Chapter 17- Prep U

A nurse is interviewing a client as part of a routine examination of his ears and hearing. The nurse notes that this client has high blood pressure. Which of the following questions regarding his hearing should the nurse ask that is associated with his high blood pressure? - "Do you have any ear pain?" - "Do you experience any ringing, roaring, or crackling in your ears?" - "Do you have any ear drainage?" - "Are you ever concerned that you may be losing your ability to hear well?"

- "Do you experience any ringing, roaring, or crackling in your ears?"

A client presents with otalgia and yellow-green discharge from the external ear canal. Which question should the nurse ask to determine the cause of this problem? - "Have you had any recent trauma to the inside of your ear?" -"Do you hear ringing in your ears?" - "Are their times when you feel dizzy?" - "Have you ever taken medication that is ototoxic?"

- "Have you had any recent trauma to the inside of your ear?"

The mother of a small child with tubes in both eardrums asks the nurse if it is okay if the child travels by airplane. What is the nurse's best response? - "He should avoid flying for 6 months after tube placement." - "The child must wear ear plugs while flying." - "It's safe to fly because the tubes will equalize pressure." - "He shouldn't fly with anyone who is immunocompromised."

- "It's safe to fly because the tubes will equalize pressure."

A client calls the clinic and tells the nurse that the doctor told her that she has "otalgia." The client cannot remember what the doctor explained this to be. How would the nurse most appropriately respond? - "Otalgia is discoloration of the ear." - "Otalgia is pain in the ear." - "Otalgia is the beginning of hearing loss." - "Otalgia is a disease of the inner ear."

- "Otalgia is pain in the ear."

The results of a client's Rinne test are as follows: bone conduction > air conduction. How should the nurse explain these findings to the client? - "You have a high frequency hearing loss." - "You have a conductive hearing loss." - "You have nerve damage in your ears." - "You have a unilateral hearing loss."

- "You have a conductive hearing loss."

An increased risk of falls is dangerous for any client. What client would be at an increased risk of falls? - A client with a hearing loss of 45 dB. - A client with acute otitis media. - A client with vertigo. - A client with damage to the VIIIth cranial nerve.

- A client with vertigo.

Upon examination, the Advanced Practice Nurse finds that a client has otitis media with effusion. What assessment finding is most clearly indicative of this diagnosis? - A diffuse cone of light - A gray tympanic membrane - A perforated tympanic membrane - Inflammation in the ear canal

- A diffuse cone of light

You are teaching a class on diseases of the ear. What would you teach the class is the most characteristic symptom of otosclerosis? - The client being distressed in the mornings - A progressive, bilateral loss of hearing - A red and swollen ear drum - The client describing a history of having had a recent upper respiratory infection.

- A progressive, bilateral loss of hearing

A mother of a small child calls the clinic and asks to schedule an appointment for ear tube removal. The call is transferred to the nurse. What is the nurse's best action? - Schedule first available office appointment. - Schedule appointment at hospital for tubes to be removed surgically. - Ask healthcare provider about prescribing antibiotics before removal. - Ask the mother how long the tubes have been in place.

- Ask the mother how long the tubes have been in place.

A nurse is educating a client about the function of the parts of the auditory system. Which is the function of the eustachian tube? - Transmits vibration to the fluid filled inner ear at the oval window. - Separates the external from the middle ear. - Sends sensory information to the cerebellum and midbrain. - Equalizes the pressure in the middle ear with atmospheric pressure.

- Equalizes the pressure in the middle ear with atmospheric pressure.

A client visits a community clinic reporting severe allergies causing a "crackling sensation" in the ear. The physician diagnoses serous otitis media. Which of the following is a characteristic of this condition? - Fluid collects in the middle ear causing an obstruction of the auditory tube. - An upper respiratory infection spreads through the auditory tube. - This condition develops if acute purulent otitis media is not treated promptly. - This condition is usually associated with a puncture eardrum.

- Fluid collects in the middle ear causing an obstruction of the auditory tube.

A six-month old male infant is brought to the emergency department by his parents for inconsolable crying and pulling at his right ear. When assessing this infant the nurse is aware that the tympanic membrane should be what color in a healthy ear? - Yellowish-white - Red - Gray - Bluish-white

- Gray

The eustachian tube is a passage between the middle ear and the nasopharynx. What is the function of the eustachian tube? - Helps to regulate pressure in the middle ear - Protects the middle ear - Allows for drainage of fluid from the middle ear - Maintains fluid in the middle ear

- Helps to regulate pressure in the middle ear

Which finding should a nurse recognize as normal when assessing the ears of an elderly client? - Decrease in cerumen production - Shortened earlobes - High-tone frequency loss - Bulging tympanic membrane

- High-tone frequency loss

In examining a client's external auditory canal with an otoscope, the nurse discovers impacted ear wax, known as cerumen. Which of the following is characteristic of cerumen? Select all that apply. - Keeps the tympanic membrane soft - Has bacteriostatic properties - Serves as a defense against foreign bodies - Has a translucent, pearly gray appearance - Serves as a partition stretched across the inner end of the auditory canal - Has a sticky consistency

- Keeps the tympanic membrane soft - Has bacteriostatic properties - Serves as a defense against foreign bodies - Has a sticky consistency

A client comes to the clinic and reports pain when he touches his ear. With what is this finding most consistent? - Acoustic neuroma - Otitis externa - Otitis media - Meniere disease

- Otitis externa

You are a pediatric nurse caring for a child who has been brought to the clinic with otitis externa. What assessment finding is characteristic of otitis externa? - Tophi on the pinna and ear lobe - Dark yellow cerumen in the external auditory canal - Pain on manipulation of the auricle - Air bubbles visible in the middle ear

- Pain on manipulation of the auricle

Which precaution should a nurse take to ensure the safety of a client when performing the Romberg test? - Instruct the client to hold on to a chair - Offer assistance by holding the client's arm - Place arms around the client without touching - Tell the client to keep the eyes open & focused ahead

- Place arms around the client without touching

What action should the nurse implement using an otoscope when assessing the ear of an adult client? - Pull the auricle out, up, and back - Choose the smallest speculum for client comfort - Hold the speculum in the nondominant hand - Insert the speculum gently down and backward

- Pull the auricle out, up, and back

Which characteristic feature of the tympanic membrane should a nurse anticipate finding in a client with acute otitis media? - Pearly, translucent, with no bulging - Yellowish, bulging, with fluid bubbles - Gray, translucent, with no retraction - Red, bulging, with an absent light reflex

- Red, bulging, with an absent light reflex

The nurse notes otitis media with effusion in the left ear of a 3-year-old child. Which assessment data is consistent with otitis media with effusion? - Redness and bulging of the eardrum - Clear discharge in the ear canal - Bloody discharge in the ear canal - Dense white patches on the tympanic membrane

- Redness and bulging of the eardrum

A nurse is caring for a child with an inner ear infection. The child's mother is worried because the child is having recurrent ear infections and wants to know how the function of the inner ear might be affected. Based on this information, what is the best description the nurse can tell the mother about the function of the inner ear? (Select all that apply.) - Responsible for protecting internal structures of the ear from foreign substances - Responsible for the transmission of sound - Responsible for the transmitting sound waves - Responsible for providing information about the body position to the brain

- Responsible for the transmitting sound waves - Responsible for providing information about the body position to the brain

Which of the following tests use a tuning fork between two positions to assess hearing? - Whisper - Watch tick - Rinne - Weber's

- Rinne

A client admitted to the health care facility is diagnosed with vertigo. Which test is appropriate for the nurse to perform to assess for equilibrium in the client? - Weber - Rinne - Romberg - Whisper

- Romberg

A client presents at the clinic complaining of a loss of balance. What test should the nurse expect the physician to carry out on a client with a loss of balance? - Audiometric test - Romberg test - Weber test - Rinne test

- Romberg test

The nurse is presenting an educational event for gardeners. When discussing the ears, what would be an important topic to cover? - Skin cancer prevention - Otalgia - Tinnitus - Sound control

- Skin cancer prevention

Which action by the nurse is consistent with Weber's test? - The nurse activates the tuning fork and places it on the midline of the parietal bone in line with both ears. - The nurse strikes the tuning fork and places it on the client's mastoid process to measure bone conduction. - The nurse uses a bulb insufflator attached to an otoscope to observe movement of the tympanic membrane. - The nurse shields their mouth and whispers a simple sentence approximately 18 inches from the client's ear.

- The nurse activates the tuning fork and places it on the midline of the parietal bone in line with both ears.

A 52-year-old client fails the Romberg test. The nurse explains that this might indicate a dysfunction in what part of the ear? - The bones of the middle ear - The eustachian tubes - The pinna - The vestibular portion of the inner ear

- The vestibular portion of the inner ear

After examining the client's tympanic membranes, the nurse documents "Right tympanic membrane, red and bulging with no light reflex." The nurse recognizes that these are signs of - acute otitis media. - serous otitis media. - skull trauma. - trauma from infection.

- acute otitis media.

The nurse has performed the Rinne test on an older adult client. After the test, the client reports that her bone conduction sound was heard longer than the air conduction sound. The nurse determines that the client is most likely experiencing - normal hearing. - sensorineural hearing loss. - conductive hearing loss. - central hearing loss.

- conductive hearing loss.

The transmission of sound waves through the external ear and the middle ear is known as - perceptive hearing. - conductive hearing. - external hearing. - connective hearing.

- conductive hearing.

An adult client visits the clinic and complains of tinnitus. The nurse should ask the client if she has been - dizzy. - hypotensive. - taking antibiotics. - experiencing ear drainage.

- taking antibiotics.