specific head positioning to reposition canaliths. Prone positioning, saline instillation, or hearing tests are not part of the procedure.
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The nurse is discussing the results of a patients diagnostic testing with the nurse practitioner. What Weber test result would indicate the presence of a sensorineural loss?
- A. The sound is heard better in the ear in which hearing is better.
- B. The sound is heard equally in both ears.
- C. The sound is heard better in the ear in which hearing is poorer.
- D. The sound is heard longer in the ear in which hearing is better.
Correct Answer: A
Rationale: In sensorineural hearing loss, the Weber test shows sound lateralizing to the better-hearing ear, as the affected ear has impaired nerve function. Equal hearing or sound in the poorer ear suggests normal hearing or conductive loss.
The nurse is providing discharge education for a patient with a new diagnosis of Mnires disease. What food should the patient be instructed to limit or avoid?
- A. Sweet pickles
- B. Frozen yogurt
- C. Shellfish
- D. Red meat
Correct Answer: A
Rationale: Mnires disease is exacerbated by high salt and sugar intake, which sweet pickles contain. Dairy, shellfish, and red meat are not contraindicated unless processed or canned.
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.
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.
The nurse is caring for a patient who has undergone a mastoidectomy. In an effort to prevent postoperative infection, what intervention should the nurse implement?
- A. Teach the patient about the risks of ototoxic medications.
- B. Instruct the patient to protect the ear from water for several weeks.
- C. Teach the patient to remove cerumen safely at least once per week.
- D. Instruct the patient to protect the ear from temperature extremes until healing is complete.
Correct Answer: B
Rationale: Keeping the ear dry for 6 weeks post-mastoidectomy prevents infection by avoiding water entry into the surgical site. Ototoxic drugs, cerumen removal, or temperature extremes are not infection-related risks.