Nokea
Which of the following nursing interventions would most likely facilitate effective communication with a hearing-impaired patient?
- A. Ask the patient to repeat what was said in order to evaluate understanding.
- B. Stand directly in front of the patient to facilitate lip reading.
- C. Reduce environmental noise and distractions before communicating.
- D. Raise the voice to project sound at a higher frequency.
Correct Answer: C
Rationale: Reducing environmental noise enhances the patient's ability to hear and focus, improving communication. Asking to repeat may frustrate, raising the voice distorts sound, and not all patients lip-read effectively.
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Which of the following nurses actions carries the greatest potential to prevent hearing loss due to ototoxicity?
- A. Ensure that patients understand the differences between sensory hearing loss and conductive hearing loss.
- B. Educate patients about expected age-related changes in hearing perception.
- C. Educate patients about the risks associated with prolonged exposure to environmental noise.
- D. Be aware of patients medication regimens and collaborate with other professionals accordingly.
Correct Answer: D
Rationale: Monitoring and collaborating on medication regimens prevent ototoxicity from drugs like aspirin, which can cause hearing loss. Education on hearing types or noise is less relevant.
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.
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.
The nurse is providing discharge education for a patient with a new diagnosis of Mnires disease. What food should the patient be instructed to limit or avoid?
- A. Sweet pickles
- B. Frozen yogurt
- C. Shellfish
- D. Red meat
Correct Answer: A
Rationale: Mnires disease is exacerbated by high salt and sugar intake, which sweet pickles contain. Dairy, shellfish, and red meat are not contraindicated unless processed or canned.
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.