Chapter 20 Pathophysiology NCLEX-Style Review Questions
The nurse is teaching a client who has tinnitus about suggested dietary modifications. The most important information for the nurse to include would be: -"You can drink one serving of caffeine a day and one cola." -"There are no dietary restrictions that you have to follow." -"Cut down on takeout meals because of high amounts of monosodium glutamate." -"Increase intake of red wine to two glasses per day twice a week."
"Cut down on takeout meals because of high amounts of monosodium glutamate."
A new mother brings her infant to the clinic reporting that the child is not sleeping or eating much. Upon assessment, the health care provider notes that the infant's ear canal is reddened with a bulging tympanic membrane. Which other data collected would lead to the diagnosis of acute otitis media (AOM)? Select all that apply. -"He's been very irritable and fussy the past couple of days." -"He jabbers all the time usually." -"When I dropped a pan on the floor, he jumped." -"Yes, he has been pulling at his ear." -"We like to throw him up in the air hoping any water in his ear will drain."
"He's been very irritable and fussy the past couple of days.", "Yes, he has been pulling at his ear."
The nurse is describing to a new mother the health screening actions that will be performed on her infant. The client states, "I'm sure my baby's exhausted. I'd prefer to do this in a few weeks." What rationale for early hearing testing should the nurse describe? -"If there is a hearing problem, it can be addressed right away before your baby starts to adapt to it." -"We do these tests to ensure that all fluids from birth have been cleared from your baby's auditory canal." -"It's actually a very easy test, so it's best to just get it out of the way now." -"We prioritize these tests in order to determine if any hearing damage occurred during the birth process."
"If there is a hearing problem, it can be addressed right away before your baby starts to adapt to it."
A client reports occasional ringing in the ears that worsens toward the end of the day. The most important question for the nurse to ask would be: -"Do you use Q-tips in your ears?' -"How often do you clean your ears?" -"What prescription medication and over-the-counter medication do you take?" -"Have you had any recent respiratory infections?"
"What prescription medication and over-the-counter medication do you take?"
The nurse is caring for a client who has suffered hearing loss related to an ototoxic medication. The nurse understands which classes of drugs may be ototoxic? Select all that apply. -Antidiabetic agents -Glucocorticosteroids -Aminoglycosides -Some chemotherapeutic drugs -Loop diuretics
Aminoglycosides, Some chemotherapeutic drugs, Loop diuretics
The nurse is admitting a client to the acute medicine unit and is reviewing the results of the medication reconciliation. The nurse should recognize which drugs as having the potential for ototoxicity? Select all that apply. -Aspirin -A loop diuretic -A beta adrenergic blocker -Vitamin D supplements -An opioid analgesic
Aspirin, A loop diuretic
A 26-year-old client who has recently traveled by airplane complains of pain in his right ear. The nurse suspects which condition? -Barotrauma -Cerumen accumulation -Otitis media -Otitis externa
Barotrauma
Which interventions will the nurse reinforce when preparing to discharge a client being treated for Ménière's disease? -Insert cotton balls to protect ear canal -Implementation of a physical exercise routine -Avoidance of foods high in saturated fats -Compliance with prescribed prednisone therapy
Compliance with prescribed prednisone therapy
The nurse is caring for a client whose hearing is impaired due to impacted earwax. The nurse understands that the associated deafness is due to: -Conduction disorder -Mixed sensorineural and conduction disorder -Infection -Sensorineural disorder
Conduction disorder
For which type of hearing loss should the nurse assess in a child who has had recurrent otitis media since birth? -Cochlear nerve loss -Conductive loss -Cerumen impaction loss -Sensorineural loss
Conductive loss
The nurse is educating a client diagnosed with Meniere disease on lifestyle modifications to reduce the frequency and/or intensity of exacerbations. Which should the nurse include? -Decrease dietary intake of fats -Decrease dietary intake of sodium -Avoid crowds to reduce infection -Avoid acetaminophen
Decrease dietary intake of sodium
To diagnose a vestibular disorder, which test would be used that assesses the eye movements in response to vestibular, visual, and positional stimulation? -Electronystagmography -Caloric stimulation -Romberg test -Audiogram
Electronystagmography
What are the clinical manifestations of Ménière disease? Select all that apply. -Feeling of fullness in the ear(s) -Episodes of disabling vertigo -Dizziness triggered by turning the head -Severe ringing in the ear(s) -Acute pain in ear(s)
Feeling of fullness in the ear(s), Episodes of disabling vertigo, Dizziness triggered by turning the head, Severe ringing in the ear(s)
The nurse is conducting a Weber test on a client diagnosed with a conductive hearing loss. The nurse anticipates that the client will report that the sound has what qualities? -Radiates to the side without the hearing loss -Can be heard equally on both sides -Is louder on the side with the hearing loss -Cannot be heard on either side
Is louder on the side with the hearing loss
A 5-month-old infant is being treated for acute otitis media (AOM) for the second time in the past 10 weeks. Which action should the nurse recommend to prevent future recurrences? -Gently rinsing the infant's outer ears with saline twice weekly -Limiting the infant's exposure to large group settings -Administration of the hepatitis B vaccine -Administration of the measles-mumps-rubella (MMR) vaccine
Limiting the infant's exposure to large group settings
The nurse is discussing strategies to decrease the likelihood of motion sickness with a client who is concerned about a planned car trip. Which interventions might the nurse suggest? Select all that apply. -Reading a book while traveling -Looking out of the car window and focusing on the scenery -Asking your health care professional to prescribe an anti-motion sickness drug -Chewing gum while traveling
Looking out of the car window and focusing on the scenery, Asking your health care professional to prescribe an anti-motion sickness drug
A client reports feeling like the room is spinning around him when standing still. Which diagnosis is this client likely experiencing? -Nystagmus -Objective vertigo -Syncopal episodes -Subjective vertigo
Objective vertigo
Presbycusis is degenerative hearing loss associated with aging. What is the first symptom of this disorder? -Reduction in ability to identify sounds -Reduction in ability to understand speech -Inability to localize sounds -Inability to detect sound
Reduction in ability to understand speech
The nurse is developing a plan of care for a 65-year-old client who has significant hearing loss. Which treatment option is most appropriate to include in this client's plan of care? Select all that apply. -Speech reading class -Hearing aids -Use of sign language -Closed captioning on televised programs -Vascular decompression
Speech reading class, Hearing aids, Closed captioning on televised programs
Which condition or situation is a risk factor for the development of acute otitis media in a child? -Inappropriate ear hygiene techniques -Foreign object in the ear -Upper respiratory infection -Repeated exposure to loud noises
Upper respiratory infection
A client, who travels frequently for work, reports intense ear pain during ascent from and descent into airports. The health care provider will recommend which category of medications to help alleviate this symptom? -antihistamine nasal spray such as olopatadine -oral corticosteroid, such as prednisone -decongestant nasal spary such as phenylephrine -intranasal steroid such as fluticasone propionate
decongestant nasal spary such as phenylephrine
