Which physical assessment finding should the nurse anticipate in the patient with otosclerosis?
1. Rinne test results show that bone conduction is equal to or greater than air conduction.
2. The patient has severe vertigo.
3. Purulent drainage is observed or reported with cyanosis of the tympanic membrane.
4. Diminished hearing is noted with higher tones, such as a woman's speaking voice.
1
Rationale 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).
Rationale 2: Severe vertigo is the hallmark symptom of inner ear disturbances, not the middle ear stapes fixation associated with otosclerosis.
Rationale 3: 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.
Rationale 4: Diminished hearing begins with the lower pitches. Higher tones are more easily heard by a patient with otosclerosis.
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