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The student nurse asks the nurse, 'Which type of hearing loss involves damage to the cochlea or vestibulocochlear nerve?' Which statement is the best response of the nurse?
- A. It is called conductive hearing loss.
- B. It is called a functional hearing loss.
- C. It is called a mixed hearing loss.
- D. It is called sensorineural hearing loss.
Correct Answer: D
Rationale: Sensorineural hearing loss involves cochlear or vestibulocochlear nerve damage. Conductive loss affects the outer/middle ear, functional loss is psychological, and mixed involves both.
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Which referral is most important for the nurse to implement for the client with permanent hearing loss?
- A. Aural rehabilitation.
- B. Speech therapist.
- C. Social worker.
- D. Vocational rehabilitation.
Correct Answer: A
Rationale: Aural rehabilitation addresses communication strategies and hearing aids, critical for permanent hearing loss. Speech therapy, social work, and vocational rehab are secondary.
The nurse writes the diagnosis 'risk for injury related to impaired balance' for the client diagnosed with vertigo. Which nursing intervention should be included in the plan of care?
- A. Provide information about vertigo and its treatment.
- B. Assess for level and type of diversional activity.
- C. Assess for visual acuity and proprioceptive deficits.
- D. Refer the client to a support group and counseling.
Correct Answer: C
Rationale: Assessing visual and proprioceptive deficits identifies factors contributing to vertigo-related falls, enhancing safety. Information, activities, and referrals are secondary.
The nurse reviews the chart of the client diagnosed with closed-angle glaucoma. Which documented finding should the nurse question with the HCP?
- A. Sudden onset of eye pain
- B. Reduced central visual acuity
- C. Normal intraocular pressure
- D. Nausea and vomiting
Correct Answer: C
Rationale: Closed-angle glaucoma causes an increased, not normal, intraocular pressure. This documentation finding should be questioned. Sudden eye pain, reduced central visual acuity, and nausea and vomiting are consistent with closed-angle glaucoma.
The nurse is caring for a client who is very hard of hearing. How should the nurse communicate with this person?
- A. Speak loudly and talk in his better ear
- B. Stand in front of him and speak clearly and distinctly
- C. Yell at him using a high-pitched voice
- D. Write all communication on a note pad or magic slate
Correct Answer: B
Rationale: Standing in front and speaking clearly aids lip-reading and communication for a hard-of-hearing client.
Which statement best describes the scientific rationale for the nurse holding the otoscope with the hand in a pencil-hold position when examining the client's ear?
- A. It is usually the most comfortable position to hold the otoscope.
- B. This allows the best visualization of the tympanic membrane.
- C. This prevents inserting the otoscope too far into the external ear.
- D. It ensures the nurse will not cause pain when examining the ear.
Correct Answer: C
Rationale: The pencil-hold prevents deep insertion, protecting the ear canal and tympanic membrane. Comfort, visualization, and pain avoidance are secondary.