Question 1

While reviewing the laboratory reports of a client, the nurse finds an increased volume of endolymph fluid in the inner ear. On further examination, the nurse finds that the client is positive for the Romberg test. Which pathological condition does the nurse anticipate in the client?

Accepted Answer

Ménière's disease is characterized by an increased volume of endolymph fluid in the inner ear, which can lead to symptoms such as vertigo, hearing loss, and a positive Romberg test, indicating a balance disorder.

Question 2

During a client assessment, a client reports a loss of hearing to the nurse. The nurse also finds an increased volume of endolymph fluid in the inner ear. Which instruction does the nurse give the client?

Accepted Answer

A low-salt diet can help reduce fluid retention, including the volume of endolymph fluid in the inner ear, potentially alleviating symptoms related to inner ear disorders such as Meniere's disease.

Question 3

While examining a client's ear through a pneumatic otoscope, the nurse notes decreased movement of the tympanic membrane in the client. Additional assessment reveals pharyngeal erythema and rhinorrhea in the client. Which is an appropriate nursing intervention for the client?

Accepted Answer

Decreased movement of the tympanic membrane, along with pharyngeal erythema and rhinorrhea, suggests an infection such as otitis media or a related upper respiratory tract infection. Obtaining a throat culture is an appropriate intervention to identify the causative agent and guide treatment.

Question 4

While reviewing the magnetic resonance imaging (MRI) reports of a client who has a hearing impairment, the nurse notes the presence of a tumor associated with the auditory nerve. During additional assessment, the nurse finds the client is positive for the Romberg test. Which diagnosis does the nurse anticipate?

Accepted Answer

The presence of a tumor associated with the auditory nerve and a positive Romberg test, which indicates a balance disorder, suggest the client has vestibular schwannoma (also known as acoustic neuroma). This condition involves a benign tumor on the vestibulocochlear nerve, which affects hearing and balance.

Question 5

The nurse is teaching care measures to be followed by a client who has otitis externa. Which instruction by the nurse is most beneficial to the client?

Accepted Answer

Using ear plugs while bathing can help prevent water from entering the ear canal, which is beneficial for someone with otitis externa to avoid exacerbating the condition.

Question 6

A client reports an inability to hear any sounds after takeoff during airplane flight to the nurse. Which does the nurse conclude from the client's statement?

Accepted Answer

The Eustachian tube helps equalize pressure in the middle ear. During takeoff, the rapid change in air pressure can prevent the Eustachian tube from functioning properly, leading to difficulty hearing. The other options do not directly relate to the symptoms described.

Question 7

A client reports difficulty with hearing. The nurse performs a hearing test and discovers the client cannot hear any sounds softer than 44 dB. Which type of hearing loss does the nurse record on the client's chart?

Accepted Answer

Moderate hearing loss is typically defined as the inability to hear sounds softer than 41-55 dB. Since the client cannot hear sounds softer than 44 dB, it falls within the range of moderate hearing loss.

Question 8

After multiple follow-up visits, the nurse finds that a client with persistent otitis media for 12 weeks is not improved using the initial treatment regimen. Which intervention is the nurse most likely expecting to be prescribed?

Accepted Answer

A tympanostomy, which involves placing tubes in the eardrums to allow fluid to drain from the middle ear, is a common treatment for persistent otitis media that does not improve with initial treatments. This can help prevent further infections and improve hearing.

Question 9

While reviewing the laboratory reports of a client who presented with hearing loss, the nurse notes the presence of inflammation in the membranous labyrinth. The client also reports vertigo and loss of balance. Which treatment strategy does the nurse anticipate to be most beneficial to the client?

Accepted Answer

The symptoms and laboratory findings suggest the client is suffering from labyrinthitis, an inflammation of the inner ear or the nerves that connect the inner ear to the brain. This condition often results from an infection, so antibiotics to treat the underlying infection and meclizine to address symptoms of vertigo and loss of balance are appropriate treatments. Tympanostomy, destructive surgery, and analgesic/antipyretic therapy do not directly address the underlying infection or the specific symptoms of vertigo and balance loss associated with labyrinthitis.

Question 10

While caring for an older adult client, the nurse finds the client is in the initial stage of presbycusis. Which instruction by the nurse to the client's family member is most beneficial to the client?

Accepted Answer

Presbycusis is age-related hearing loss, and the most beneficial action would be to consult an audiologist for a professional assessment and management plan, including the potential need for a hearing aid tailored to the client's specific hearing loss profile.

Question 11

The nurse is addressing treatment for a client diagnosed with profound hearing loss. The nurse is recommending digital hearing aids and the benefits of learning lip reading and/or sign language. Which hearing test result is the nurse addressing? 1.10 decibels

Accepted Answer

The nurse is addressing a client with profound hearing loss, which is indicated by a hearing test result of 90 decibels. Profound hearing loss requires more significant interventions such as digital hearing aids, lip reading, or sign language for effective communication.

Question 12

The nurse finds accumulation of yellow-brown-colored earwax in the client's ear canal while assessing a client who reports hearing difficulty. Which is an appropriate nursing intervention?

Accepted Answer

Irrigation or the use of a curette by a healthcare professional are appropriate methods for removing earwax that is causing symptoms such as hearing difficulty. These methods are safe and effective when performed correctly. Using tissue paper, cotton-tipped applicators, or surgical forceps are not recommended for earwax removal as they can push the wax further into the ear canal or cause injury.

Question 13

The nurse is assessing a child who exhibits the manifestations of otitis media. Which additional finding does the nurse associate with otitis media?

Accepted Answer

Otitis media often follows an upper respiratory tract infection due to the spread of infection from the throat to the middle ear through the Eustachian tube.

Question 14

A client reports difficulty hearing. The nurse finds that the client's external ear exhibits a cause for the altered function. Which finding in the client supports the nurse's finding?

Accepted Answer

The eardrum, or tympanic membrane, is part of the external ear. Inflammation of the eardrum can impair hearing by affecting the transmission of sound waves.

Question 15

The nurse is performing a follow-up assessment on a client being treated for back pain. The client reports that long-term treatment with naproxen is moderately effective and the addition of aspirin is providing better pain management. Which testing is the nurse likely to request for this client?

Accepted Answer

The answer of The nurse is performing a follow-up assessment...

Question 16

Which part of the ear conducts sound waves to the tympanic membrane?

Accepted Answer

The external ear, consisting of the pinna and the ear canal, directs sound waves towards the tympanic membrane (eardrum), initiating the process of hearing.

Question 17

After reviewing the magnetic resonance imaging (MRI) reports of a client, the health-care provider instructs the nurse to schedule the client for surgery. Which condition in the client is likely responsible for this prescription?

Accepted Answer

Vestibular schwannoma, also known as acoustic neuroma, is a benign tumor that develops on the balance and hearing nerves leading from your inner ear to your brain. When these tumors grow, they can press against the brain, potentially causing serious health issues. Surgery is a common treatment option to remove the tumor and alleviate symptoms or prevent further complications. Conditions like otitis media, labyrinthitis, and Ménière's disease are typically managed with medications and other non-surgical treatments.

Question 18

A client reports feelings of instability with head movement while standing. Which cranial nerve does the nurse suspect is involved in the client's manifestations?

Accepted Answer

Cranial nerve VIII, also known as the vestibulocochlear nerve, is responsible for hearing and balance. Feelings of instability with head movement suggest an issue with balance, which is directly related to the function of the vestibulocochlear nerve.

Question 19

The nurse is providing care for a client with a perforated tympanic membrane after a scuba diving event. Which treatment is best for the health-care provider to recommend?

Accepted Answer

The answer of The nurse is providing care for a...

Question 20

The nurse reviews a culture report on a client's ear secretions, which identifies the presence of Staphylococcus aureus and Pseudomonas bacterial strains. The client initially presented with pain, tenderness, and itching on the auricle. Which conclusion does the nurse conclude from these findings?

Accepted Answer

The presence of Staphylococcus aureus and Pseudomonas bacterial strains in the ear secretions, along with symptoms of pain, tenderness, and itching on the auricle, are indicative of otitis externa, an infection of the outer ear canal.

Quiz 44: Ear Disorders