Nokea
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.
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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 is reviewing the health history of a newly admitted patient and reads that the patient has been previously diagnosed with exostoses. How should the nurse accommodate this fact into the patients plan of care?
- A. The nurse should perform the Rinne and Weber tests.
- B. The nurse should arrange for audiometry testing as soon as possible.
- C. The nurse should collaborate with the pharmacist to assess for potential ototoxic medications.
- D. No specific assessments or interventions are necessary to addressing exostoses.
Correct Answer: D
Rationale: Exostoses are benign bony growths in the ear canal that typically do not affect hearing or require specific interventions. Testing or medication reviews are unnecessary unless other symptoms arise.
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.
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.
A patient is being discharged home after mastoid surgery. What topic should the nurse include in discharge teaching?
- A. Expected changes in facial nerve function
- B. The need for audiometry testing every 6 months following recovery
- C. Safe use of analgesics and antivertiginous agents
- D. Appropriate use of OTC ear drops
Correct Answer: C
Rationale: Teaching about analgesics and antivertiginous agents supports safe management of pain and vertigo post-mastoidectomy. Facial nerve changes are complications, audiometry is not routine, and OTC ear drops are not recommended.