Nokea
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.
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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.
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.
A patient with a sudden onset of hearing loss tells the nurse that he would like to begin using hearing aids. The nurse understands that the health professional dispensing hearing aids would have what responsibility?
- A. Test the patients hearing promptly.
- B. Perform an otoscopy.
- C. Measure the width of the patients ear canal.
- D. Refer the patient to his primary care physician.
Correct Answer: D
Rationale: Sudden hearing loss requires medical evaluation to rule out pathology, so referral to a physician is mandatory before dispensing hearing aids. Other actions are secondary.
The advanced practice nurse is attempting to examine the patients ear with an otoscope. Because of impacted cerumen, the tympanic membrane cannot be visualized. The nurse irrigates the patients ear with a solution of hydrogen peroxide and water to remove the impacted cerumen. What nursing intervention is most important to minimize nausea and vertigo during the procedure?
- A. Maintain the irrigation fluid at a warm temperature.
- B. Instill short, sharp bursts of fluid into the ear canal.
- C. Follow the procedure with insertion of a cerumen curette to extract missed ear wax.
- D. Have the patient stand during the procedure.
Correct Answer: A
Rationale: Warm irrigation fluid prevents vertigo and nausea, which cold fluid can trigger. Forceful irrigation risks perforation, curettes require special training, and standing is unnecessary.
A patient has been diagnosed with hearing loss related to damage of the end organ for hearing or cranial nerve VIII. What term is used to describe this condition?
- A. Exostoses
- B. Otalgia
- C. Sensorineural hearing loss
- D. Presbycusis
Correct Answer: C
Rationale: Sensorineural hearing loss results from damage to the cochlea or cranial nerve VIII. Exostoses are bony growths, otalgia is ear pain, and presbycusis is age-related hearing loss.