EXAM 4 : Chapter 50 (Nursing Management: Patients With Hearing and Balance Disorders)
The nurse is instructing a client on the benefits of a cochlear implant. The client asks, "How am I able to interpret sound?" The nurse credits which of the following as significant in the production of hearing?
Auditory nerve
A patient is participating in aural rehabilitation. The nurse understands that this type of training emphasizes which of the following?
Listening skills
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
A client is being prepared for a cochlear implant. Which client statement would alert the nurse to the need for additional teaching?
"I'm going to be able to hear normally again."
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."
When preparing a teaching plan for a client diagnosed with otitis externa, the nurse instructs the client to avoid any water sport for which duration?
7 to 10 days
A dietary modification for a patient with Ménière's disease would be:
A decrease in sodium intake to 1500 mg daily.
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
The nurse caring for a client with Ménière's disease needs to assist with what when the client is experiencing an attack?
ADLs
A nurse is preparing a plan of care for a client with otitis externa. Based on the typical assessment findings, which of the following would the nurse most likely identify as the priority nursing diagnosis?
Acute pain related to inflammation
A nurse has overheard an unlicensed care provider downplay an older adult patient's expressed concerns about hearing loss. What should the nurse teach this care provider about the aging process and hearing?
Age-related changes tend to decrease hearing acuity in older adults, but strategies for managing this can be learned.
Which of the following classification of medications is the most common cause of ototoxicity?
Aminoglycosides
A nurse is aware of the significant potential benefits of cochlear implants for certain individuals. Which one of the following individuals is the most appropriate candidate for a cochlear implant?
An individual who has profound, bilateral, sensorineural hearing loss
A client is receiving long-term intravenous therapy with gentamicin for a chronic wound infection. Which of the following would be most important for the nurse to ensure?
Arrange for audiograms twice a week.
High doses of which medication can produce bilateral tinnitus?
Aspirin
The physician suggests that a client use meclizine as treatment for his motion sickness. The nurse explains the rationale for this drug based on an understanding of which of the following as the drug's action?
Blocks conduction of the vestibular pathways
Which of the following brain structures is responsible for equilibrium?
Cerebellum
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?
Conductive
During assessment of a patient with a hearing loss, the nurse notes a defect in the tympanic membrane. The nurse documents this disturbance as a loss known as:
Conductive.
Loud, persistent noise has been found to have which of the following effects on the body? Select all that apply.
Constriction of peripheral blood vessels Increased blood pressure Increased heart rate
A patient with significant and increasing sensorineural hearing loss has opted not to have surgery and has chosen instead to focus on aural rehabilitation with an emphasis on auditory training. What will be the primary focus of the patient's rehabilitation?
Developing effective skills and strategies for listening
A nurse practitioner explains to a patient recently diagnosed with noise-induced hearing loss that the basic altered physiology in the ear is the result of:
Damage to the hair cells inside the cochlea.
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 nurse caring for a client with Ménière's disease makes which primary assessments?
Gross hearing
Which precaution should the nurse take when a client is at risk of injury secondary to vertigo and probable imbalance?
Have the client wait for help before moving
The parent of a young client with severe hearing loss is quite concerned about the child's future independence and asks about the effectiveness of hearing aids. What information should the nurse include when responding?
Hearing aids may help, but other methods such as reading lips will likely also be required.
The nurse is caring for a client in the triage section of a walk-in clinic. Which triad of common symptoms suggests a diagnosis of Ménière disease?
Hearing loss, vertigo, tinnitus
A nurse is working with a client who range of hearing loss is diagnosed as "mild to moderately severe." What hearing aid sites would the audiologist recommend? Select all that apply.
In the ear In the canal
A client has undergone a myringotomy. The nurse interprets this as which of the following?
Incision of the eardrum
A client complains of vertigo. The nurse anticipates that the client may have a problem with which portion of the ear?
Inner ear
A client comes to the walk-in clinic reporting feeling 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 adapting to the use of a hearing aid for the first time. What is the most common challenge experienced by a patient with hearing loss who is adapting to using a hearing aid for the first time?
Learning to cope with amplification of background noise
The nurse is developing a plan of care for a client with Meniere's disease and identifies a nursing diagnosis of excess fluid volume related to fluid retention in the inner ear. Which intervention would be most appropriate to include in the plan of care?
Limit foods that are high in sodium.
Hearing aids help with which of the following problems?
Makes sound louder
The nurse recognizes which methods are not correct for removing a foreign body from the ear?
Manual pressure
The nurse is caring for a client with recurrent ear infections. The nurse assesses the client for further infectious processes traveling deeper into the tissue and becoming more lethal. Which infection, originated in the ear, is of most concern?
Meningitis
Which of the following describes vertigo? Select all that apply.
Misperception of motion Spinning sensation Objects are moving around him or her
Which of the following is an involuntary rhythmic movement of the eyes that is also associated with vestibular dysfunction?
Nystagmus
The nurse on a cruise ship is assessing clients for motion sickness. Which of the following is a common misconception?
Once symptoms occur, they will always be present.
The nurse on a cruise ship is assessing clients for motion sickness. Which of the following is a common misconception?
Oncey symptoms occur, they will always be present.
You are teaching the daughter how to instill ear drops into her father's ear to remove impacted cerumen. What is a priority action to teach this woman?
Place the container in warm water before instillation.
Tap water irrigation of an older adult's ear canal has failed to dislodge the impacted cerumen that has been causing the patient to experience otalgia. In preparation for another attempt at relieving the patient's problem, what action should the nurse take?
Put a small amount of mineral oil in the patient's ear before attempting removal.
Which of the following nursing interventions would be most likely to facilitate effective communication with a hearing impaired patient?
Reduce environmental noise and distractions before communicating.
Which test uses a tuning fork shifted between two positions to assess hearing?
Rinne
Which statements correctly match the nursing diagnosis with its appropriate nursing intervention for a client suffering with vertigo? Select all that apply.
Risk for trauma: Assist with ambulation. Anxiety: Provide information about vertigo and its treatment. Risk for injury: Encourage vestibular therapy. Risk for deficient fluid volume intake: Encourage oral fluids.
A patient has been diagnosed with a loss of hearing related to damage of the end organ for hearing. What term is used to describe this condition?
Sensorineural hearing loss
During his annual physical examination, a retired airplane mechanic reports noticeable hearing loss. The nurse practitioner prescribes a series of hearing tests to confirm or rule out noise-induced hearing loss, which is classified as a:
Sensorineural loss.
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
What inner ear structure is affected when a patient is diagnosed with otosclerosis?
Stapes
Which phrase defines ossiculoplasty?
Surgical reconstruction of the middle ear bones
A nurse has just received a patient into the PACU after a tympanoplasty. What is a tympanoplasty is defined as?
Surgical repair of the eardrum
The nurse is caring for a patient with Ménière's disease. The patient is scheduled to go home tomorrow, so the nurse is preparing the patient's discharge teaching. Dietary guidelines will be included. What foods should the patient be instructed to limit or avoid?
Sweet pickles
A nurse is caring for a 24-year-old female client diagnosed with otosclerosis. Which teaching by the nurse is most accurate?
Symptoms may be accelerated by pregnancy.
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.
A 70-year-old patient with severe presbycusis is weighing the possibility of getting hearing aids. The nurse who is contributing to this patient's care should be aware that the patient's potential benefit of using hearing aids will depend upon which of the following factors?
The patient's ability to adequately discriminate sounds
Which statement describes benign paroxysmal positional vertigo (BPPV)?
The vertigo is usually accompanied by nausea and vomiting.
When discussing diseases of the middle ear, the nursing instructor distinguishes the different types of otitis media. What generally causes purulent otitis media?
Upper respiratory infections
A client who is a competitive swimmer is diagnosed with swimmer's ear (otitis externa). Which instruction would be least appropriate for the nurse to include when teaching the client about this condition?
Use a hair dryer set on high to dry the ear canal after swimming.
A nurse is providing care to a client diagnosed with an acoustic neuroma. The nurse understands that which cranial nerve is affected?
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
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.
Audiometry confirms a client's chronic progressive hearing loss. Further investigation reveals ankylosis of the stapes in the oval window, a condition that prevents sound transmission. This type of hearing loss is called:
conductive hearing loss.
If untreated, squamous cell carcinoma of the external ear can spread through the temporal bone, causing
facial nerve paralysis.
A client is diagnosed with a conductive hearing loss. When performing a Weber test, the nurse expects that this client will hear sound:
on the affected side by bone conduction.
A client who has a lengthy history of progressive hearing loss is very forthright about the condition, and the nurse wants to develop a communication strategy for this client's hospital stay. Which communication strategy has proven to be the most effective?
the one the client will use
