If an employee reports unilateral hearing loss, what should the nurse do first?

• A. Schedule MRI
• B. Advise rest and return next week
• C. Prescribe antibiotics
• D. Conduct a physical examination

Answer: (D)

When a patient reports unilateral hearing loss, the priority is to perform a focused physical examination to identify the likely cause and guide next steps. The first action is to inspect the ear with an otoscope to assess the external ear canal and the tympanic membrane, looking for obvious reversible issues such as cerumen impaction, otitis externa, or trauma. This examination helps determine whether immediate management or urgent referral is needed and what the next steps should be (for example, removing blockage or directing to imaging or a physician). Imaging or antibiotic therapy aren’t appropriate as the initial move without an initial exam, and telling the patient to rest and return later isn’t suitable for potential acute problems.