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The nurse is planning the care of a patient who is adapting to the use of a hearing aid for the first time. What is the most significant challenge experienced by a patient with hearing loss who is adapting to using a hearing aid for the first time?
- A. Regulating the tone and volume
- B. Learning to cope with amplification of background noise
- C. Constant irritation of the external auditory canal
- D. Challenges in keeping the hearing aid clean while minimizing exposure to moisture
Correct Answer: B
Rationale: Amplification of background noise is the primary challenge for new hearing aid users, often leading to discontinuation. Tone/volume adjustment, canal irritation, and cleaning are secondary concerns.
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A patient is scheduled to have an electronystagmography as part of a diagnostic workup for Mnires disease. What question is it most important for the nurse to ask the patient in preparation for this test?
- A. Have you ever experienced claustrophobia or feelings of anxiety while in enclosed spaces?
- B. Do you currently take any tranquilizers or stimulants on a regular basis?
- C. Do you have a history of falls or problems with loss of balance?
- D. Do you have a history of either high or low blood pressure?
Correct Answer: B
Rationale: Electronystagmography requires withholding medications like tranquilizers or stimulants that affect nystagmus, ensuring accurate results. Claustrophobia, falls, or blood pressure are less relevant to test preparation.
A patient with mastoiditis is admitted to the post-surgical unit after undergoing a radical mastoidectomy. The nurse should identify what priority of postoperative care?
- A. Assessing for mouth droop and decreased lateral eye gaze
- B. Assessing for increased middle ear pressure and perforated ear drum
- C. Assessing for gradual onset of conductive hearing loss and nystagmus
- D. Assessing for scar tissue and cerumen obstructing the auditory canal
Correct Answer: A
Rationale: Facial nerve injury during mastoidectomy can cause mouth droop and decreased lateral gaze, making this a priority assessment. Middle ear pressure, hearing loss, or scar tissue are not immediate postoperative concerns.
While reviewing the health history of an older adult experiencing hearing loss the nurse notes the patient has had no trauma or loss of balance. What aspect of this patients health history is most likely to be linked to the patients hearing deficit?
- A. Recent completion of radiation therapy for treatment of thyroid cancer
- B. Routine use of quinine for management of leg cramps
- C. Allergy to hair coloring and hair spray
- D. Previous perforation of the eardrum
Correct Answer: B
Rationale: Quinine is ototoxic and its long-term use is associated with hearing loss. Radiation therapy, hair product allergies, and a single healed eardrum perforation are less likely to cause hearing deficits.
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.
A patient has been diagnosed with serous otitis media for the third time in the past year. How should the nurse best interpret this patients health status?
- A. For some patients, these recurrent infections constitute an age-related physiologic change.
- B. The patient would benefit from a temporary mobility restriction to facilitate healing.
- C. The patient needs to be assessed for nasopharyngeal cancer.
- D. Blood cultures should be drawn to rule out a systemic infection.
Correct Answer: C
Rationale: Recurrent unilateral serous otitis media in adults may indicate nasopharyngeal cancer obstructing the eustachian tube, requiring evaluation. It is not age-related, does not require mobility restriction, and is not systemic.