Prep U for Brunner and Suddarth's Textbook of Medical Surgical Nursing, 13th Edition Chapter 64: Assessment and Management of Patients With Hearing and Balance Disorders

A nurse is performing an eye examination. Which question would not be included in the examination?

"Are you able to raise both eyebrows?" pg. 1843

A client with a conductive hearing disorder caused by ankylosis of the stapes in the oval window undergoes a stapedectomy to remove the stapes and replace the impaired bone with a prosthesis. After the stapedectomy, the nurse should provide which client instruction?

"Don't fly in an airplane, climb to high altitudes, make sudden movements, or expose yourself to loud sounds for 30 days." pg. 1896

Which manifestation is most problematic for the client diagnosed with Ménière disease?

Vertigo pg. 1897

Which manifestation is the most problematic for the client diagnosed with Ménière disease?

Vertigo pg. 1897

Postoperative nursing assessment for a patient who has had a mastoidectomy should include observing for facial paralysis, which might indicate damage to which cranial nerve?

Seventh p. 1894

A client has undergone tonometry to evaluate for possible glaucoma. Which result would the nurse record as abnormal?

25 mm Hg pg. 1856

When preparing a teaching plan for a client diagnosed with otitis externa, the nurse instructs the client to avoid any water sport for which duration?

7 to 10 days pg. 1891

A dietary modification for a patient with Ménière's disease would be:

A decrease in sodium intake to 2,000 mg daily. p. 1898

The nurse caring for a client with Ménière's disease needs to assist with what when the client is experiencing an attack?

ADLs p. 1897

A client is receiving long-term intravenous therapy with gentamicin for a chronic wound infection. Which of the following would be most important for the nurse to ensure?

Arrange for audiograms twice a week. p. 1902

High doses of which medication can produce bilateral tinnitus?

Aspirin pg. 1901

Audiometry is testing that measures hearing acuity precisely. Who does the nurse know can perform audiometric testing?

Audiologist p. 1886

A patient is to have an angiography done using fluorescein as a contrast agent to determine if the patient has macular edema. What laboratory work should the nurse monitor prior to the angiography?

BUN and creatinine pg. 1845

A client you are caring for has a hearing loss. The client tells you he is self-conscious about his hearing loss. What advice should the nurse give a self-conscious client with hearing loss to protect his self-esteem?

Be forthright and inform others about the hearing deficit. p. 1888

An initial, convenient assessment of an older adult client's complaint of hearing loss would be inspection, using an otoscope, for the presence of impacted cerumen. Which of the following is a primary cause of an external ear disorder in the elderly?

Conduction problem pg. 1888

The nurse is caring for a client experiencing hearing loss. The nurse uses the otoscope to assess the ear canal and tympanic membrane and notes a significant accumulation of cerumen. Which documentation of hearing loss type would be most accurate?

Conductive pg. 1880

Acoustic neuromas are benign tumors of which of the following cranial nerves?

Cranial Nerve VII pg. 1902

Health teaching for a patient who suffers from motion sickness would include recommending the use of which one of the following over-the-counter drugs?

Dramamine pg. 1897

The nurse is caring for a client who just returned from a trip requiring an airline flight. The client commented on how his ears hurt upon descent. The nurse is correct in stating which site as being the pressure equalizer in the ear?

Eustachian tube pg. 1882

The nursing student hopefuls are taking a pre-nursing anatomy and physiology class. What will they learn is the anatomical feature that equalizes air pressure in the middle ear?

Eustachian tube pp. 1881-1882.

Which portion of the middle ear equalizes pressure?

Eustachian tube pp. 1881-1882.

A nures is performing an otoscopic examination on a client. Which finding would the nurse document as abnormal?

External auditory canal erythema pg. 1805

The nurse should monitor for which manifestation in a client who has undergone LASIK?

Halos and glare pg. 1863

The nurse is working in the triage section of a walk-in clinic. Which triad of common symptoms, when placed together, indicate Ménière's disease?

Hearing loss, vertigo, tinnitus pg. 1897

A client has undergone enucleation. What complication of enucleation should be addressed by the nurse?

Hemorrhage pg. 1876

The nurse identifies the nursing diagnosis of deficient knowledge related to a new hearing aid for a client. After teaching a client about caring for his new hearing aid, the nurse determines that the outcome has been achieved when the client states which of the following?

I need to keep my ear canal clean and dry p. 1903

A client with chronic open-angle glaucoma is now presenting with eye pain and intraocular pressure of 50 mm Hg. An immediate iridotomy is scheduled. Which of the following describes the desired effects of this procedure?

Improve outflow drainage pg. 1855

The client is having a Weber test. During a Weber test, where should the tuning fork be placed?

In the midline of the client's skull or in the center of the forehead p. 1885

Loud, persistent noise has what effect on the body?

Increased B/P pg. 1888

A nurse practitioner in an emergency room receives a telephone call from a mother whose 4-year-old child has a mosquito stuck in his external ear canal. Which of the following is the best information the nurse could give the mother?

Instill a few drops of warmed mineral oil to cover the insect. pg. 1890

The nurse is developing a plan of care for a client with Meniere's disease and identifies a nursing diagnosis of excess fluid volume related to fluid retention in the inner ear. Which intervention would be most appropriate to include in the plan of care?

Limit foods that are high in sodium p. 1898

A client is diagnosed with an exudative retinal detachment. When reviewing the client's history, the nurse would identify which of the following as a possible underlying cause?

Macular degeneration pg. 1864

Hearing aids help with which of the following problems?

Makes sound louder p. 1902

The nurse is caring for a patient with Ménière's disease who is hospitalized with severe vertigo. What medication does the nurse anticipate administering to shorten the attack?

Meclizine (Antivert) pg. 1898

A client comes to the emergency department, reporting that a bee has flown into his ear and is stuck. The client reports a significant amount of pain. Which of the following would be most appropriate to use to remove the bee?

Mineral oil pg. 1890

Which of the following describes vertigo? Select all that apply.

Misperception of motion -Objects are moving around him or her -Spinning sensation pg. 1897

The nurse is assisting with the administration of a caloric stimulation test. Which client response would the nurse document as an expected response?

Nystagmus p. 1886

Which condition is characterized by the formation of abnormal spongy bone around the stapes?

Otosclerosis pg. 1896

Which condition refers to hearing loss associated with degenerative changes?

Presbycusis

An aging client is brought to the eye clinic by the son. The son states he has seen his parent holding reading materials at an increasing distance to focus properly. What age-related changes does this indicate?

Presbyopia pg. 1847

A client is newly diagnosed with otitis externa. Which information should the nurse teach the client before the client leaves the clinic?

Proper instillation of prescribed ear drops p. 1891

The nurse is caring for a client ordered for multiple eye screening. Following which procedure will the nurse instruct the client on a yellow coloring to the skin and urine as being normal?

Retinal Angiography pp. 1845-1846.

Which test uses a tuning fork shifted between two positions to assess hearing?

Rinne pg. 1886

A client is diagnosed with Meniere's disease. The nurse would most likely expect the client to report which of the following?

Vertigo pg. 1897

The nurse is examining the area behind the patient's auricle and sees a flaky scaliness. What disorder does the nurse suspect the patient has?

Seborrheic dermatitis p. 1883

A client has undergone a mastoidectomy. The nurse teaches the client about possible complications, instructing the client to notify the physician immediately if which of the following occur?

Slurred speech pg. 1895

A nurse is preparing to perform the whisper test to assess a client's gross auditory acuity. Which of the following would be most appropriate for the nurse to do?

Stand about 1 to 2 feet away from the ear to be tested. pg. 1923

A client has been diagnosed with otosclerosis. The nurse explains to the client that this is a common cause of hearing impairment among adults and is the result of a bony overgrowth of the:

Stapes pg. 1896

Which of the following is the treatment of choice for acoustic neuromas?

Surgery pg. 1902

Which phrase defines ossiculoplasty?

Surgical reconstruction of the middle ear bones p. 1894

The nurse is assessing a client for objective symptoms of hearing difficulties. Which symptom leads the nurse to take alternate measures to ensure client understanding of teaching?

The client leans forward and turns the head p. 1888

Which statement describes benign paroxysmal positional vertigo (BPPV)?

The vertigo is usually accompanied by nausea and vomiting; generally, however, hearing is not impaired. pg. 1898

During a pharmacology class, the students are told that some drugs need to be closely monitored. What aspect should the nurse closely monitor for in clients who have been administered salicylates, loop diuretics, quinidine, quinine, or aminoglycosides?

Tinnitus and sensorineural hearing loss pp. 1889, 1901-1902.

The nurse is doing discharge teaching with a client newly diagnosed with Ménière's disease. Why would the nurse advise a low-sodium diet to this client?

To reduce the production of fluid in the inner ear pg. 1898

When discussing diseases of the middle ear, the nursing instructor distinguishes the different types of otitis media. What generally causes purulent otitis media?

Upper respiratory infections pg.1892

When caring for a client after ear surgery, what is an important aspect of nursing care?

Validate client's feelings of discomfort. pg. 1894

The nurse is talking with a patient diagnosed with Ménière's disease about the patient's symptoms. What symptom does the patient inform the nurse is the most troublesome?

Vertigo p. 1897

A nurse needs to change a dressing on an abdominal wound for a patient who is hearing-impaired and whose speech is difficult to understand. Which of the following is the best approach for the nurse?

Write down the steps of the procedure for the patient to read before beginning the treatment. p. 1890

Which instructions regarding swimming should the nurse give to a client who is recovering from otitis externa? Select all that apply.

wear soft plastic earplugs p. 1891