CH 20 Practice Questions Disorders of Hearing and Vestibular Function PATHO AT

a. objective vertigo Objective vertigo is the sensation of the person being stationary and the environment in motion. subjective vertigo is a sensation of a person who may be in motion and the environment stationary. Nystagmus refers to the involuntary rhythmic and oscillatory eye movements that preserve eye fixation on stable objects in the visual field during angular and rotational movement of the head. Syncope is "fainting".

A client reports feeling like the room is spinning around him when standing still. Which diagnosis is this client likely experiencing? a. objective vertigo b. syncopal episodes c. subjective vertigo d. nystagmus

d."What prescription medication and over-the-counter medication do you take?" Medications and stimulants, such as aspirin, caffeine, and nicotine, can cause tinnitus. The clients should be questioned to determined if this is a potential cause. Impacted cerumen is a benign cause of tinnitus, which resolves after the earwax is removed. Respiratory infections may cause fluid in the ears and decreased hearing.

A client reports occasional ringing in the ears that worsens toward the end of the day. The most important question for the nurse to ask would be: a. "How often do you clean your ears?" b."Have you had any recent respiratory infections?" c."Do yo use Q-tips in your ears?" d."What prescription medication and over-the-counter medication do you take?"

c. Reduction in ability to understand speech Later on the ability to detect, identify and localize sounds is evident

Presbycusis is a degenerative hearing loss associated with aging. What is the first symptom of this disorder? a. Inability to detect sound b. Inability to localize sounds d. Reduction in ability to understand speech d. Reduction in ability to identify sounds

c. closed captioning on tv programs d. hearing aids e. speech reading class

The nurse is developing a plan of care for a sixty-five year old client who has significant hearing loss. Which treatment options is most appropriate to include in this client's plan of care? select all that apply a. use of sign language b. vascular decompression c. closed captioning on tv programs d. hearing aids e. speech reading class

b. Tympanostomy tube insertion Tubes should be the next course of action with the child having hearing loss and OM persisting for 4 months or longer. The parents should be taught to continue to monitor for signs of OM.

A 2-year old child who has had otitis media (OM) for 4 months and been treated with several courses of antibiotics now appears to have some hearing loss. The nurse anticipates that the most appropriate treatment for the child would be: a. the child will need a hearing aid b.Tympanostomy tube insertion c. retreating with a stronger antibiotic d. monitoring for complication of OM

c. Barotrauma Considering the client's age and recent air travel, a likely diagnosis would be barotrauma. the other options are not affect by age and changes in pressure experienced during air travel.

A 26-year old client who has recently traveled by airplane complains of pain in his right ear. The nurse suspects which condition? a. otitis externa b. cerumen accumulation c. barotrauma d. otitis media

c.Limiting the infant's exposure to large group settings Ways to reduce the development of AOM include minimal exposure to group settings. MMR and hepatitis vaccines are irrelevant to the etiology of AOM. Ear rinsing is not recommended.

A 5 month old infant is being treated for acute otitis media (AOM) for the second time in the past 10 weeks. Which action should the nurse recommend to prevent future recurrences? a.Administration of the hepatitis B vaccine b.Gently rinsing the infant's outer ears with saline twice weekly. c.Limiting the infant's exposure to large group settings d.Administration of the measles--mumps--rubella (MMR) vaccine

a. He's been very irritable and fussy the past couple of days. e. Yes, he has been pulling at his ear. AOM characterized by acute onset of otalgia (ear pain), fever, and hearing loss. Younger children often have nonspecific signs and symptoms that manifest as ear tugging, irritability, nighttime awakening, and poor feeding. Key diagnostic criteria includes ear pain that interferes with activity or sleep, tympanic membrane erythema, and middle ear effusion. A child with otitis media with effusion (OME) may develop delayed speech and language skills.

A new mother brings her infant to the clinic reporting that the child isn't sleeping or eating much. Upon assessment, the health care providers notes that the infant's ear canal is reddened with a bulging tympanic membrane. Which other data collected would lead to the diagnosis of acute otitis media (AOM)? Select all that apply. a. He's been very irritable and fussy the past couple of days. b.He jabbers all the time usually. c. We like to throw him up in the air hoping any water in his ear will drain. d. When I dropped a pan on the floor, he jumped. e. Yes, he has been pulling at his ear.

a. Feeling of fullness in the ear(s) b. Severe ringing in the ear(s) d. Episodes of disabling vertigo e. Dizziness triggered by turning the head

What are the clinical manifestations of Meniere disease? Select all that apply a. Feeling of fullness in the ear(s) b. Severe ringing in the ear(s) c. Acute pain in the ear(s) d. Episodes of disabling vertigo e. Dizziness triggered by turning the head

d. is louder n the side with the hearing loss With the Weber test, the sound would be louder on the side with the hearing loss. In a person with sensorineural hearing loss, the sound radiates to the side with the better hearing.

The nurse is conducting a Weber test on a patient diagnosed with a conductive hearing loss.The nurse anticipates that the patient will report that the sound has what qualities? a. can be heard equally on both sides b. cannot be heard on either side c. radiates to the side without the hearing loss d. is louder n the side with the hearing loss

b. Some chemotherapeutic drugs d. Loop diuretics e. Aminoglycosides Some antimicrobial agents, antimalarial drugs, and salicylates are also identified as ototoxic.

The nurse is caring for a client who has suffered hearing loss related to an ototoxic medication. The nurse understands which classes of drugs may be ototoxic. Select all that apply. a. Glucocerticosteroids b. Some chemotherapeutic drugs c. Antidiabetic agents d. Loop diuretics e. Aminoglycosides

b. Conduction disorder

The nurse is caring for a client whose hearing is impaired due to impacted earwax. The nurse understands that the associated deafness is due to which of the following? a. Infection b. Conduction disorder c. Sensorineural disorder d. Mixed sensorineural and conduction disorder

b. If there is a hearing problem, it can be addressed right away before your baby starts to adapt to it. hearing deficits in newborns are not typically the result of fluid or of trauma during birth.

The nurse is describing to a new mother the health screening actions that will be performed on her infant. The client states, "I'm sure my baby's exhausted. I'd prefer to do this in a few weeks." What rationale for early hearing testing should the nurse describe? a.We do these tests to ensure that all the fluids from the birth have been cleared from your baby's auditory canal. b.If there is a hearing problem, it can be addressed right away before your baby starts to adapt to it. c.It's actually a very easy test, so it's best to just get it out the way now. d.We prioritize these tests in order to determine if any hearing damage occurred during the birth process.

b. asking your healthcare professional to prescribe anti-motion sickness drug d. reading a book while traveling Motion sickness can usually be suppressed by supplying visual signals that more closely match the motion signals being supplied to the vestibular system. For example, l looking out the window and watching the environment move when experiencing motion sickness associated with care travel provides the vestibular system with the visual sensation of motion, but reading a book provides the vestibular system with the miscue that the environment is stable. Motion sickness usually decreases in severity with repeated exposures. Anti-motion sickness drugs also may be used to reduce or ameliorate the symptoms.

The nurse is discussing strategies to decrease the likelihood of motion sickness with a client who is concerned about a planned car trip. Which interventions might the nurse suggest? Select all that apply. a. chewing gum while driving. b. asking your healthcare professional to prescribe anti-motion sickness drug c. looking out of car window and focusing on the scenery d. reading a book while traveling

d. Decrease dietary intake of sodium A lifestyle change that would be recommended for a patient with Meniere's disease is to consume a low sodium diet, released to the medications treatment (diuretics). The other modifications are not relevant to Meniere's disease.

The nurse is educating a patient diagnosed with Meniere's disease on lifestyle modifications to reduce the frequency and/or intensity of exacerbations. Which should the nurse include? a. Avoid crowds to reduce infections b. Decrease dietary intake of fats c. Avoid acetaminophen d. Decrease dietary intake of sodium

d. Cut down on takeout meals because of high amounts of monosodium glutamate Tinnitus can be caused by some cheeses, red wine, monosodium glutamate, and caffeine. These items should be reduced in the diet to help control the symptoms.

The nurse is teaching a client who has tinnitus about suggested dietary modifications. The most important information for the nurse to include would be: a. Increase intake of red wine to two glasses per day twice a week. b. You can drink one serving of caffeine a day and one cola. c. There are no dietary restrictions that you have to follow d. Cut down on takeout meals because of high amounts of monosodium glutamate

c. Electronystagmonography this is a rest that records the eye movements in response to vestibular, visual, cervical, rotational and positional stimulation

To diagnose a vestibular disorder, which test would be used that assesses eye movements in response to vestibular, visual and positional stimulation? a. caloric stimulation b. audiogram c. electronystagmography d. romberg test

False.

True or false: Nystagmus is an abnormal condition.

d. the eustachian tube is shorter The eustachian tube is shorter, more horizontal and wider, and with infants laying on their back most of the time, it is easy for the infection to spread

Which of the following explains why infants are more susceptible to acute otitis media? a. kids practice poor hygiene b. kids will usually put things in their ears c. the infant ear canal is smaller d. the eustachian tube is shorter

d. upper respiratory infection Acute OM, which refers to an acute middle ear infection, usually follows an upper respiratory tract infection. The other options may be considered risk factors for certain types of hearing loss.

Which of the following is a risk factor for the development of acute otitis media in a child? a. inappropriate ear hygiene techniques b. repeated exposures to loud noises c. foreign object in the ear d. upper respiratory infection

d. conductive loss hearing loss that is associated with recurrent otitis media is conductive loss

Which type of hearing loss should the nurse assess for in a child who has had recurrent otitis media since birth? a. cochlear nerve loss b. sensorineural loss c. cerumen impaction loss d. conductive loss