Med Surg: Chapter 43

The nurse is teaching new assistive personnel (AP) about caring for older adults. Which statement would the nurse include about hearing ability of this client group? A- "You need to talk very loudly when communicating with these clients." B- "You always need to check each client's ears for excess ear wax." C- "Remember to face the client when talking with him or her." D- "Assess each client's hearing ability using the voice or whisper test."

C- "Remember to face the client when talking with him or her."

A client has external otitis. About what comfort measure would the nurse instruct the client? A- Applying ice four times a day B- Instilling vinegar-and-water drops C- Use of a heating pad to the ear D- Using a home humidifier

C- Use of a heating pad to the ear

The nurse is caring for a client after ear surgery. What health teaching instruction(s) would the nurse provide for this client to promote healing? (Select all that apply.) A- "Avoid straining when having a bowel movement." B- "Avoid drinking through a straw for 2 to 3 weeks." C- "Avoid air travel for 2 to 3 weeks after surgery." D- "Avoid crowds and people with infection, especially respiratory infection." E- "Avoid moving your head quickly, jumping, or bending over for 2 to 3 weeks." F- "Blow your nose very gently without blocking either nostril and keep your mouth open."

*All are correct* A- "Avoid straining when having a bowel movement." B- "Avoid drinking through a straw for 2 to 3 weeks." C- "Avoid air travel for 2 to 3 weeks after surgery." D- "Avoid crowds and people with infection, especially respiratory infection." E- "Avoid moving your head quickly, jumping, or bending over for 2 to 3 weeks." F- "Blow your nose very gently without blocking either nostril and keep your mouth open."

The nurse is teaching a family member who is caring for a client who is hearing impaired. What health teaching would the nurse include about communicating with the client? (Select all that apply.) A- "Make sure that the room is well lighted." B- "Speak slowly and clearly." C- "Do not shout but you may need to speak loudly." D- "Have conversations in a quiet room with minimal noise." E- "Get the client's attention before you begin to speak." F- "Move closer to the better hearing ear if possible."

*All are correct* A- "Make sure that the room is well lighted." B- "Speak slowly and clearly." C- "Do not shout but you may need to speak loudly." D- "Have conversations in a quiet room with minimal noise." E- "Get the client's attention before you begin to speak." F- "Move closer to the better hearing ear if possible."

A hospitalized client has a new diagnosis of Ménière disease. What would the nurse include in health teaching to reduce symptoms for this disorder? (Select all that apply.) A- "Apply heat to the ear for 20 minutes three times a day." B- "Move the head slowly to prevent worsening of vertigo." C- "Avoid food additives such as monosodium glutamate (MSG)." D- "Quit smoking to increase blood flow to the inner ear." E- "Avoid caffeinated beverages." F- "Avoid standing on chairs, step stools, or ladders."

B- "Move the head slowly to prevent worsening of vertigo." C- "Avoid food additives such as monosodium glutamate (MSG)." D- "Quit smoking to increase blood flow to the inner ear." E- "Avoid caffeinated beverages." F- "Avoid standing on chairs, step stools, or ladders."

The nurse is assessing a client's medication profile to determine risk for tinnitus. Which drug classification is most likely to cause this health problem? A- Cephalosporins B- NSAIDs C- Beta-adrenergic blockers D- Osmotic diuretics

B- NSAIDs

The nurse is teaching a client about factors that can cause external otitis. Which of these factors would the nurse emphasize as the highest risk? A- Excess cerumen B- Swimming C- Sinus congestion D- Meniere disease

B- Swimming Reason: External otitis is often called "swimmer's ear" because it is most often caused by swimming in lakes, ponds, and untreated pools.

The client's electronic health record indicates a sensorineural hearing loss. What assessment the question does the nurse ask to determine the possible cause? A- "Do you feel like something is in your ear?" B- "Do you have frequent ear infections?" C- "Have you been exposed to loud noises?" D- "Have you been told your ear bones don't move?"

C- "Have you been exposed to loud noises?"

A client is scheduled for a tympanoplasty. What action(s) by the nurse are (is) most appropriate? (Select all that apply). A- Administer preoperative opioids. B- Assess for allergies to local anesthetics. C- Ensure that informed consent is on the health record. D- Give prescribed antivertigo medications. E- Teach that hearing improves immediately.

C- Ensure that informed consent is on the health record.

A client with Ménière disease is in the hospital when the client has an episode of this disorder. What action by the nurse is appropriate? A- Assess vital signs every 15 minutes. B- Dim or turn off lights in the client's room. C- Place the client in bed with the upper side rails up. D- Provide a cool, wet cloth for the client's face.

C- Place the client in bed with the upper side rails up. Reason: Clients with Meniere disease can have vertigo so severe that they can fall

A client has severe tinnitus that has not responded to treatment. What action by the nurse is appropriate? A- Advise the client to take antianxiety medication. B- Educate the client on nerve-cutting procedures. C- Refer the client to online or local support groups. D- Refer the client to a mental health professional.

C- Refer the client to online or local support groups. Reason: If the client's tinnitus cannot be treated, he or she will need to learn how to cope with it. Referring the client to tinnitus support groups can be helpful. The other options are not warranted.

The nurse is teaching an older adult how to prevent buildup of ear wax. Which statement by the nurse is most appropriate? A- "Visit your primary health care provider each month for wax removal." B- "Drink plenty of water and other liquids to prevent hardening of the ear wax." C- "Irrigate each ear once a month to remove wax and prevent was buildup." D- "Put one drop of mineral oil in each ear once a week at bedtime."

D- "Put one drop of mineral oil in each ear once a week at bedtime." Reason: Mineral oil provides lubrication to soften cerumen so that it flows out of the ears to prevent buildup. It is a safer method than irrigating the ears

A nurse is teaching a community group about noise-induced hearing loss. Which client who does not use ear protection would the nurse refer to an audiologist as the priority? A- Client with an hour car commutes on the freeway each day. B- A client who rides a motorcycle to work 20 minutes each way. C- A client who sat in the back row at a rock concert recently D- A client who is a tree-timmer and uses a chainsaw 6-7 hours a day

D- A client who is a tree-timmer and uses a chainsaw 6-7 hours a day

A client who has had cold symptoms for a week visits the local urgent care center with report of left ear discomfort, dizziness, and decreased hearing. What additional assessment findings would the nurse expect? A- High fever B- Nausea and vomiting C- Elevated blood pressure D- Purulent ear drainage

D- Purulent ear drainage

A nurse is teaching a client about ear hygiene and health. Which statement by the client indicates a need for further teaching? A- "A soft cotton swab is alright to clean my ears with" B- "I make sure my ears are dry after I go swimming." C- "I use good earplugs when I practice with the band" D- "Keeping my diabetes under control helps my hearing"

A- "A soft cotton swab is alright to clean my ears with"

A nurse is teaching a community group about preventing hearing loss. What instruction is appropriate? A- "Always wear a bicycle helmet." B- "Avoid swimming in ponds or lakes." C- "Don't attend fireworks shows." D- "Use a cerumen spoon to clean ears"

A- "Always wear a bicycle helmet."

A client has a hearing aid. What care instructions does the nurse provide the assistive personnel (AP) in the care of this client? (Select all that apply.) A- "Be careful not to drop the hearing aid when handling." B- "Soak the hearing aid in hot water for 20 minutes." C- "Turn the hearing aid off when the client goes to bed." D- "Use a toothpick to clean debris from the device." E- "Wash the device with soap and a small amount of warm water." F- "Avoid using hair or cosmetic products near the hearing aid."

A- "Be careful not to drop the hearing aid when handling." C- "Turn the hearing aid off when the client goes to bed." D- "Use a toothpick to clean debris from the device." F- "Avoid using hair or cosmetic products near the hearing aid."

A client has mastoiditis and is prescribed antibiotics. What health teaching by the nurse is most important for this client? A- "Immediately report headache or stiff neck." B- "Keep all follow-up appointments." C- "Take the antibiotics with a full glass of water." D- "Take the antibiotic on an empty stomach."

A- "Immediately report headache or stiff neck."

An older adult in the family practice clinic reports a decrease in hearing in one ear for over a week. What action by the nurse is most appropriate? A- Assess for cerumen buildup B- Facilitate audiological testing. C- Perform tuning fork tests. D- Review the medication list.

A- Assess for cerumen buildup

A client had a myringotomy. What would the nurse include as part of discharge teaching? A- Buy dry shampoo to use for a week. B- Drink liquids through a straw. C- Flying is not allowed for 1 month. D- Hot water showers will help the pain.

A- Buy dry shampoo to use for a week.

A client is scheduled to have a tumor of the middle ear removed. Which perioperative health teaching is most important for the nurse to include? A- Expecting hearing loss in the affected ear B- Managing postoperative pain C- Maintaining NPO status prior to surgery D- Understanding which medications are allowed the day of surgery

A- Expecting hearing loss in the affected ear