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.
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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 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.
The nurse in the ED is caring for a 4 year-old brought in by his parents who state that the child will not stop crying and pulling at his ear. Based on information collected by the nurse, which of the following statements applies to a diagnosis of external otitis?
- A. External otitis is characterized by aural tenderness.
- B. External otitis is usually accompanied by a high fever.
- C. External otitis is usually related to an upper respiratory infection.
- D. External otitis can be prevented by using cotton-tipped applicators to clean the ear.
Correct Answer: A
Rationale: Aural tenderness is a key feature of otitis externa due to canal inflammation. High fever and upper respiratory infections are more typical of otitis media, and cotton-tipped applicators can cause otitis externa.
A patient diagnosed with arthritis has been taking aspirin and now reports experiencing tinnitus and hearing loss. What should the nurse teach this patient?
- A. The hearing loss will likely resolve with time after the drug is discontinued.
- B. The patients hearing loss and tinnitus are irreversible at this point.
- C. The patients tinnitus is likely multifactorial, and not directly related to aspirin use.
- D. The patients tinnitus will abate as tolerance to aspirin develops.
Correct Answer: A
Rationale: Aspirin-induced ototoxicity, causing tinnitus and hearing loss, is typically reversible upon discontinuation. It is directly related to aspirin, not multifactorial, and tolerance does not resolve it.
A child goes to the school nurse and complains of not being able to hear the teacher. What test could the school nurse perform that would preliminarily indicate hearing loss?
- A. Audiometry
- B. Rinne test
- C. Whisper test
- D. Weber test
Correct Answer: C
Rationale: The whisper test, assessing the ability to hear a whispered phrase, is a simple screening tool for hearing loss that a nurse can perform. Audiometry, Rinne, and Weber tests require specialized training or equipment.
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