Disorders of the Ear

*Possible exam question* A client with Meniere's disease is experiencing severe vertigo. Which instruction would the nurse give to the client to assist in controlling the vertigo? A) Increase fluid intake to 3000 ml a day B) Avoid sudden head movements C) Lie still and watch the television D) Increase sodium in the diet

B) Avoid sudden head movements Rationale: The nurse instructs the client to make slow head movements to prevent worsening of the vertigo. Dietary changes such as salt and fluid restrictions that reduce the amount of endolymphatic fluid sometimes are prescribed. Lying still and watching television will not control vertigo.

The part of the ear that contains the receptors for hearing is the: A) Utricle B) Cochlea C) Middle ear D) Tympanic cavity

B) Cochlea Rationale: The dendrites of the cochlear nerve terminate on the hair cells of the organ of Corti in the cochlea.

*Possible Exam question* The nurse is reviewing the physician's orders for a client with Meniere's disease. Which diet will most likely be prescribed? A) Low-cholesterol diet B) Low-sodium diet C) Low-carbohydrate diet D) Low-fat diet

B) Low sodium diet Rationale: Dietary changes such as salt and fluid restrictions that reduce the amount of endolymphatic fluid sometimes are prescribed.

The nurse is performing a voice test to assess hearing. Which of the following describes the accurate procedure for performing this test? A) Stand 4 feet away from the client to ensure that the client can hear at this distance B) Whisper a statement and ask the client to repeat it C) Whisper a statement with the examiners back facing the client D) Whisper a statement while the client blocks both ears

B) Whisper a statement and ask the client to repeat it Rationale: The examiner stands 1-2 feet away from the client and asks the client to block one external ear canal. The nurse whispers a statement and asks the client to repeat it. Each ear is tested separately.

A labyrinthectomy can be performed to treat Meniere's syndrome. This procedure results in: A) Anosmia B) Absence of pain C) Reduction in cerumen D) Permanent irreversible deafness

D) Permanent irreversible deafness Rationale: The labyrinth is the inner ear and consists of the vestibule, cochlea, semicircular canals, utricle, saccule, cochlear duct, and membranous semicircular canals. A labyrinthectomy is performed to alleviate the symptoms of vertigo but results in deafness, because the organ of Corti and cochlear nerve are located in the inner ear.

The nurse has conducted discharge teaching for a client who had a fenestration procedure for the treatment of otosclerosis. Which of the following, if stated by the client, would indicate that teaching was effective? A) "I should drink liquids through a straw for the next 2-3 weeks." B) "It's ok to take a shower and wash my hair." C) "I will take stool softeners as prescribed by my doctor." D) "I can resume my tennis lessons starting next week."

C) "I will take stool softeners as prescribed by my doctor." Rationale: Following ear surgery, the client needs to avoid straining while having a bowel movement. The client needs to be instructed to avoid drinking through a straw for 2-3 weeks, air travel, and coughing excessively. The client needs to avoid getting his or her hair wet, washing hair, showering for 1 week, and rapidly moving the head, bouncing, and bending over for 3 weeks.

Physiologically, the middle ear, containing the three ossicles, serves primarily to: A) Maintain balance B) Translate sound waves into nerve impulses C) Amplify the energy of sound waves entering the ear D) Communicate with the throat via the Eustachian tube.

C) Amplify the energy of sound waves entering the ear Rationale: The middle ear contains the three ossicles—malleus, incus, and stapes—which, along with the tympanic membrane and oval window, form an amplifying system.

*Possible exam question* When teaching the client about Meniere's disease, which of the following instructions would a nurse give about vertigo? A) Report dizziness at once B) Drive in daylight hours only C) Get up slowly, turning the entire body D) Change your position using the logroll method

C) Get up slowly, turning the entire body Rationale: Turning the entire body, not the head, will prevent vertigo. Dizziness is expected but can be prevented. The client shouldn't drive as he may reflexively turn the wheel to correct vertigo. Turning the client in bed slowly and smoothly will be helpful; logrolling isn't needed.

The ear bones that transmit vibrations to the oval window of the cochlea are found in the: A) Inner ear B) Outer ear C) Middle ear D) Eustachian tube

C) Middle ear Rationale: The bones in the middle ear transmit and amplify air pressure waves from the tympanic membrane to the oval window of the cochlea, which is the inner ear. The tympanic membrane separates the other from the middle ear.