Question 1

Which component separates the two labyrinths from each other?

Accepted Answer

The perilymph fluid is the fluid that separates the two labyrinths (the bony labyrinth and the membranous labyrinth) from each other in the inner ear. Sebum and cerumen are both substances produced by the skin, but they do not separate the labyrinths. Endolymph fluid is found within the membranous labyrinth.

Question 2

While examining a client's ear through a pneumatic otoscope,a nurse finds decreased movement of the tympanic membrane in the client.On further assessment,the nurse finds pharyngeal erythema and rhinorrhea in the client.What should be the accurate nursing intervention for the client?

Accepted Answer

The client's manifestations suggest that the client may have an ear infection. Obtaining a specimen for a throat culture could assist in detecting the pathogen causing the infection, thereby guiding appropriate treatment. Providing a low-fluid diet, preparing the client for an MRI, and using a Meniett device are not indicated in this situation.

Question 3

Which auditory ossicle connects to the upper portion of the tympanic membrane?

Accepted Answer

The malleus is the auditory ossicle that connects to the upper portion of the tympanic membrane (also known as the eardrum). The incus and stapes connect to the malleus, forming a chain of bones that transmit sound from the outer ear to the inner ear.

Question 4

While reviewing the magnetic resonance imaging (MRI)reports of a client who has a hearing impairment,a nurse finds the presence of a tumor that is associated with the auditory nerve.On further assessment,the nurse finds that the client is positive for the Romberg test.What should the nurse anticipate in the client?

Accepted Answer

The presence of a tumor associated with the auditory nerve on MRI and a positive Romberg test suggest the possibility of vestibular schwannoma, which is a type of benign tumor that develops on the balance and hearing nerves leading from the inner ear to the brain. Otitis media is an inner ear infection, labyrinthitis is an inflammation of the inner ear, and Meniere's disease is a chronic disorder of the inner ear that causes vertigo, tinnitus, and hearing loss, but none of these conditions are indicated by the MRI findings and positive Romberg test.

Question 5

While reviewing the laboratory reports of a client,a nurse finds that the client's ear secretions show the presence of Staphylococcus aureus and Pseudomonas bacterial strains.The client has pain,tenderness,and itching on the auricle.What should the nurse infer from these findings?

Accepted Answer

The presence of Staphylococcus aureus and Pseudomonas bacterial strains in ear secretions and the symptoms of pain, tenderness, and itching on the auricle suggest that the client has otitis externa, also known as swimmer's ear. This is an infection of the outer ear canal and is commonly caused by exposure to water or overly aggressive cleaning of the ear canal.

Question 6

Which level of sound intensity can result in hearing loss in clients?

Accepted Answer

Sound intensity above 85 decibels is considered harmful to hearing and exposure to sound intensity of 90 decibels or more for an extended period can cause permanent hearing loss.

Question 7

Which cranial nerve senses the flow of endolymph fluid in the ear?

Accepted Answer

Cranial nerve VIII, also known as the vestibulocochlear nerve, is responsible for both hearing and balance. The vestibular branch of this nerve is the one that senses the flow of endolymph fluid in the inner ear, which helps maintain balance and equilibrium.

Question 8

Which part of the ear aids in proprioception?

Accepted Answer

Proprioception, the perception of the body's position and movement, is aided by the inner ear. The receptors in the inner ear provide information about the head's position and movement, which helps the brain to determine the body's position and movements. The middle and external ear are mostly responsible for transmitting sound to the inner ear.

Question 9

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

Accepted Answer

The external ear, which consists of the auricle and auditory canal, conducts sound waves to the tympanic membrane (eardrum). The middle ear, composed of the ossicles (malleus, incus, and stapes), amplifies the sound waves and transmits them to the inner ear. The inner ear, which includes the cochlea and vestibular system, converts the sound waves into neural signals that are sent to the brain for processing. Therefore, only choice C is correct.

Question 10

While assessing a client,a nurse finds that the client's external ear has an altered function.Which finding in the client supports the nurse's finding?

Accepted Answer

The eardrum is an external structure that acts as a barrier between the outer and middle ear. If the eardrum is damaged, it can affect the function of the external ear and lead to altered hearing. Damaged cochlea, Eustachian tube, or auditory ossicles do not necessarily affect the function of the external ear.

Question 11

While assessing a child,a nurse finds that the child has otitis media.Which other finding in the child should the nurse associate with otitis media?

Accepted Answer

Otitis media is an infection of the middle ear, which is often preceded by an upper respiratory tract infection. Therefore, choice D is the best match in this case. Choices A, B, and C are not typically associated with otitis media.

Question 12

While assessing a client who has a hearing difficulty,a nurse finds the accumulation of yellow-brown colored earwax in the client's ear canal.What should be the accurate nursing intervention for the client?

Accepted Answer

Irrigate or using a curette to remove the earwax is the best option for removing earwax as tissues and cotton-tipped applicators can push the earwax further into the ear canal, and surgical forceps require specialist training and should only be used by a doctor. However, it is important to ensure that the earwax is not impacted and the eardrum is intact before attempting any removal. Nurses should refer to the healthcare provider if there is any doubt about the client's ear condition.

Question 13

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

Accepted Answer

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

Question 14

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

Accepted Answer

Increased endolymph fluid in the inner ear is a symptom of Meniere's disease. To manage Meniere's disease, clients are advised to follow a low-salt diet to help reduce the amount of fluid retained in the body.

Question 15

After multiple follow-up visits,a nurse finds that a client who has otitis media has not improved using an initial treatment regimen.The nurse finds that the client has persistent otitis media for 12 weeks.What test will likely be ordered for this client?

Accepted Answer

After 12 weeks of persistent otitis media, a tympanostomy may be ordered as a diagnostic and treatment measure. This involves creating a small opening in the eardrum to allow for drainage of fluid and removal of the source of infection. This can be done as an outpatient procedure and can help to alleviate symptoms and promote healing. A Romberg test and low-salt diet are not relevant to the treatment of otitis media, and destructive surgery would not be recommended as a first-line treatment option.

Question 16

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

Accepted Answer

A vestibular schwannoma is a benign tumor that grows in the vestibulocochlear nerve, which is responsible for balance and hearing. Surgery may be indicated to remove the tumor and relieve symptoms. Otitis media, labyrinthitis, and Meniere's disease are all ear conditions, but they would not normally require surgery based on MRI findings alone.

Question 17

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

Accepted Answer

The presence of inflammation in the membranous labyrinth indicates a possible inner ear infection or labyrinthitis, which can cause hearing loss, dizziness, and loss of balance. The best treatment strategy in this case would be a combination of antibiotics to treat the infection and meclizine to relieve the vertigo symptoms. Tympanostomy and destructive surgery are not indicated in clients with inner ear inflammation, and analgesics and antipyretics would not address the underlying cause of the symptoms.

Question 18

While reviewing the laboratory reports of a client,a 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 should the nurse anticipate in the client?

Accepted Answer

Meniere's disease is a disorder of the inner ear that causes episodes of vertigo, ringing in the ears (tinnitus), a feeling of fullness or pressure in the ear, and fluctuating hearing loss. The increased volume of endolymph fluid in the inner ear and positive Romberg test both suggest involvement of the vestibular system, which is a characteristic feature of Meniere's disease.

Question 19

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

Accepted Answer

The best choice is to make an appointment with an audiologist for the client. Presbycusis is a gradual hearing loss that occurs as people age. An audiologist can provide a thorough hearing evaluation and recommend appropriate interventions, such as hearing aids or assistive listening devices. Limiting conversation or using gestures may help to some extent, but they do not address the underlying hearing loss. Similarly, borrowing a used hearing aid may not be safe or effective without proper fitting and programming by a professional.

Question 20

A client in an airplane reports to the flight nurse that he or she is unable to hear any sounds after takeoff of the flight.What should the flight nurse anticipate from the client's statement?

Accepted Answer

After takeoff, there is a change in air pressure which can cause blockage or damage to the Eustachian tube leading to a decrease or loss of hearing. This is a common occurrence during air travel and can usually be relieved by yawning or swallowing repeatedly to open up the Eustachian tube.

Quiz 44: Ear Disorders