Chapter 64

The nurse is working in the triage section of a walk-in clinic. Which triad of common symptoms, when placed together, indicate Ménière's disease?

Hearing loss, vertigo, tinnitus

The client is having a Weber test. During a Weber test, where should the tuning fork be placed?

In the midline of the client's skull or in the center of the forehead

A nurse practitioner in an emergency room receives a telephone call from a mother whose 4-year-old child has a mosquito stuck in his external ear canal. Which of the following is the best information the nurse could give the mother?

Instill a few drops of warmed mineral oil to cover the insect.

A client comes to the walk-in clinic complaining of a "bug in my ear." What action should be taken when there is an insect in the ear?

Instillation of mineral oil

A patient is participating in aural rehabilitation. The nurse understands that this type of training emphasizes which of the following?

Listening skills

The nurse is teaching the client with Meniere's disease about controlling symptoms through diet. Which of the following would the nurse emphasize? Select all that apply.

Maintain hydration. Limit intake of caffeinated beverages. Avoid foods high in sugar. Read labels carefully for sodium content.

Which nursing diagnosis takes highest priority for a client admitted for evaluation for Ménière's disease?

Risk for injury related to vertigo

What kind of otitis media is a pathogen-free fluid behind the tympanic membrane, resulting from irritation associated with respiratory allergies and enlarged adenoids?

Serous otitis media

Postoperative nursing assessment for a patient who has had a mastoidectomy should include observing for facial paralysis, which might indicate damage to which cranial nerve?

Seventh

Which symptom is related to vertigo?

Spinning sensation

A nurse is preparing to perform the whisper test to assess a client's gross auditory acuity. Which of the following would be most appropriate for the nurse to do?

Stand about 1 to 2 feet away from the ear to be tested.

Which of the following is the treatment of choice for acoustic neuromas?

Surgery

Which phrase defines ossiculoplasty?

Surgical reconstruction of the middle ear bones

The nurse is caring for a client with symptoms of ototoxicity from aminoglycoside administration. On which structure does the medication produce the ototoxic effect?

The eighth cranial nerve

The nurse is working in the emergency department when a physician asks for help as the client is performing a Romberg test. In which position would the nurse stand to be most helpful?

The nurse would stand laterally to the client, opposite side to where the physician is standing.

Which statement describes benign paroxysmal positional vertigo (BPPV)?

The vertigo is usually accompanied by nausea and vomiting; generally, however, hearing is not impaired.

During a pharmacology class, the students are told that some drugs need to be closely monitored. What aspect should the nurse closely monitor for in clients who have been administered salicylates, loop diuretics, quinidine, quinine, or aminoglycosides?

Tinnitus and sensorineural hearing loss

Which term refers to surgical repair of the tympanic membrane?

Tympanoplasty

Acoustic neuromas are benign tumors of which of the following cranial nerves?

VIII

When caring for a client after ear surgery, what is an important aspect of nursing care?

Validate client's feelings of discomfort.

A client is diagnosed with Meniere's disease. The nurse would most likely expect the client to report which of the following?

Vertigo

Which manifestation is most problematic for the client diagnosed with Ménière disease?

Vertigo

A nurse is preparing a presentation for a local community about hearing loss and prevention. Which of the following would the nurse integrate into the presentation as the most effective preventive measure?

Wearing ear protection when exposed to noise

A nurse needs to change a dressing on an abdominal wound for a patient who is hearing-impaired and whose speech is difficult to understand. Which of the following is the best approach for the nurse?

Write down the steps of the procedure for the patient to read before beginning the treatment.

You are doing discharge teaching with a client after a stapedectomy. Why would it be important for you to advise the client to refrain from blowing the nose?

It may dislodge the prosthesis.

Hearing aids help with which of the following problems?

Makes sounds louder

Which test uses a tuning fork shifted between two positions to assess hearing?

Rinne

The clinical manifestations of motion sickness are caused by an overstimulation in what system?

Vestibular

Which portion of the middle ear equalizes pressure?

Eustachian tube

The nurse is caring for a patient with Ménière's disease who is hospitalized with severe vertigo. What medication does the nurse anticipate administering to shorten the attack?

Meclizine (Antivert)

A client comes to the emergency department, reporting that a bee has flown into his ear and is stuck. The client reports a significant amount of pain. Which of the following would be most appropriate to use to remove the bee?

Mineral oil

What is located in the cochlea of the inner ear?

Organ of Corti

The nurse is employed in an ear, nose, and throat (ENT) physician's office, obtaining a client history. The nurse documents the following client statements. Which symptoms may indicate a diagnosis of otosclerosis? Select all that apply.

"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 instilling ear drops into the client's ear. Which of the following statements, made by the family member, would require further nursing instruction?

"These drops are cold from being on the window sill."

A client is diagnosed as having serous otitis media. When describing this condition to the client, which of the following would be most accurate?

"You have some fluid that has collected in your middle ear but no infection."

The nurse caring for a client with Ménière's disease needs to assist with what when the client is experiencing an attack?

ADLs

A dietary modification for a patient with Ménière's disease would be:

A decrease in sodium intake to 1500 mg daily.

Which symptoms may a client with Ménière disease report before an attack?

A full feeling in the ear

The nurse is assisting the client in planning care during exacerbations of Ménière's disease. Which diet would the nurse identify as appropriate at this time?

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 progressive, bilateral loss of hearing

You are teaching a class on diseases of the ear. What would you teach the class is the most characteristic symptom of otosclerosis?

A progressive, bilateral loss of hearing

High doses of which medication can produce bilateral tinnitus?

Aspirin

A client newly diagnosed with otitis media reports that the pain and pressure in the ear has suddenly disappeared. What is the best action by the nurse?

Assess the tympanic membrane.

The nurse is instructing a client's family members on the most incapacitating symptom of Ménière's disease. Which nursing instruction associated with the symptom is most helpful?

Assist the client when ambulating.

A mother brings her daughter to the clinic for an evaluation because the child is complaining of ear pain. Which of the following would lead the nurse to suspect that the child is experiencing otitis externa and not otitis media?

Aural tenderness

A client you are caring for has a hearing loss. The client tells you he is self-conscious about his hearing loss. What advice should the nurse give a self-conscious client with hearing loss to protect his self-esteem?

Be forthright and inform others about the hearing deficit.

Which nursing goal is a priority when caring for a client newly diagnosed with vertigo?

Client will remain safe while ambulating in the home.

Which statement is consistent with acute otitis media?

Conductive hearing loss may occur.

The nurse is caring for a client who just returned from a trip requiring an airline flight. The client commented on how his ears hurt upon descent. The nurse is correct in stating which site as being the pressure equalizer in the ear?

Eustachian tube

Which term refers to an altered sensation of orientation in space?

Dizziness

Health teaching for a patient who suffers from motion sickness would include recommending the use of which one of the following over-the-counter drugs?

Dramamine

The client is consulting with a physician regarding a potential diagnosis of Ménière's disease. The nurse is assisting in positional testing and documentation. Which diagnostic test would the nurse anticipate to obtain a more precise evaluation of vestibular function?

Electronystagmography

A client has a history of hearing loss and is returning for an annual hearing examination. During client education, the nurse explains that hearing involves which areas of the ear?

all sections

During assessment for cranial nerve functions, the client closes the eyes and begins to fall to one side. Which cranial nerve alteration causes this response?

cranial nerve VIII

Changes in pressure at high altitudes can cause discomfort in the ears. Which structure within the middle ear is instrumental in equalizing pressure?

eustachian tubes

A client is being evaluated after noticing a decline in hearing. The client's level of hearing loss will be determined by a hearing test administered by an audiologist. The description of hearing loss is based on the:

intensity of the first heard sound.

The parent of a young client with severe hearing loss is quite concerned about the child's future independence because of impaired hearing. Which type of hearing loss is usually irreversible?

sensorineural

Which is not a surgical procedure used in the treatment of Ménière's disease?

stapedectomy

A client has been diagnosed with otosclerosis. The nurse explains to the client that this is a common cause of hearing impairment among adults and is the result of a bony overgrowth of the:

stapes

Which instructions regarding swimming should the nurse give to a client who is recovering from otitis externa?

Wear soft plastic earplugs.

The occupational nurse is advising a customer service representative client on assistive devices for hearing because the client has progressive hearing loss. In discussing the options with the client, which type would be the last option offered by the nurse?

American sign language

Which precautions should the nurse take when a client is at risk of injury secondary to vertigo and probable imbalance?

Grasp the siderails when rising to a standing position.

Which of the following precautions should the nurse take when a patient is at risk of injury secondary to vertigo and probable imbalance?

Have the patient sit in a wheelchair when moving.

Loud, persistent noise has what effect on the body?

Increased blood pressure