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Outdoors, where sounds are distinct: Outdoor settings include unpredictable sounds such as wind, traffic, or birds, which can be overwhelming for new hearing aid users. This can make adaptation frustrating and less successful.

At social functions, where simultaneous conversations take place: Social gatherings present too much competing background noise, which is especially difficult for someone just learning to use a hearing aid. This can discourage use rather than promote adjustment.

In public areas such as malls or stores, where others will not notice its use: Public areas have a variety of unpredictable noises, making them poor initial learning environments. The priority is not hiding the hearing aid but ensuring effective adaptation in a controlled setting.

Nystagmus may result from perilymph disturbances caused by surgery: While nystagmus can occur, it is usually transient and does not directly increase the risk of injury as much as vertigo and imbalance do. The major safety concern is dizziness and instability.

Blowing the nose or coughing may precipitate dislodgement of the tympanic graft: This is true regarding graft protection, but it does not directly explain the risk for injury diagnosis. It is more related to risk for impaired healing.

Postoperative tinnitus may decrease the patient’s awareness of environmental hazards: Tinnitus is bothersome but does not significantly impair safety or balance compared to vertigo. It is not the primary risk factor for injury.

Hearing is improved with irrigation of the external ear canal: Improvement in hearing after irrigation usually indicates removal of impacted cerumen, which is unrelated to vestibular system function. This finding does not diagnose inner ear disease.

The patient experiences intolerable pain with irrigation of the external ear: Pain suggests an inflamed or infected external ear canal (otitis externa) but has nothing to do with the vestibular system’s integrity. It is not the purpose of caloric testing.

Irrigation of the external ear with water produces nystagmus opposite the side of instillation: Nystagmus is the normal expected response, indicating intact vestibular function. This would not point to disease, but rather to a healthy vestibular system.

Encourage the patient to start learning to lip-read: Lip-reading is typically recommended for patients with moderate-to-severe hearing loss. It is unnecessary and premature for a very mild high-frequency deficit.

Avoid words in conversation that have many high-pitched consonants: Although consonant sounds may be harder to hear in advanced high-frequency loss, avoiding such words is not a realistic or appropriate strategy for such a minimal loss.

Discuss the advantages and disadvantages of various hearing aids with the patient: A 10-dB hearing loss does not warrant the use of a hearing aid, as it is within the range of normal conversational hearing. This would not be appropriate at this stage.

The presence of a retracted eardrum on otoscopic examination is indicative of positive pressure in the middle ear: A retracted eardrum actually indicates negative pressure due to eustachian tube dysfunction, not positive pressure.

In chronic otitis media, the nurse would expect to find a lack of landmarks and a bulging eardrum on otoscopic examination: A bulging tympanic membrane is more typical of acute otitis media. Chronic otitis media usually shows scarring, perforation, or thickening, not acute bulging.

To straighten the ear canal in an adult before insertion of the otoscope, the nurse grasps the auricle and pulls downward and backward: For adults, the auricle should be pulled upward and backward. Downward and backward is correct for children under 3 years of age.