Question 1

While performing the otoscopic examination of a 3-year-old boy who has been pulling on his left ear,the nurse finds that his left tympanic membrane is bright red and that the light reflex is not visible.The nurse interprets these findings to indicate:

Accepted Answer

Absent or distorted light reflex and a bright red color of the eardrum are indicative of acute otitis media.See Table 15-5 for descriptions of the other conditions.

Question 2

During an examination,the nurse notices that the patient stumbles a bit while walking,and,when she sits down,she holds on to the sides of the chair.The patient states,"It feels like the room is spinning!" The nurse notices that the patient is experiencing:

Accepted Answer

With objective vertigo,the patient feels like the room spins;with subjective vertigo,the person feels like he or she is spinning.Tinnitus is a sound that comes from within a person;it can be a ringing,crackling,or buzzing sound.It accompanies some hearing or ear disorders.Dizziness is not the same as true vertigo;the person who is dizzy may feel unsteady and lightheaded.

Question 3

During an examination,the patient states he is hearing a buzzing sound and says that it is "driving me crazy!" The nurse recognizes that this symptom indicates:

Accepted Answer

Tinnitus is a sound that comes from within a person;it can be a ringing,crackling,or buzzing sound.It accompanies some hearing or ear disorders.

Question 4

During an otoscopic examination,the nurse notices an area of black and white dots on the tympanic membrane and ear canal wall.What does this finding suggest?

Accepted Answer

A colony of black or white dots on the drum or canal wall suggests a yeast or fungal infection (otomycosis).

Question 5

In performing an examination of a 3 year old with a suspected ear infection,the nurse would:

Accepted Answer

In addition to its place in the complete examination,eardrum assessment is mandatory for any infant or child requiring care for illness or fever.For the infant or young child,the timing of the otoscopic examination is best toward the end of the complete examination.

Question 6

The mother of a 2-year-old is concerned about the upcoming placement of tympanostomy tubes in her son's ears.The nurse would include which of these statements in the teaching plan?

Accepted Answer

Polyethylene tubes are inserted surgically into the eardrum to relieve middle ear pressure and to promote drainage of chronic or recurrent middle ear infections.Tubes extrude spontaneously in 6 months to 1 year.

Question 7

An assessment of a 23-year-old patient reveals the following: an auricle that is tender and reddish-blue in color with small vesicles.Additional information the nurse would need to know includes which of these?

Accepted Answer

Frostbite causes reddish-blue discoloration and swelling of the auricle after exposure to extreme cold.Vesicles or bullae may develop,and the person feels pain and tenderness.

Question 8

The nurse suspects that a patient has otitis media.Early signs of otitis media include which of these findings of the tympanic membrane?

Accepted Answer

An early sign of otitis media is hypomobility of the tympanic membrane.As pressure increases,the tympanic membrane begins to bulge.

Question 9

The nurse is preparing to do an otoscopic examination on a 2-year-old child.Which of these reflects correct procedure?

Accepted Answer

For an otoscopic examination,pull the pinna down on an infant and a child under 3 years of age.The other responses are not part of the correct procedure.

Question 10

The nurse is preparing to perform an otoscopic examination of a newborn infant.Which statement is true regarding this examination?

Accepted Answer

During the first few days,the tympanic membrane often looks thickened and opaque.It may look "injected" and have a mild redness from increased vascularity.The other statements are not correct.

Question 11

The nurse is performing an ear examination of an 80-year-old patient.Which of these would be considered a normal finding?

Accepted Answer

A high-tone frequency hearing loss is apparent for those affected with presbycusis,the hearing loss that occurs with aging.The pinna loses elasticity,causing earlobes to be pendulous.The eardrum may be whiter in color and more opaque and duller than in the young adult.

Question 12

A patient has been admitted after an accident at work.During the assessment,the patient is having trouble hearing and states,"I don't know what the matter is.All of a sudden,I can't hear you out of my left ear!" What should the nurse do next?

Accepted Answer

Any sudden loss of hearing in one or both ears,that is not associated with an upper respiratory infection,needs to be reported at once to the patient's health care provider.Hearing loss associated with trauma is often sudden.It is not appropriate to irrigate the ear or remove cerumen at this time.

Question 13

In an individual with otitis externa,which of these signs would the nurse expect to find on assessment?

Accepted Answer

The lymphatic drainage of the external ear flows to the parotid,mastoid,and superficial cervical nodes.The signs are severe swelling of the canal,inflammation,and tenderness.Rhinorrhea,periorbital edema,and pain over the maxillary sinuses do not occur with otitis externa.

Question 14

In performing a voice test to assess hearing,which of these actions would the nurse do?

Accepted Answer

With your head 30 to 60 cm (1 to 2 ft)from the person's ear,exhale and whisper slowly a set of random numbers and letters,such as "5,B,6." Normally,the person repeats each number and letter correctly after you say it.

Question 15

The nurse assesses the hearing of a 7-month-old by clapping hands.What is the expected response?

Accepted Answer

With a loud sudden noise,the nurse should notice the infant turning his or her head to localize sound and responding to his or her own name.A startle reflex and acoustic blink reflex is expected in newborns;at age 3 to 4 months,the infant stops movements and appears to listen.

Question 16

The nurse is performing an assessment on a 65-year-old male patient.He reports a crusty nodule behind the pinna.It bleeds intermittently and has not healed over the past 6 months.On physical assessment,the nurse finds an ulcerated crusted nodule with an indurated base.The preliminary analysis in this situation is that this:

Accepted Answer

An ulcerated crusted nodule with an indurated base that fails to heal is characteristic of a carcinoma.These lesions fail to heal and bleed intermittently.Individuals with such symptoms should be referred for a biopsy.The other responses are not correct.See Table 15-2.

Question 17

A 17-year-old student is a swimmer on her high school's swim team.She has had three bouts of otitis externa so far this season and wants to know what to do to prevent it.The nurse instructs her to:

Accepted Answer

With otitis externa (swimmer's ear),swimming causes the external canal to become waterlogged and swell;skinfolds are set up for infection.Prevent by using rubbing alcohol or 2% acetic acid eardrops after every swim.

Question 18

The nurse is conducting a child safety class for new mothers.Which of these is a risk factor for ear infections in young children?

Accepted Answer

Exposure to passive and gestational smoke is a risk factor for ear infections in infants and children.

Question 19

The nurse is performing a middle ear assessment on a 15-year-old patient who has a history of chronic ear infections.When examining the right tympanic membrane,the nurse sees the presence of dense white patches.The tympanic membrane is otherwise unremarkable.It is pearly,with the light reflex at 5 o'clock and landmarks visible.The nurse should:

Accepted Answer

Dense white patches on the tympanic membrane are sequelae of repeated ear infections.They do not necessarily affect hearing.

Question 20

When performing an otoscopic examination of a 5-year-old child with a history of chronic ear infections,the nurse sees that his right tympanic membrane is amber-yellow in color and that there are air bubbles behind the tympanic membrane.The child reports occasional hearing loss and a popping sound with swallowing.The preliminary analysis based on this information is that:

Accepted Answer

An amber-yellow color to the tympanic membrane suggests serum or pus in the middle ear.Often air or fluid or bubbles behind the tympanic membrane are visible.The patient may have feelings of fullness,transient hearing loss,and a popping sound with swallowing.The other responses are not correct.

Quiz 15: Ears