Deck 48: Assessment and Care of Patients with Ear and Hearing Problems

Question 1

A nurse is teaching a community group about noise-induced hearing loss.Which client who does not use ear protection should the nurse refer to an audiologist as the priority?

A) Client with an hour car commute on the freeway each day
B) Client who rides a motorcycle to work 20 minutes each way
C) Client who sat in the back row at a rock concert recently
D) Client who is a tree-trimmer and uses a chainsaw 6 to 7 hours a day

Answer 1

Client who is a tree-trimmer and uses a chainsaw 6 to 7 hours a day

Question 2

A client is scheduled to have a tumor of the middle ear removed.What teaching topic is most important for the nurse to cover?

A) Expecting hearing loss in the affected ear
B) Managing postoperative pain
C) Maintaining NPO status prior to surgery
D) Understanding which medications are allowed the day of surgery

Answer 2

Expecting hearing loss in the affected ear

Question 3

A client has external otitis.On what comfort measure does the nurse instruct the client?

A) Applying ice four times a day
B) Instilling vinegar-and-water drops
C) Use of a heating pad to the ear
D) Using a home humidifier

Answer 3

Use of a heating pad to the ear

Question 4

The client's chart indicates a sensorineural hearing loss.What assessment question does the nurse ask to determine the possible cause?

A) "Do you feel like something is in your ear?"
B) "Do you have frequent ear infections?"
C) "Have you been exposed to loud noises?"
D) "Have you been told your ear bones don't move?"

Question 5

The nurse works with clients who have hearing problems.Which action by a client best indicates goals for an important diagnosis have been met?

A) Babysitting the grandchildren several times a week
B) Having an adaptive hearing device for the television
C) Being active in community events and volunteer work
D) Responding agreeably to suggestions for adaptive devices

Question 6

The student nurse is performing a Weber tuning fork test.What technique is most appropriate?

A) Holding the vibrating tuning fork 10 to 12 inches from the client's ear
B) Placing the vibrating fork in the middle of the client's head
C) Starting by placing the vibrating fork on the mastoid process
D) Tapping the vibrating tuning fork against the bridge of the nose

Question 7

A nurse is teaching a community group about preventing hearing loss.What instruction is best?

A) Always wear a bicycle helmet.
B) Avoid swimming in ponds or lakes.
C) Don't go to fireworks displays.
D) Use a soft cotton swab to clean ears.

Question 8

A client with Ménière's disease is in the hospital when the client has an attack of this disorder.What action by the nurse takes priority?

A) Assess vital signs every 15 minutes.
B) Dim or turn off lights in the client's room.
C) Place the client in bed with the upper siderails up.
D) Provide a cool, wet cloth for the client's face.

Question 9

A client had a myringotomy.The nurse provides which discharge teaching?

A) Buy dry shampoo to use for a week.
B) Drink liquids through a straw.
C) Flying is not allowed for 1 month.
D) Hot water showers will help the pain.

Question 10

A client has Ménière's disease with frequent attacks.About what drugs does the nurse plan to teach the client? (Select all that apply.)

A) Broad-spectrum antibiotics
B) Chlorpromazine hydrochloride (Thorazine)
C) Diphenhydramine (Benadryl)
D) Meclizine (Antivert)
E) Nonsteroidal anti-inflammatory drugs (NSAIDs)

Question 11

A client hospitalized for a wound infection has a blood urea nitrogen of 45 mg/dL and creatinine of 4.2 mg/dL.What action by the nurse is best?

A) Assess the ordered antibiotics for ototoxicity.
B) Explain how kidney damage causes hearing loss.
C) Use ibuprofen (Motrin) for pain control.
D) Teach that hearing loss is temporary.

Question 12

A client is scheduled for a tympanoplasty.What actions by the nurse are most appropriate? (Select all that apply.)

A) Administer preoperative antibiotics.
B) Assess for allergies to local anesthetics.
C) Ensure that informed consent is on the chart.
D) Give ordered antivertigo medications.
E) Teach that hearing improves immediately.

Question 13

A client has labyrinthitis and is prescribed antibiotics.What instruction by the nurse is most important for this client?

A) Immediately report headache or stiff neck.
B) Keep all follow-up appointments.
C) Take the antibiotics with a full glass of water.
D) Take the antibiotic on an empty stomach.

Question 14

An older adult in the family practice clinic reports a decrease in hearing over a week.What action by the nurse is most appropriate?

A) Assess for cerumen buildup.
B) Facilitate audiological testing.
C) Perform tuning fork tests.
D) Review the medication list.

Question 15

A nursing student studying the auditory system learns about the structures of the inner ear.What structures does this include? (Select all that apply.)

A) Cochlea
B) Epitympanum
C) Organ of Corti
D) Semicircular canals
E) Vestibule

Question 16

A nurse is irrigating a client's ear when the client becomes nauseated.What action by the nurse is most appropriate for client comfort?

A) Have the client tilt the head back.
B) Re-position the client on the other side.
C) Slow the rate of the irrigation.
D) Stop the irrigation immediately.

Question 17

A client is going on a cruise but has had motion sickness in the past.What suggestion does the nurse make to this client?

A) Avoid alcohol on the cruise ship.
B) Change positions slowly on the ship.
C) Change your travel plans.
D) Try scopolamine (Transderm Scop).

Question 18

A nurse is teaching a client about ear hygiene and health.What client statement indicates a need for further teaching?

A) "A soft cotton swab is alright to clean my ears with."
B) "I make sure my ears are dry after I go swimming."
C) "I use good earplugs when I practice with the band."
D) "Keeping my diabetes under control helps my ears."

Question 19

A nursing student is instructed to remove a client's ear packing and instill eardrops.What action by the student requires intervention by the registered nurse?

A) Assessing the eardrum with an otoscope
B) Inserting a cotton ball in the ear after the drops
C) Warming the eardrops in water for 5 minutes
D) Washing the hands and removing the packing

Question 20

A client has severe tinnitus that cannot be treated adequately.What action by the nurse is best?

A) Advise the client to take antianxiety medication.
B) Educate the client on nerve cutting procedures.
C) Refer the client to online or local support groups.
D) Teach the client side effects of furosemide (Lasix).

Question 21

A client is admitted to the nursing unit after having a tympanoplasty.What activities does the nurse delegate to the unlicensed assistive personnel (UAP)? (Select all that apply.)

A) Administer prescribed antibiotics.
B) Keep the head of the client's bed flat.
C) Remind the client to lie on the operative side.
D) Remove the iodoform gauze in 8 hours.
E) Take and record postoperative vital signs.

Question 22

A client is scheduled for a stapedectomy in 2 weeks.What teaching instructions are most appropriate? (Select all that apply.)

A) Avoid alcohol use before surgery.
B) Blow the nose gently if needed.
C) Clean the telephone often.
D) Sneeze with the mouth open.
E) Wash the external ear daily.

Question 23

A client has a hearing aid.What care instructions does the nurse provide the unlicensed assistive personnel (UAP)in the care of this client? (Select all that apply.)

A) Be careful not to drop the hearing aid when handling.
B) Soak the hearing aid in hot water for 20 minutes.
C) Turn the hearing aid off when the client goes to bed.
D) Use a toothpick to clean debris from the device.
E) Wash the device with soap and a small amount of warm water.

Question 24

A hospitalized client has Ménière's disease.What menu selections demonstrate good knowledge of the recommended diet for this disorder? (Select all that apply.)

A) Chinese stir fry with vegetables
B) Broiled chicken breast
C) Chocolate espresso cookies
D) Deli turkey sandwich and chips
E) Green herbal tea with meals