Answer to Question 1
Correct Answer: 1, 2, 3, 4
Hand hygiene will minimize cross-contamination and the risk of bringing other organisms to an already infected eye. Hand hygiene should be encouraged at all times, but especially when infection is present. Soaking the lids with warm saline softens the crusts from exudates that accompany Staphylococcus infection. Sharing supplies, such as towels, makeup, or contacts, is inappropriate due to potential for cross-contamination from person to person. But during an actual infection, instructions should include not using the same equipment after the infection is cleared. Towels should be washed in hot water. Makeup and contacts should be discarded and not reused. Teach to apply warm compresses to reduce inflammation and discomfort. Rubbing the eyes can traumatize them further and risks cross-contamination if only one eye is infected, and should not be encouraged.
Answer to Question 2
Correct Answer: 1
The Rinne test differentiates between bone and air conduction. In otosclerosis, there is greater bone conduction due to the calcification and fixation of the malleus, incus, and stapes (bony ossicles). Talking on the phone is retained longer than direct verbal communication, since it involves bone conduction rather than air conduction. Severe vertigo is the hallmark symptom of inner ear disturbances, not the middle ear stapes fixation associated with otosclerosis. Purulent drainage with cyanosis of the tympanic membrane represents an acute or chronic middle ear infection that has caused a rupture of the tympanic membrane. Infection is not related to otosclerosis. Diminished hearing begins in the upper tones or higher pitches which are lost first. Lower tones, such as the deeper pitch of men's voices, are more easily heard by a patient with otosclerosis.