Adult Nursing - Chapter 64: Assessment and Management of Patients with Hearing and Balance Disorders - PrepU

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

- Serous otitis media

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? - Speak a phrase in a low normal tone of voice. - Stand about 1 to 2 feet away from the ear to be tested. - Stand at a position diagonal to the client. - Have the client use a finger to occlude the ear to be tested.

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

Which phrase defines ossiculoplasty? - Incision into the eardrum - Surgical repair of the eardrums - Surgical reconstruction of the middle ear bones - Incision into the tympanic membrane

- Surgical reconstruction of the middle ear bones

The nurse is examining the area behind the patient's auricle and sees a flaky scaliness. What disorder does the nurse suspect the patient has? - Seborrheic dermatitis - Acute external otitis - Tophi - Sebaceous cysts

- Seborrheic dermatitis

A client with a conductive hearing disorder caused by ankylosis of the stapes in the oval window undergoes a stapedectomy to remove the stapes and replace the impaired bone with a prosthesis. After the stapedectomy, the nurse should provide which client instruction? - "Lie in bed with your head elevated, and refrain from blowing your nose for 24 hours." - "Don't fly in an airplane, climb to high altitudes, make sudden movements, or expose yourself to loud sounds for 30 days." - "Try to ambulate independently after about 24 hours." - "Shampoo your hair every day for 10 days to help prevent ear infection."

- "Don't fly in an airplane, climb to high altitudes, make sudden movements, or expose yourself to loud sounds for 30 days."

The nurse identifies the nursing diagnosis of deficient knowledge related to a new hearing aid for a client. After teaching a client about caring for his new hearing aid, the nurse determines that the outcome has been achieved when the client states which of the following? - "I should insert the ear mold when it is wet." - "I need to keep my ear canal clean and dry." - "I need to wipe the ear mold daily with a moist washcloth." - "I should wash the receiver with soap and water once a week."

- "I need to keep my ear canal clean and dry."

A client is being prepared for a cochlear implant. Which client statement would alert the nurse to the need for additional teaching? - "I'll wear an external transmitter and microphone." - "I'm going to be able to hear normally again." - "I'll be able to hear medium and loud sounds for once." - "I'll have a small incision behind my ear."

- "I'm going to be able to hear normally again."

A dietary modification for a patient with Ménière's disease would be: - An increase in vitamin C to 1.5 g/day. - Fluid restriction to 2 L/day. - An increase in calcium to 1 g/day. - A decrease in sodium intake to 2,000 mg daily.

- A decrease in sodium intake to 2,000 mg daily.

Which symptoms may a client with Ménière disease report before an attack? - A full feeling in the ear - Photosensitivity - Nystagmus - Low blood pressure

- 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-fat diet - A high-protein diet - A low-sodium diet - A calorie-controlled diet

- 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? - The client being distressed in the mornings - A red and swollen ear drum - The client describing a recent upper respiratory infection - A progressive, bilateral loss of hearing

- A progressive, bilateral loss of hearing

It is important for the nurse to educate clients newly diagnosed with Ménière disease to avoid which foods in their diet? Select all that apply. - Milk - Alcohol - Monosodium glutamate - Spicy food - Caffeine - Whole grains - High-salt foods

- Alcohol - Monosodium glutamate - Caffeine - High-salt foods

High doses of which medication can produce bilateral tinnitus? - Aspirin - Dimenhydrinate - Meclizine - Promethazine

- Aspirin

A client is diagnosed with otitis externa. Which instruction is most appropriate for the nurse to give? - Keep a dry cotton ball in the ear canal. - Avoid swimming for 7 to 10 days. - Avoid using cold water when shampooing hair. - Keep the ear covered with a scarf.

- Avoid swimming for 7 to 10 days.

Which of the following brain structures is responsible for equilibrium? - Cerebellum - Hypothalamus - Thalamus - Brainstem

- Cerebellum

Which is a correct rationale for encouraging a client with otitis externa to eat soft foods? - Chewing may lead to further complications, such as otitis media. - Chewing may cause excessive drainage. - Chewy foods, such as red meat, may react with prescribed analgesics and antibiotics. - Chewing may cause discomfort.

- Chewing may cause discomfort.

The nurse is caring for a client experiencing hearing loss. The nurse uses the otoscope to assess the ear canal and tympanic membrane and notes a significant accumulation of cerumen. Which documentation of hearing loss type would be most accurate? - Sensorineural - Conductive - Central - Mixed

- Conductive

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? - Ephedrine - Scopolamine - Phenergan - Dramamine

- Dramamine

Which action by the nurse has the highest priority when caring for a client diagnosed with vertigo? - Educate the client on using the call light for assistance with ambulation. - Encourage the client to stare straight ahead, focusing on one object. - Encourage the client to keep his or her eyes open. - Administer antivertiginous medication as ordered.

- Educate the client on using the call light for assistance with ambulation.

Which action by the nurse has the highest priority when caring for a client diagnosed with vertigo? - Encourage the client to keep his or her eyes open. - Educate the client on using the call light for assistance with ambulation. - Administer antivertiginous medication as ordered. - Encourage the client to stare straight ahead, focusing on one object.

- Educate the client on using the call light for assistance with ambulation.

A client is newly diagnosed with benign paroxysmal positional vertigo. Which is the priority nursing intervention? - Attempt the Epley/canalith repositioning procedure. - Encourage bed rest. - Administer meclizine for 1 to 2 weeks. - Teach balance exercises.

- Encourage bed rest.

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? - Labyrinth - Tympanic membrane - Auricle - Eustachian tube

- Eustachian tube

A nurse is performing an otoscopic examination on a client. Which finding would the nurse document as abnormal? - External auditory canal erythema - Tympanic membrane pearly gray - Manubrium superior to the umbo - Umbo in the center of the tympanic membrane

- External auditory canal erythema

Which precaution should the nurse take when a client is at risk of injury secondary to vertigo and probable imbalance? - Encourage the client to move the head slowly - Restrict the client from focusing on one spot - Have the client wait for help before moving - Recommend that the client keep his or her eyes closed

- Have the client wait for help before moving

The client is having a Weber test. During a Weber test, where should the tuning fork be placed? - Near the external meatus of each ear - Under the bridge of the nose - On the mastoid process behind the ear - In the midline of the client's skull or in the center of the forehead

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

The client is having a Weber test. During a Weber test, where should the tuning fork be placed? - On the mastoid process behind the ear - Under the bridge of the nose - In the midline of the client's skull or in the center of the forehead - Near the external meatus of each ear

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

Loud, persistent noise has what effect on the body? - Increased blood pressure - Decreased heart rate - Decreased gastrointestinal activity - Dilation of peripheral blood vessels

- Increased blood pressure

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 - Instillation of hot water - Use of a small forceps - Instillation of carbamide peroxide

- Instillation of mineral oil

A patient is participating in aural rehabilitation. The nurse understands that this type of training emphasizes which of the following? - Social skills - Occupational skills - Listening skills - Functional skills

- Listening skills

Hearing aids help with which of the following problems? - Makes sounds louder - Improves discrimination of words - Improves understanding of speech - Improves communication skills

- Makes sounds louder

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? - Furosemide (Lasix) - Meclizine (Antivert) - Cortisporin otic solution - Gentamicin (Garamycin) intravenously

- Meclizine (Antivert)

Which of the following is an involuntary rhythmic movement of the eyes that is also associated with vestibular dysfunction? - Presbycusis - Tinnitus - Vertigo - Nystagmus

- Nystagmus

The nurse is developing a plan of care for a patient with severe vertigo. What expected outcome statement would be a priority for this patient? - Patient will have decreased fear and anxiety. - Patient will experience no falls due to balance disorder. - Patient will take medications as prescribed. - Patient will perform exercises as prescribed.

- Patient will experience no falls due to balance disorder.

The nurse is performing an assessment of a patient's ears. When looking at the tympanic membrane, the nurse observes a healthy membrane. What should the appearance be? - Dark yellow with cerumen - White and cloudy - Pink with white exudate - Pearly gray and translucent

- Pearly gray and translucent

Which nursing suggestion would be most helpful to the client with recurrent otitis externa? - Place ear plugs into the ears before swimming - Flush the ear with hydrogen peroxide - Avoid lying on the side of the affected ear - Use a cotton applicator to ensure that the ear canal is dry.

- Place ear plugs into the ears before swimming

Which terms refers to the progressive hearing loss associated with aging? - Otalgia - Presbycusis - Sensorineural hearing loss - Exostoses

- Presbycusis

A client is newly diagnosed with otitis externa. Which information should the nurse teach the client before the client leaves the clinic? - Strategies to cope with temporary sensorineural hearing loss - Cleaning ear canal with cotton-tipped applicator after showering - Side effects of oral antibiotics - Proper instillation of prescribed ear drops

- Proper instillation of prescribed ear drops

The nurse is caring for an 86-year-old client with hearing impairment. The nurse is preparing to educate the client on the diagnosis and discharge plan. What action(s) should the nurse take when talking with the client? Select all that apply. - Ensure adequate lighting by standing in front of an uncovered window. - Provide written instructions and information. - Speak in a loud, high-pitched tone. - Always face the client when talking. - Written material is written to an eighth-grade reading level.

- Provide written instructions and information. - Always face the client when talking.

Which diagnostic test distinguishes between conductive and sensorineural hearing loss? - Audiometry - Rinne test - Weber test - Whisper test

- Rinne test

Which nursing diagnosis takes highest priority for a client admitted for evaluation for Ménière's disease? - Imbalanced nutrition: Less than body requirements related to nausea and vomiting - Risk for injury related to vertigo - Risk for deficient fluid volume related to vomiting - Acute pain related to vertigo

- Risk for injury related to vertigo

The nurse is examining the area behind the patient's auricle and sees a flaky scaliness. What disorder does the nurse suspect the patient has? - Sebaceous cysts - Acute external otitis - Seborrheic dermatitis - Tophi

- Seborrheic dermatitis

Which statement describes benign paroxysmal positional vertigo (BPPV)? - The onset of BPPV is gradual. - The vertigo is usually accompanied by nausea and vomiting; generally, however, hearing is not impaired. - BPPV is caused by tympanic membrane infection. - BPPV is stimulated by the use of certain medications, such as acetaminophen.

- 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 - Reduced urinary output - Impaired facial movement - Signs of hypotension

- Tinnitus and sensorineural hearing loss

The nurse is doing discharge teaching with a client newly diagnosed with Ménière's disease. Why would the nurse advise a low-sodium diet to this client? - To minimize the risk of a tumor that involves the vestibulocochlear nerve - To minimize the adverse effects of drug therapy - To reduce the production of fluid in the inner ear - To reduce the magnitude of the hearing deficit

- To reduce the production of fluid in the inner ear

Which term refers to surgical repair of the tympanic membrane? - Myringotomy - Tympanoplasty - Ossiculoplasty - Tympanotomy

- Tympanoplasty

Acoustic neuromas are benign tumors of which of the following cranial nerves? - VII - V - VI - VIII

- VIII

The nurse is talking with a patient diagnosed with Ménière's disease about the patient's symptoms. What symptom does the patient inform the nurse is the most troublesome? - Vertigo - Tinnitus - Nausea - Diarrhea

- Vertigo

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. - Minimize misunderstandings by completing the patient's sentences (e.g., fill-in-the-blanks) to decrease the patient's embarrassment. - Use nonverbal signals of agreement (head nodding), even if unsure, to instill confidence and trust. - Change the dressing while the patient is reading the steps of the treatment because distraction decreases anxiety.

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

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? - inner section - outer section - all sections - middle section

- all sections

If untreated, squamous cell carcinoma of the external ear can spread through the temporal bone, causing - motor impairment. - diplopia. - nystagmus. - facial nerve paralysis.

- facial nerve paralysis.

Which is not a surgical procedure used in the treatment of Ménière's disease? - stapedectomy - labyrinthectomy - endolymphatic sac decompression - middle and inner ear perfusion

- stapedectomy

When performing the Weber test, where would the nurse place the vibrating tuning fork?

Top of the head; forehead