Which of the following clients is at risk for sensorineural hearing loss?

A client who is being treated for otitis media

A client who has experienced an injury to the eardrum

A client who works in a loud environment

A client whose ear canal is impacted with wax

Answer and Explanation

The Correct Answer is C

A.   Otitis media is an infection or inflammation of the middle ear. This condition primarily affects the middle ear structures and can cause conductive hearing loss, which is due to problems with sound transmission through the outer or middle ear.
B.   An injury to the eardrum, such as a perforation, can lead to conductive hearing loss. This occurs because the eardrum (tympanic membrane) is crucial for transmitting sound waves from the outer ear to the middle ear. While an eardrum injury affects sound transmission, it does not directly damage the inner ear or auditory nerve, so it does not typically cause sensorineural hearing loss.
C.   Exposure to loud noise is a common cause of sensorineural hearing loss. Prolonged or intense noise exposure can damage the sensory hair cells in the cochlea or the auditory nerve pathways, leading to permanent hearing loss. This type of hearing loss is due to damage in the inner ear or auditory nerve rather than the outer or middle ear structures.
D.   Impacted earwax can cause conductive hearing loss by blocking sound transmission through the ear canal. This type of hearing loss is due to a blockage and is usually reversible once the wax is removed. It does not cause sensorineural hearing loss, which involves damage to the inner ear or auditory nerve.

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Correct Answer is B

Explanation

A. The immediate concern with abrupt cessation is more related to adrenal insufficiency rather than hyperglycemia. However, chronic use of prednisone can contribute to glucose intolerance and diabetes, but this is not the primary issue with sudden discontinuation.
B. Abrupt discontinuation of prednisone can lead to adrenal insufficiency because the body has become reliant on the medication to suppress inflammation and regulate various bodily functions. The adrenal glands may not immediately resume normal cortisol production, which can lead to symptoms of adrenal insufficiency, including hypotension.

C. Fluid retention is a common side effect of prednisone use. However, stopping prednisone suddenly does not typically cause fluid retention; rather, it can lead to other issues like adrenal insufficiency. Fluid retention is more related to the medication's use rather than its abrupt discontinuation.
D. Abruptly stopping high-dose prednisone, especially after long-term use, can be dangerous. The body may not immediately resume normal cortisol production, leading to symptoms of adrenal insufficiency, such as fatigue, weakness, and hypotension. It is crucial to taper off prednisone gradually under medical supervision to allow the adrenal glands time to recover and to avoid withdrawal symptoms.

A. Cool, clammy skin B. Chest pain radiating into the back and jaw C. Nausea and vomiting D. Peripheral edema

Correct Answer is D

Explanation

A. Cool, clammy skin can be a sign of a myocardial infarction. It occurs due to the body's stress response during an MI, leading to decreased perfusion and sweating. This symptom is consistent with the autonomic response to a heart attack.
B. Chest pain radiating into the back, jaw, or arms is a classic symptom of myocardial infarction. This radiation of pain is due to the way pain signals are transmitted and referred from the heart to other parts of the body. It is a common and significant symptom of MI.

C. Nausea and vomiting can occur during a myocardial infarction, particularly in older adults. These symptoms are related to the autonomic nervous system's response to the stress of an MI and can sometimes be the presenting symptoms, especially in women and older adults.
D. Peripheral edema is generally not a direct symptom of myocardial infarction. It is more commonly associated with chronic heart failure or other conditions leading to fluid overload. While MI can lead to heart failure over time, peripheral edema itself is not a typical acute symptom of an MI.

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Which of the following clients is at risk for sensorineural hearing loss?

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Naxlex Comprehensive Predictor Exams

A client has been on daily, high-dose prednisone therapy to treat an exacerbation of rheumatoid arthritis. His prescription runs out before his next paycheck. He decides to skip his prednisone for a few days. What is likely to happen to this patient when he abruptly stops taking prednisone?

Correct Answer is B

Explanation

A nurse is providing education to a group of older adults about the signs and symptoms of a myocardial infarction. Which of the following is not a sign of a myocardial infarction?

Correct Answer is D

Explanation

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