Question 1

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

Inflammation in the membranous labyrinth indicates a viral or bacterial infection, which can be treated with antibiotics. Meclizine can help with the vertigo and dizziness associated with the labyrinthitis. Tympanostomy is a surgical procedure to relieve pressure or fluid in the middle ear and would not address inflammation in the membranous labyrinth. Destructive surgery is not indicated for labyrinthitis. Analgesics and antipyretics are not effective treatments for labyrinthitis.

Question 2

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

A tympanostomy procedure involves the insertion of ear tubes into the ear drum to help drain fluid and relieve pressure caused by persistent otitis media. This test would likely be ordered for the client who has not improved with initial treatment and has persistent otitis media for 12 weeks. A Romberg test is used to assess balance and coordination, and a low-salt diet is not relevant in the diagnosis and treatment of otitis media. Destructive surgery is not typically indicated for otitis media.

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 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 decreased movement of the tympanic membrane and symptoms of pharyngeal erythema and rhinorrhea indicate a possible middle ear infection, also known as otitis media. Obtaining a specimen for a throat culture can help confirm the presence of bacterial infection and guide appropriate antibiotic treatment. Providing a low-fluid diet and using a Meniett device are not relevant interventions for otitis media. MRI is not necessary for this condition unless there are complications, which is not indicated in this scenario.

Question 5

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 part of the external ear and helps to transmit sound vibrations to the middle ear. If it is damaged, it can alter the function of the ear. The cochlea is part of the inner ear and is responsible for converting sound waves into electrical signals that the brain can understand. The Eustachian tube is part of the middle ear and helps to regulate pressure and drain fluids, but damage to it would not directly affect the external ear. The auditory ossicles are small bones in the middle ear that help to transmit sound vibrations, but damage to them would not directly affect the external ear.

Question 6

Which component separates the two labyrinths from each other?

Accepted Answer

The perilymph fluid is located between the bony labyrinth and membranous labyrinth, serving as a cushion and allowing for the transmission of sound and balance signals. Sebum and cerumen are produced by glands in the ear canal but do not separate the two labyrinths. Endolymph fluid is found within the membranous labyrinth itself.

Question 7

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 volume of endolymph fluid in the inner ear is a symptom of Meniere's disease. Treatment for Meniere's disease includes a low-salt diet to help reduce fluid retention in the inner ear. A low-iron diet, low-protein diet, or low-carbohydrate diet is not indicated in the treatment of Meniere's disease.

Question 8

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

Irrigation or using a curette to remove the earwax is the recommended nursing intervention for a client with accumulated earwax. Cleaning with tissue paper or cotton-tipped applicator can push the earwax further into the ear canal, and using small surgical forceps can cause injury to the ear canal.

Question 9

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

The inability to hear sounds after takeoff on a flight is likely due to a blockage or dysfunction in the Eustachian tube, which connects the middle ear to the back of the throat. This can occur due to changes in air pressure during ascent or descent.

Question 10

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 associated with upper respiratory tract infections, such as the common cold. Therefore, option D is the correct choice. Kidney infections, vaginal infections, and gastrointestinal infections are not commonly associated with otitis media.

Question 11

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 and a positive Romberg test suggests that the client has vestibular schwannoma, which is a benign tumor that develops on the vestibular (balance) nerve leading from the inner ear to the brain. It can cause symptoms such as hearing loss, tinnitus, vertigo, and unsteadiness. Otits media, labyrinthitis, and Meniere's disease are not typically associated with either the presence of a tumor or a positive Romberg test.

Question 12

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

Vestibular schwannoma is a benign tumor that develops on the eighth cranial nerve, which is responsible for hearing and balance. Surgery may be necessary to remove the tumor if it is causing symptoms such as balance problems or hearing loss. Otitis media, labyrinthitis, and Meniere's disease are all inner ear conditions but do not typically require surgery as a first-line treatment.

Question 13

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

Accepted Answer

The external ear consists of the pinna and the ear canal, which collects and conducts sound waves to the tympanic membrane (also known as the eardrum) in the middle ear. The inner ear includes structures that help to convert sound waves into electrical signals that can be processed by the brain.

Question 14

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 along with pain, tenderness, and itching on the auricle are classic signs of otitis externa, commonly known as swimmer's ear. Labyrinthitis, Meniere's disease, and vestibular schwannoma do not typically present with these symptoms or bacterial strains.

Question 15

Which part of the ear aids in proprioception?

Accepted Answer

The inner ear contains structures such as the semicircular canals and the vestibule, which are responsible for detecting changes in head position and movement, and thus aid in proprioception. The middle and external ear do not have a direct role in proprioception.

Question 16

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 17

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 sensory information related to hearing and balance. Its vestibular branch senses the flow of endolymph fluid in the ear, which contributes to balance and spatial orientation.

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

The increased volume of endolymph fluid in the inner ear and positive Romberg test are characteristic features of Meniere's disease, which is a disorder of the inner ear. Otitis media is an infection of the middle ear. Labyrinthitis is an inflammation of the inner ear that can be caused by infection or injury. Vestibular schwannoma is a benign tumor that grows on the nerve that connects the inner ear to the brain. None of these conditions are associated with increased volume of endolymph fluid or positive Romberg test.

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 most beneficial instruction for the client would be to make an appointment with an audiologist who can evaluate the degree and type of hearing loss and recommend appropriate interventions, such as hearing aids or assistive listening devices. Limiting conversation or relying on gestures may not be effective in addressing the client's hearing difficulties, and borrowing a used hearing aid may be unsafe and ineffective.

Question 20

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

Accepted Answer

Hearing loss can occur with prolonged exposure to sound at 90 decibels or higher. Therefore, the level of sound intensity that can result in hearing loss in clients is 90 decibels.

Quiz 44: Ear Disorders