Nokea
The nurse is conducting a health history with a new patient in the outpatient clinic. Which of the following medications in the health history may indicate the need to perform a focused hearing assessment?
- A. Salbutamol for acute asthma
- B. Atenolol to prevent angina
- C. Acetaminophen frequently for headaches
- D. Ibuprofen for 20 years to treat arthritis
Correct Answer: D
Rationale: Nonsteroidal anti-inflammatory drugs (NSAIDs) are potentially ototoxic. Acetaminophen, atenolol, and salbutamol are not associated with hearing loss. Other drugs that are potentially ototoxic include aminoglycosides, other antibiotics, salicylates, antimalarial agents, chemotherapeutic drugs, and diuretics.
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The nurse is obtaining a nursing history from a patient when the patient indicates symptoms of dizziness when bending over and nausea and dizziness associated with physical activities. Which of the following topics should the nurse include in this patient's teaching plan?
- A. Tympanometry
- B. Rotary chair testing
- C. Pure-tone audiometry
- D. Bone-conduction testing
Correct Answer: B
Rationale: The patient's clinical manifestations of dizziness and nausea suggest a disorder of the labyrinth, which controls balance and contains three semicircular canals and the vestibule. Rotary chair testing is used to test vestibular function. The other tests are used to test for problems with hearing.
Which of the following actions should the nurse include in the plan of care for a patient who has vestibular disease?
- A. Check Rinne's and Weber's tests.
- B. Face the patient when speaking.
- C. Enunciate clearly when speaking.
- D. Monitor the patient's ability to ambulate safely.
Correct Answer: D
Rationale: Vestibular disease affects balance so the nurse should monitor the patient during activities that require balance. The other actions might be used for patients with hearing disorders.
The nurse is preparing a patient in the eye clinic for refractometry. Which of the following information should the nurse include in patient teaching?
- A. You will need to wear sunglasses for a few hours after the exam.'
- B. The surface of your eye will be numb while the doctor does the exam.'
- C. You should not take any of your eye medicines before the examination.'
- D. The doctor will shine a bright light into your eye during the examination.'
Correct Answer: A
Rationale: The pupil is dilated by using cycloplegic medications during refractometry. This effect will last several hours and cause photophobia. The other teaching would not be appropriate for a patient who was having refractometry.
The nurse is teaching a patient about routine glaucoma testing. Which of the following information should the nurse include in the teaching plan?
- A. The test involves reading a Snellen chart at a distance of 6 m.
- B. Application of a Tono-pen to the surface of the eye will be needed.
- C. The examination includes checking the pupil's reaction to a bright light.
- D. Medications to dilate the pupil will be used before testing for glaucoma.
Correct Answer: B
Rationale: Glaucoma is caused by an increase in intraocular pressure, which would be measured using the Tono-pen. The other techniques are used in testing for other eye disorders.
The nurse is caring for a child who has a perforated eardrum. Which of the following are possible causes?
- A. Persistent otitis media
- B. Mastoiditis
- C. Eustachian tube blockage
- D. Serous otitis media
- E. Acute otitis media
Correct Answer: A,B,E
Rationale: Perforation of the eardrum, central or marginal, can be caused by persistent otitis media, mastoiditis, and acute otitis media. Eustachian tube blockage could be the cause of a retracted eardrum. Serous otitis media presents as hairline fluid level, yellow-amber bubbles above the fluid line.