A patient is being evaluated for hearing loss. The doctor is unable to examine the tympanic membrane due to a blockage caused by cerumen. What actions can the nurse take to allow for an examination?
Instill mineral oil into the canal and immediately irrigate to remove the impacted wax.
Instill a small amount of mineral oil into the canal, then have the patient return in 30 minutes for wax removal.
Irrigate the ear with cold water until all the wax is removed.
Irrigate the ear with warm water and a high amount of otic pressure.
The Correct Answer is B
Choice A rationale
Instilling mineral oil into the canal and immediately irrigating to remove the impacted wax is not typically recommended. This approach may not allow enough time for the mineral oil to soften the cerumen, making it more difficult to remove and potentially causing discomfort or injury.
Choice B rationale
Instilling a small amount of mineral oil into the canal, then having the patient return in 30 minutes for wax removal is a common and effective method for managing cerumen impaction. The mineral oil helps to soften the cerumen, making it easier to remove through irrigation.
Choice C rationale
Irrigating the ear with cold water is not typically recommended. Cold water can cause discomfort and potentially lead to vertigo.
Choice D rationale
Irrigating the ear with warm water and a high amount of otic pressure is not typically recommended. High pressure can potentially damage the ear canal or tympanic membrane.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale
The Rinne test is a hearing test used to evaluate the difference between sound transmission through air conduction versus bone conduction. It is not typically used following a Romberg test, which evaluates balance.
Choice B rationale
While ensuring the patient’s safety is always important, repositioning the client supine is not the typical response to slight swaying during a Romberg test.
Choice C rationale
Slight swaying during a Romberg test is considered normal. Therefore, documenting successful completion of the assessment would be the appropriate action.
Choice D rationale
A referral to a neurologist is not typically necessary for slight swaying during a Romberg test, as this is considered within normal limits.
Correct Answer is A
Explanation
Choice A rationale
Slowing of activity, also known as bradykinesia, is a common symptom of Parkinson’s disease. It is characterized by a general reduction in the speed and amplitude of voluntary movements, leading to difficulties with tasks such as walking, talking, and performing other self-care activities.
Choice B rationale
Muscle flaccidity is not typically associated with Parkinson’s disease. Instead, people with Parkinson’s often experience muscle rigidity or stiffness.
Choice C rationale
A gait with the body leaning backward is not a typical symptom of Parkinson’s disease. People with Parkinson’s disease often have a stooped posture, with the body leaning forward.
Choice D rationale
Continuous tremors are a hallmark symptom of Parkinson’s disease, but they are not present in all cases. Tremors in Parkinson’s disease are often described as a “pill-rolling” tremor because the movement resembles the motion of trying to roll a pill between the thumb and index finger.
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