Chapter 43: Caring for Clients With Ear Disorders **

What aspect should the nurse closely monitor for in clients who have been administered salicylates, loop diuretics, quinidine, quinine, or aminoglycosides? A. Signs of hypotension B. Reduced urinary output C. Tinnitus and sensorineural hearing loss D. Impaired facial movement

Tinnitus and sensorineural hearing loss

The nurse, employed in an ear, nose, and throat (ENT) physician's office, is obtaining a client history. The nurse documents the client's statements. Which symptom(s) may indicate a diagnosis of otosclerosis? SATA A. "It seems that I increasingly could not hear my kids talk to me." B. "I woke up on Monday and had ear pain with a marked decrease in hearing." C. "I now notice a ringing in my ears especially when I lay down to sleep at night." D. "I can hear better when someone speaks in low tones." E. "I can hear best when you put the tuning fork behind my ear."

"It seems that I increasingly could not hear my kids talk to me." "I now notice a ringing in my ears especially when I lay down to sleep at night." "I can hear best when you put the tuning fork behind my ear."

The nurse is supervising a family member who is instilling ear drops into the client's ear. Which of the following statements, made by the family member, would prompt further nursing instruction? A. "Turn your head to the side so I can put these drops in." B. "These drops are cold from being on the windowsill." C. "Let me put this cotton ball in your ear because I put the drop in." D. "I squeeze the dropper to put a drop of medicine in the ear."

"These drops are cold from being on the windowsill."

The nurse is assisting the client in planning care during exacerbations of Meniere disease. Which diet would the nurse identify as appropriate at this time? A. A high-protein diet B. A low-sodium diet C. A low-fat diet D. A calorie-controlled diet

A low-sodium diet

The nurse is teaching a class on diseases of the ear. What would the nurse teach the class is the most characteristic symptom of otosclerosis? A. The client being distressed in the mornings B. A progressive, bilateral loss of hearing C. A red and swollen ear drum D. The client describing a recent upper respiratory infection

A progressive, bilateral loss of hearing

Which symptom reported by a client would the nurse relate to a tentative diagnosis of objective vertigo? A. Frequency of a headache B. Pain in the outer ear C. Hearing ability fluctuations D. A sensation of things moving

A sensation of things moving

The occupational nurse is advising a client on options to enhance workplace communication because the client has progressive hearing loss. The client works as a customer service representative. In discussing the options with the client, which type would be the last option offered by the nurse? A. Battery-operated hearing aid B. American sign language C. Headsets with amplifiers D. Text-based telecommunications

American sign language

The nurse is caring for a client who is post-stapedectomy. What would the nurse include in the nursing care? A. Place the client on the operative side. B. Keep the affected ear packed with cotton. C. Encourage the client to exercise within 24 hours. D. Assess the facial nerve.

Assess the facial nerve

The nurse is instructing a client's family members on the most incapacitating symptom of Meniere disease. Which nursing instruction associated with the symptom is most helpful? A. Assist the client when ambulating. B. Keep a bucket beside the bed. C. Ensure low lighting in the room. D. Sit in front of the client when speaking.

Assist the client when ambulating

The nurse is instructing a client on the benefits of a cochlear implant. The client asks, "How am I able to interpret sound?" The nurse credits which of the following as significant in the production of hearing? A. External microphone B. Internal processor C. Amplifier D. Auditory nerve

Auditory nerve

Which nursing goal is a priority when caring for a client newly diagnosed with vertigo? A. Client will maintain therapeutic medication schedule. B. Client will remain safe while ambulating in the home. C. Client will have a caretaker in the home. D. Client will close eyes as needed to reduce symptoms.

Client will remain safe while ambulating in the home

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 accurate? A. Conductive B. Mixed C. Central D. Sensorineural

Conductive

There are several types of hearing loss. Which type of hearing loss benefits from the use of a hearing aid? A. Sensorineural B. Conductive C. Genetic D. Acquired

Conductive

The nurse is caring for a client being treated for Meniere disease. Which medication is monitored closely due to its addictive properties? A. Meclizine B. Hydrochlorothiazide C. Diazepam D. Promethazine

Diazepam

A nurse anticipates that an 8-year-old client has otitis externa from symptoms stated on the history. Which symptom(s), from the history and physical examination, would confirm the diagnosis? SATA A. Discomfort in the ear B. Redness of the ear canal C. Pus noted in the ear canal D. Conductive hearing loss E. Tympanic membrane may appear normal

Discomfort in the ear Redness of the ear canal Pus noted in the ear canal Conductive hearing loss Tympanic membrane may appear normal

The nurse is obtaining a history from a client complaining of ear pain and dizziness. Which assessment finding is the best evidence that the client has a perforated eardrum? A. Fluid draining in the external canal B. Pain has resolved C. Elevated white blood cell count D. Inflammation and a reddened eardrum

Fluid draining in the external canal

The nurse is caring for a client in the triage section of a walk-in clinic. Which triad of common symptoms suggests a diagnosis of Meniere disease? A. Blurred vision, vertigo, nausea B. Syncope, vertigo, ear pain C. Disorientation, vertigo, nausea D. Hearing loss, vertigo, tinnitus

Hearing loss, vertigo, tinnitus

A client comes to walk-in clinic reporting feeling a "bug in my ear." What action should be taken when there is an insect in the ear? A. Instillation of mineral oil B. Instillation of carbamide peroxide C. Instillation of hot water D. Use of a small forceps

Instillation of mineral oil

A nursing instructor is teaching pre-nursing students in a pathophysiology class. What would the instructor teach the students about Meniere disease? A. It is referred to as endolymphatic hydrops. B. It originates in the middle ear. C. It is referred to as lymphatic hydrops. D. It originates in the outer ear.

It is referred to as endolymphatic hydrops

The nurse is caring for a client with recurrent ear infections. The nurse assesses the client for further infectious processes traveling deeper into the tissue and becoming more lethal. Which infection, originated in the ear, is of most concern? A. Mastoiditis B. Meningitis C. Sinusitis D. Labyrinthitis

Meningitis

A nursing student is presenting a report on Meniere disease to other members of the class. What symptom would the student list? A. Pinkish-orange eardrum B. Nystagmus of the eyes C. Enlarged lymph nodes behind the ear D. Swelling and redness in the auditory canal

Nystagmus of the eyes

The nurse on a cruise ship is assessing clients for motion sickness. Which is a common misconception regarding motion sickness? A. Repeated motion is the cause. B. Once symptoms occur, they will always be present. C. Medications help the symptoms. D. Pallor and diaphoresis is a first symptom.

Once symptoms occur, they will always be present

Which nursing suggestion would be most helpful to the client with recurrent otitis external? A. Use a cotton applicator to ensure that the ear canal is dry. B. Place ear plugs into the ears before swimming C. Flush the ear with hydrogen peroxide D. Avoid lying on the side of the affected ear

Place ear plugs into the ears before swimming

The nurse is teaching a family member how to instill ear drops to the client to remove impacted cerumen. What is important to teach this family member? A. Insert the irrigating syringe deeply. B. Direct the flow of the ear drops toward the eardrum. C. Refrigerate before instillation. D. Place the container in warm water before instillation.

Place the container in warm water before instillation

The nurse is instructing the client with dried cerumen blocking the ear canal on potential methods to reduce symptoms. Which at-home methods of cerumen removal are discouraged? A. Instilling 1 to 2 drops of half-strength peroxide in the ear B. Using warm glycerin or mineral oil to soften the cerumen C. Removing the cerumen by means of a cotton tip applicator D. Irrigating the ear with warm water and a rubber-bulb syringe

Removing the cerumen by means of a cotton top applicator

The nurse is obtaining a history from a client who indicated hearing loss due to drug toxicity. Which type of hearing loss is noted? A. Conductive B. Sensorineural C. Mixed D. Central

Sensorineural

What kind of otitis media is a pathogen-free fluid behind the tympanic membrane, resulting from irritation associated with respiratory allergies and enlarged adenoids? A. Purulent otitis media B. Infectious otitis media C. Serous otitis media D. Sterile otitis media

Serous otitis media

The nurse is obtaining subjective data from a client with difficulty hearing. What should the nurse do to facilitate communication with the client? SATA A. Speak clearly at a normal pace. B. Avoid gesturing. C. Ensure there is adequate natural or artificial light. D. Exaggerate pronunciations. E. Promote a clear image of the nurse's mouth. F. Face the client when speaking.

Speak clearly at a normal pace Ensure there is adequate natural or artificial light Promote a clear image of the nurse's mouth Face the client when speaking

A nurse is caring for a 24-year-old female client diagnosed with otosclerosis. Which teaching by the nurse is most accurate? A. Symptoms may be accelerated by pregnancy. B. Medications can interfere with birth control pills. C. Menstrual periods may be longer and more severe. D. Females otosclerosis is linked with infertility.

Symptoms may be accelerated by pregnancy

The nurse is evaluating the independent care of a client recovering from a stapedectomy. Which action made by the client indicates a need for futher teaching? A. The client turns head slowly when family approaches. B. The client uses clean technique to clean the wound. C. The client takes antibiotics on schedule D. The client asks for assistance upon ambulation.

The client uses clean technique to clean the wound

The nurse is caring for a client with symptoms of ototoxicity from aminoglycoside administration. On which structure does the medication produce the ototoxic effect? A. The auditory canal B. The eighth cranial nerve C. The tympanic membrane D. The cochlear nerve

The eighth cranial nerve