Deck 63: Caring for the Patient With Hearing and Balance Disorders

Question 1

The nurse is instructing a patient who has a hearing and balance disorder. Which guidelines should the nurse discuss?.Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) Changing positions slowly
B) Avoiding bending over to pick things up
C) Using two or more pillows at night
D) Sitting on the edge of the bed for a few moments when arising
E) Standing very still when vertigo occurs

Answer 1

Changing positions slowly
Avoiding bending over to pick things up
Using two or more pillows at night
Sitting on the edge of the bed for a few moments when arising

Question 2

A patient complains of feeling "off balance." The nurse should consider that the patient might have a disorder affecting which structure?

A) Organ of Corti
B) Vestibular system
C) Middle ear
D) Cochlea

Answer 2

Vestibular system

Question 3

The nurse is working with a patient newly diagnosed with benign paroxysmal positional vertigo (BPPV). Which instruction should the nurse provide for this patient?

A) Importance of bed rest
B) Importance of medication regimen to eliminate the disorder
C) Modifications in daily activities
D) Adapting to long-term balance disorder

Answer 3

Modifications in daily activities

Question 4

A patient tells the nurse that the only way he can adequately clean his ears is with a cotton-tipped applicator. What is the nurse's best action regarding this statement?

A) Instruct the patient on the proper use of cotton-tipped applicators.
B) Educate the patient about the danger of using cotton-tipped applicators for this purpose.
C) Instruct the patient to use cotton-tipped applicators only when necessary.
D) Check to see if the ears are clean.

Question 5

A patient experiences an increase in ear pain when the auricle is pulled up and back. The nurse would conduct additional assessment for which condition?

A) Otitis externa
B) Otitis media
C) Labyrinthitis
D) Exostosis

Question 6

A patient is experiencing a severe episode of Ménière's disease. Which medication to help reduce the sensation of spinning and nausea does the nurse anticipate providing?.Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) Meclizine (Antivert)
B) Ofloxacin drops (Floxin Otic)
C) Diphenhydramine (Benadryl)
D) Phenergan
E) Dimenhydrinate (Dramamine)

Question 7

A patient is diagnosed with otosclerosis. The nurse plans interventions related to which type of hearing loss?

A) Sensorineural
B) Mixed
C) Conductive
D) Cochlear

Question 8

A patient diagnosed with profound noise-induced hearing loss (NIHL) states, "I am going to wear ear protection at work from now on. How long before my hearing gets better?" How should the nurse respond?

A) "If you rest your ears from noise, you should be back to normal in a week or so."
B) "As soon as the inflammation in your ear canal clears, your hearing will be much better."
C) "Often the nerve damage in your type of hearing loss is permanent, and hearing does not improve."
D) "It is too late to use ear protection now."

Question 9

A patient is admitted with a ruptured tympanic membrane (TM). This may result in a hearing loss due to the disruption of which function of the TM?

A) Separating the outer and inner ear
B) Vibrating with sound waves
C) Covering the eustachian tube
D) Covering the mastoid process

Question 10

Which physical assessment finding should the nurse anticipate in the patient with otosclerosis?

A) Rinne test results show that bone conduction is equal to or greater than air conduction.
B) The patient has severe vertigo.
C) Purulent drainage is observed or reported with cyanosis of the tympanic membrane.
D) Diminished hearing is noted with higher tones, such as a woman's speaking voice.

Question 11

An older patient has been diagnosed with presbycusis. The nurse would plan interventions to address which kind of hearing loss that is a common result of aging?

A) Sensorineural
B) Air conduction
C) Conductive
D) Mixed

Question 12

A 25-year-old patient has had surgery for a cochlear implant. Which statement by a family member does the nurse evaluate as indicating understanding about this device?

A) "A cochlear implant won't replace normal hearing; it will improve sound perception."
B) "It will be much nicer than a hearing aid, as nothing needs to be worn or will be visible."
C) "The speaking voice will improve too."
D) "These are so easy to use that she will be hearing well very soon."

Question 13

Which nursing diagnosis is a priority for a patient with severe symptoms of tinnitus, vertigo, sensorineural hearing deficit, nausea, and vomiting?

A) Disturbed Sensory Perception
B) Imbalanced Nutrition: Less than Body Requirements
C) Ineffective Individual Coping
D) Disturbed Sleep Patterns

Question 14

Which nursing interventions are most appropriate for a patient with a nursing diagnosis of Impaired Verbal Communication related to hearing deficit?.Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) Speak face-to-face, but do not over-articulate words.
B) Respond to the call light promptly.
C) Use touch to gain the patient's attention.
D) Speak clearly.
E) Speak in a higher pitch.

Question 15

A patient with chronic acute otitis media infections is having a myringotomy. What discharge instructions should the nurse provide?

A) Avoid getting any water into the ears.
B) Wash hair only with warm water.
C) Make sure showers are completed within 10 minutes.
D) Avoid gum chewing.

Question 16

A young child is being seen with an impaction of the ear canal caused by a large plastic bead. The nurse prepares to assist with which procedure to remove the bead?

A) Suction using a soft piece of tubing
B) Instillation of lidocaine drops
C) Instillation of mineral oil
D) Forceps

Question 17

When taking a health history, the nurse asks a patient about taking over-the-counter medications. The patient reports taking large doses of aspirin to relieve daily headaches. This comment should alert the nurse to further assess the patient's hearing for which reason?

A) The headaches are probably caused by a hearing disorder.
B) Aspirin can be ototoxic.
C) Most headaches are caused by disorders of the inner ear.
D) The patient is trying to treat a serious condition without medical intervention.

Question 18

The nurse is working with a patient who has just purchased hearing aids. Which instruction should be part of the nurse's teaching?

A) "Wear the devices only when you think you are going to need them."
B) "Leave the devices on when you are not wearing them."
C) "Only wear the devices for a part of the day at first."
D) "Bring the device back to the clinic when the battery needs to be changed."

Question 19

A nurse is working with a patient who experienced the sudden onset of dizziness, nausea, and hearing loss. A diagnosis of Ménière's disease has been made. How should the nurse instruct the patient?

A) Use tranquilizers to help cope with the disease.
B) Avoid tobacco, alcohol, and caffeine.
C) Take OTC medications for the nausea.
D) Stay in bed until symptoms subside.

Question 20

A diver is admitted complaining of ear pain and hearing loss. On examination, the nurse notes a rupture in the tympanic membrane. The nurse would conduct further assessment for which type of hearing loss?

A) Conductive hearing loss
B) Sensorineural hearing loss
C) Noise-induced hearing loss
D) Mixed hearing loss

Question 21

A patient has been diagnosed with a balance disorder that is expected to clear on its own in a few weeks. Which safety information should the nurse provide?.Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) "Use a stepladder to get things off high shelves instead of reaching up over your head."
B) "Don't pick up objects from the floor."
C) "Do not drink alcohol until your condition passes."
D) "Have someone put nonslip surfaces in the floor of your shower."
E) "Be certain to drink enough fluids while you are sick."

Question 22

Which nursing diagnosis is the top priority for a patient complaining of dizziness and disequilibrium with head movements?

A) Fluid Volume Deficit
B) Impaired Adjustment
C) Ineffective Coping
D) Risk for Injury

Question 23

During an otoscopic examination, the nurse notes a number of lumps in the patient's ear canal. Which assessment questions should the nurse ask?.Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) "Have you noticed that you are not hearing as well?'
B) "Have you ever spent time in saltwater?"
C) "Do you frequently wear earbuds or earphones?"
D) "Have you ever been a surfer?"
E) "Do you clean your ear with a cotton-tipped applicator?"

Question 24

A child has been diagnosed with perforation of the tympanic membrane (TM) secondary to a middle ear infection. What discharge information should the nurse provide the parents?.Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) "Your child's hearing loss will probably be permanent."
B) "Keep the ear canal dry."
C) "The eardrum will probably heal well on its own."
D) "You will need to call an ear surgeon for an appointment to repair this perforation."
E) "Most perforations indicate congenital weakness in the eardrum, so this is likely to occur again."

Question 25

The nurse is holding a community educational session for parents of toddlers. Which guidelines should the nurse discuss to promote healthy ears and hearing in these children?.Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) Clean the child's ear canal with the finger.
B) Avoid taking the child to places where the noise level is high.
C) Teach the child the importance of wearing a helmet when riding a bike.
D) Rinse the child's hair with a weak saltwater solution after shampooing.
E) When flying, give the child something to drink during landings.

Question 26

The nurse is assessing a 75-year-old patient. Which patient statements would alert the nurse that the patient may have presbycusis?.Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) "I have lots of earwax in my left ear."
B) "My ears ring all the time."
C) "I have a hard time hearing my granddaughter's voice."
D) "I just can't hear when the room is noisy."
E) "I woke up this morning unable to hear out my left ear."

Question 27

The nurse knows that a patient may develop sensorineural hearing loss as a result of ototoxic drugs. Which patient would be at highest risk for this type of hearing deficit?

A) A patient with methicillin-resistant Staphylococcus aureus (MRSA) on high doses of vancomycin (Vancocin)
B) A patient on low-dose aspirin to prevent stroke
C) A patient on steroids (Prednisone) for chronic spondylolisthesis
D) A patient using atorvastatin (Lipitor) to prevent heart disease and stroke

Question 28

An infant is born with low-set ears. What important information should the nurse provide the parents?

A) "Low-set ears are often a family characteristic."
B) "Genetic testing will be required."
C) "Once the baby is older, plastic surgery can improve the appearance of the ears."
D) "As long as hearing is intact, ear position is not important."

Question 29

A patient with a sore throat and head cold is complaining of "trouble with hearing." The nurse should conduct additional assessment for which most likely condition?

A) Swimmer's ear
B) A middle ear infection
C) Otosclerosis
D) An inner ear infection

Question 30

During a Weber test, a patient is found to have increased hearing in the right ear. The nurse realizes that this finding is consistent with which condition?

A) Normal aging
B) Conductive hearing loss in the left ear
C) Possible buildup of cerumen or otitis media in the right ear
D) Perforated left eardrum

Question 31

A mother brings a 4-year-old into the emergency department and reports that the child put a piece of unpopped popcorn in the ear. Which equipment should the nurse collect to treat this condition?.Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) An otoscope
B) Mineral oil
C) Irrigation supplies
D) Suction equipment
E) Liquid soap

Question 32

A child is at risk of developing mastoiditis due to a severe middle ear infection. The nurse would teach the parents that it is important to report which signs?.Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) Sudden increase in fever
B) Redness behind the ear
C) Ear sticking out more than normal
D) Redness of the throat
E) Dizziness

Question 33

A patient diagnosed with swimmer's ear says, "I haven't been swimming in 2 years." How should the nurse respond to this statement?.Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) "Let me recheck your chart to be certain I did not misinterpret the diagnosis."
B) "You must have gotten lots of water in your ear while showering."
C) "Swimmer's ear is usually a bacterial infection."
D) "Swimmer's ear can be caused by wearing ear plugs, earphones, or earbuds."
E) "Swimmer's ear is the common name for otitis externa, which has many causes."