Brunner & Suddarth Med-Surg 13th ed. Ch.64

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Which nursing suggestion would be most helpful to the client with recurrent otitis externa?

Place ear plugs into the ears before swimming

Which of the following is consistent with acute otitis media?

Conductive hearing loss may occur.

While traveling in the mountains on vacation, your 7-year-old niece begins to complain about the pressure in her ears as you reach higher altitudes. Which structure within the middle ear is instrumental in equalizing middle ear pressure?

Eustachian tubes

A client comes to the walk-in clinic complaining of an earache. The cause is found to be impacted cerumen. The client asks the nurse what they can do at home to soften hardened cerumen. What should the nurse recommend to a client to soften hardened cerumen?

Take nonprescription preparations.

The nurse is assessing a client for objective symptoms of hearing difficulties. Which symptom leads the nurse to take alternate measures to ensure client understanding of teaching?

The client leans forward and turns the head.

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

The eighth cranial nerve

When caring for a client status post 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

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

Which of the following manifestations is most problematic for the patient diagnosed with Ménière's disease?

Vertigo

Which of the following manifestations is the most problematic for the patient diagnosed with Meniere's disease?

Vertigo

Which of the following instructions regarding swimming should the nurse give to the client who is recovering from otitis externa? Choose the correct option.

Wear soft plastic earplugs.

Loud, persistent noise has been found to cause all of the following symptoms except

decreased GI activity.

If untreated, squamous cell carcinoma of the external ear can spread through the temporal bone causing

facial nerve paralysis.

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

A nurse is reviewing the medical records of several patients who have had audiometric testing performed. The results showing the loss in decibels (dB) are as follows: Patient A: 10 dB Patient B: 15 dB Patient C: 28 dB Patient D: 44 dB Which patient would the nurse identify as having normal hearing?

Patient A

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?

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

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 experience no falls due to balance disorder.

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."

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

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

Which of the following preattack symptoms may a patient with Meniere's disease report prior to an attack?

A full feeling in the ear

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

The nurse is performing the Rinne test on a client with a sensorineural hearing loss. Which of the following would the nurse expect?

Air-conducted sound heard longer than bone-conducted sound

An 88-year-old client has a history of hearing loss and is returning for his annual hearing examination. During your client education session, you explain to the client that hearing involves which areas of the ear?

All sections of the ear are involved in perceiving sound.

High doses of which of the following medications can produce bilateral tinnitus?

Aspirin

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

Which of the following instructions regarding swimming should the nurse give to the patient who is recovering from otitis externa?

Avoid swimming for 7-10 days

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

Be forthright and inform others about the hearing deficit.

Which of the following brain structures is responsible for equilibrium?

Cerebellum

Which of the following is a correct rationale for encouraging a patient with otitis externa to eat soft foods?

Chewing may cause discomfort.

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 nursing student hopefuls are taking a pre-nursing anatomy and physiology class. What will they learn is the anatomical feature that equalizes air pressure in the middle ear?

Eustachian tube

Which portion of the middle ear equalizes pressure?

Eustachian tube

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

Loud, persistent noise has what effect on the body?

Increased blood pressure

Loud, persistent noise has been found to have which of the following effects on the body? Select all that apply.

Increased blood pressure Increased heart rate Constriction of peripheral blood vessels

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

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.

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

Listening skills

Hearing aids help with which of the following problems?

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?

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

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?

Pearly gray and translucent

Which of the following is hearing loss associated with degenerative changes?

Presbycusis

Which terms refers to the progressive hearing loss associated with aging?

Presbycusis

A patient is newly diagnosed with otitis externa. Which of the following should the nurse teach the patient before the patient leaves the clinic?

Proper instillation of prescribed ear drops

Which of the following tests use a tuning fork between two positions to assess hearing?

Rinne's

Which of the following tests uses a tuning fork between two positions to assess hearing?

Rinne's

Which of the following statements correctly matches the nursing diagnosis with its appropriate nursing intervention for a patient suffering with vertigo? Select all that apply.

Risk for trauma: Assist with ambulation. Risk for deficient fluid volume intake: Encourage oral fluids. Risk for injury: Encourage vestibular therapy. Anxiety: Provide information about vertigo and its treatment.

Which of the following tests would be used to determine an inner ear dysfunction?

Romberg test

A 3-year-old client with severe hearing loss is being seen by an audiologist. Understandably, the client's mother is quite concerned about her child's future independence because of his impaired hearing. During your education session, the client asks which type of hearing loss is usually irreversible. What is your response?

Sensorineural

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

A client has undergone a mastoidectomy. The nurse teaches the client about possible complications, instructing the client to notify the physician immediately if which of the following occur?

Slurred speech

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

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.


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