Chapter 48: Care of Patient with Ear Problems

Which test best determines hearing acuity? a. Audiometry b. Electronystagmography c. Otoscope d. Snellen test

a. Audiometry

Which technique is correct when instilling ear drops? a. Maintain the head in the same position for 2 minutes after instillation. b. Place the medication bottle in a bowl of warm water before instillation. c. Rinse the ear canal with hydrogen peroxide before instillation. d. Check to see whether the eardrum is intact before instillation.

b. Place the medication bottle of warm water before instillation

The nurse is reviewing postoperative instructions with a client undergoing stapedectomy. Which statement by the client indicates a need for further teaching? a. "I may have problems with vertigo after the surgery." b. "I should not drink from a straw for several weeks." c. "I will have to take antibiotics after the surgery." d. "I will be able to hear as soon as my dressing is removed."

d. I will be able to hear as soon as my dressing is removed

Which clients are at high risk for developing hearing problems? Select all that apply. a. Airline mechanic b. Client with Down syndrome c. Drummer in a rock band d. Teenager listening to music using ear buds e. Telephone operator

a, b, c, d,

An older adult client comes in for a routine visit. During the assessment he is irritable and says, "Speak up and quit mumbling!" How will the nurse respond? a. Apologizes and speaks louder and clearer b. Asks whether the client has a hearing loss c. Shout to ensure that the client can hear d. Suggests that the client move to a soundproof examination room to improve his hearing

a. Apologizes and speaks louder and clearer

Which type of hearing loss is most likely to be reversible when treated appropriately? a. Conductive hearing loss b. Sensorineural hearing loss c. Mixed conductive-sensorineural hearing loss d. Central hearing loss

a. Conductive hearing loss

An older adult client reports ear pain. Otoscopic examination for otitis media by the nurse practitioner (NP) reveals a dull and retracted membrane. What does the NP do next? a. Continues further assessment b. Irrigates the ear c. Prescribes antibiotics for probable otitis media d. Tests hearing acuity

a. Continues further assessment

The nurse is performing an otoscopic examination of a client's ear and notes greenish-white drainage. What does the nurse do next? a. Disposes of the otoscope tip and washes the hands before examining the other ear b. Reports the finding to the health care provider immediately c. Sends a specimen for culture d. Suctions out the drainage

a. Disposes of the otoscope tip and washes the hands before examining the other ear

The nurse is preparing a client for electronystagmography. Which statement by the client indicates that teaching was effective? a. "I can't drink caffeine 24 to 48 hours before the test." b. "I should drink more fluids 4 hours before the test." c. "I'll be placed in a soundproof booth for the test." d. "I'll be sedated for the test."

a. I can't drink caffeine 24-48 hours before the test

The nurse is teaching a client about ear protection. Which statement by the client indicates that teaching was effective? a. "I wear foam ear inserts at works where it is noisy." b. "I listen to music with foam ear inserts." c. "My ears ring after a rock concert, but it goes away." d. "The machinery is loud at work, but I get used to it."

a. I wear foam ear inserts at works where it is noisy

The nurse is assessing a client with recent changes in hearing. After taking a medication history, which drugs does the nurse identify as possible causes of the client's hearing change? Select all that apply. a. Acetaminophen (Tylenol) b. Beta blockers c. Erythromycin d. Ibuprofen (Advil) e. Insulin f. Furosemide (Lasix)

c, d, f

The nurse is teaching a client with impaired hearing about audiometric testing. Which statement by the nurse effectively communicates information about the procedure to the client? a. "Here is a picture of how the test is done. See how your bad ear will be tested first? You will be alone in the soundproof booth, so you will need to watch for lights flashing on and off as your cues." b. "Here is a video of the procedure. Please watch and feel free to ask me any questions." c. "I will sit right in front of you in the soundproof booth and give you instructions on what types of sounds you will hear and how you'll need to respond." d. "You will be in a soundproof booth and the sounds will be piped in. When you first hear the loudest sound, put your hand down. When you stop hearing the sound, put your hand up to stop."

c. "I will sit right in front of you in the soundproof booth and give you instructions on what types of sounds you will hear and how you'll need to respond."

The nurse has just received change-of-shift report about these clients. Which client needs to be assessed first? a. Client with Ménière's disease who is reporting severe nausea and is requesting an antiemetic b. Client who has had removal of an acoustic neuroma and has complete hearing loss on the surgical side c. Client with labyrinthitis who has a temperature of 102.4° F (39.1° C) and a headache d. Client who has acute otitis media and is reporting drainage from the affected ear

c. Client with labyrinthitis who has a temperature of 102.4° F (39.1° C) and a headache

Which type of drug therapy does the nurse anticipate giving to a client with Ménière's disease to decrease endolymph volume? a. Antihistamines b. Antipyretics c. Diuretics d. Nicotinic acid

c. Diuretics

An older adult client reports nausea during irrigation of the ear canal to remove impacted cerumen. What does the nurse do next? a. Administer an antiemetic. b. Call the health care provider. c. Stop irrigation immediately. d. Use less water to irrigate.

c. Stop the irrigation immediately

The nurse is caring for a client who is admitted with mastoiditis. Which assessment data obtained by the nurse requires the most immediate action? a. The eardrum is red, thick-appearing, and immobile. b. The lymph nodes are swollen and painful to touch. c. The client reports a headache and a stiff neck. d. The client's oral temperature is 100.1° F (37.8° C).

c. The client reports a headache and a stiff neck

An older adult client reports ear pain. To differentiate the cause, which clinical manifestation is more indicative of otitis media? a. Dry, flaky cerumen b. Pain on movement of the tragus c. Ringing in the ears d. Dizziness

d. Dizziness

When preparing to examine an ear with drainage, what does the nurse do first? a. Begins testing at 1000 Hz b. Reassures the client that the ear drainage is normal c. Tilts the client's head away slightly d. Dons clean gloves

d. Dons clean gloves

The nurse is talking to a client about cerumen removal from the ear canal. Which statement by the client indicates a need for further teaching? a. "I dry my ears using my fingertip and a towel." b. "I may irrigate my ears with tap water." c. "I should not use an ear candle to soften the wax." d. "I use a cotton swab to remove earwax."

d. I use a cotton swab to remove earwax

The nurse is teaching a client who will soon be fitted for a hearing aid about proper care and use. Which statement by the client indicates that teaching was effective? a. "Background noises will be difficult for me to hear." b. "I should wear my hearing aid only to work at first." c. "I should just get a smaller hearing aid because I don't have much money." d. "Listening to the radio and television will help me get used to new sounds."

d. Listening to the radio and television will help me get use to new sounds

What is the proper technique for assessing an adult client's ear with an otoscope? a. Hold the otoscope right side up when inserting it into the ear canal. b. Maintain distance between the otoscope and the client's head. c. Place the otoscope in the nondominant hand. d. Pull the pinna up and back with the nondominant hand.

d. Pull the pinna up and back with the non dominant hand

A client recently diagnosed with Ménière's disease is struggling with tinnitus. How does the nurse provide support to this client? a. Provide further assessment. b. Suggest a quiet environment. c. Suggest temporary removal of a hearing aid. d. Refer the client to the American Tinnitus Association.

d. Refer the client to the American Tinnitus Association

The nurse is teaching a client with vertigo about safety precautions for fall prevention. Which statement by the client indicates a need for further instruction? a. "I may need to use a cane." b. "I should keep my grandkids' toys out of the hallway." c. "Moving more slowly may help the vertigo subside." d. "Taking my medication will allow me to drive my car again."

d. Taking my medication will allow me to drive my car again

A client is in the immediate postoperative period after tympanoplasty. How does the nurse position the client? a. On the affected side b. Supine, with eyes toward the ceiling c. With the head elevated 60 degrees d. With the affected ear facing up

d. With the affected ear facing up

A client is having a stapedectomy. Which form of postoperative communication is most effective for the nurse to use? a. Gesturing b. Sign language c. Speaking d. Writing

d. Writing