Assessment and Management of Patients With Hearing and Balance Disorders – Flashcards
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Which of the following terms refers to surgical repair of the tympanic membrane? a) Tympanotomy b) Ossiculoplasty c) Myringotomy d) Tympanoplasty
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tympanoplasty
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A patient newly diagnosed with otitis media reports the pain and pressure in the ear has suddenly disappeared. What is the best action by the nurse? a) Irrigate the ear. b) Assess tympanic membrane. c) Educate on therapeutic effects of medications. d) Document effectiveness of medications.
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Assess tympanic membrane
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Which of the following is a definition of ossiculoplasty? a) Incision into the tympanic membrane b) Surgical repair of the eardrums c) Incision into the eardrum d) Surgical reconstruction of the middle ear bones
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Surgical reconstruction of the middle ear bones
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Which nursing goal is a priority when caring for a client newly diagnosed with vertigo. a) Patient will have a caretaker with him or her in the home. b) Patient will closes eyes as needed to reduce symptoms. c) Patient will maintain therapeutic medication schedule. d) Patient will remain safe while ambulating in the home.
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Patient will remain safe while ambulating in thehome
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Audiometry is testing that measures hearing acuity precisely. Who does the nurse know can perform audiometric testing? a) Office nurse b) Hearing aide salesperson c) Audiologist d) School nurse
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Audiologist
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Which of the following brain structures is responsible for equilibrium? a) Brainstem b) Hypothalamus c) Thalamus d) Cerebellum
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Cerebellum
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The nurse is caring for a client experiencing hearing loss. The nurse uses the otoscope to assess the ear canal and tympanic membrane and notes a significant accumulation of cerumen. Which documentation of hearing loss type would be most accurate? a) Conductive b) Sensorineural c) Central d) Mixed
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Conductive
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Hearing aids help with which of the following problems? a) Makes sounds louder b) Improves discrimination of words c) Improves communication skills d) Improves understanding of speech
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Makes sounds louder
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The nurse, caring for a client with Ménière's disease, needs to assist with what when the client is experiencing an attack? a) Sleeping b) ADLs c) Coughing d) URIs
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ADLs
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The nurse identifies the nursing diagnosis of deficient knowledge related to a new hearing aid for a client. After teaching a client about caring for his new hearing aid, the nurse determines that the outcome has been achieved when the client states which of the following? a) "I need to keep my ear canal clean and dry." b) "I should wash the receiver with soap and water once a week." c) "I should insert the ear mold when it is wet." d) "I need to wipe the ear mold daily with a moist washcloth."
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I need to keep my ear canal clean and dry
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You are teaching the daughter how to instill ear drops of her father to remove impacted cerumen. What is a priority action to teach this woman? a) Insert the irrigating syringe deeply. b) Refrigerate before instillation. c) Place the container in warm water before instillation. d) Direct the flow of the ear drops toward the eardrum.
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Place the container in warm water before instillation
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Which action by the nurse has the highest priority when caring for a patient diagnosed with vertigo? a) Educate the patient on using the call light for assistance with ambulation. b) Administer antivertiginous medication as ordered. c) Encourage the patient to stare straight ahead, focusing on one object. d) Encourage the patient to keep his or her eyes open.
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Educate the patient on using the call light for assistance with ambulation
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Which of the following manifestations is the most problematic for the patient diagnosed with Meniere's disease? a) Hearing loss b) Diaphoresis c) Vertigo d) Tinnitus
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Vertigo
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When performing the Weber test, where would the nurse place the vibrating tuning fork?
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patient's head or forehead
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You are teaching a class on diseases of the ear. What would you teach the class is the most characteristic symptom of otosclerosis? a) The client describing a recent upper respiratory infection b) A progressive, bilateral loss of hearing c) A red and swollen ear drum d) The client being distressed in the mornings
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A progressive, bilateral loss of hearing
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The nurse is developing a plan of care for a client with Meniere's disease and identifies a nursing diagnosis of excess fluid volume related to fluid retention in the inner ear. Which intervention would be most appropriate to include in the plan of care? a) Restrict high-potassium foods. b) Administer prescribed antihistamine. c) Encourage intake of caffeinated fluids. d) Limit foods that are high in sodium.
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Limit foods that are high in sodium
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High doses of which of the following medications can produce bilateral tinnitus? a) Promethazine b) Aspirin c) Dramamine d) Antivert
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Aspirin
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Which of the following instructions regarding swimming should the nurse give to the patient who is recovering from otitis externa? a) Avoid swimming for 7-10 days b) Avoid cold water c) Wear a scarf d) Insert a loose cotton pledget in the external ear
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Avoid swimming for 7-10 days
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The nurse is caring for a patient with Ménière's disease who is hospitalized with severe vertigo. What medication does the nurse anticipate administering to shorten the attack? a) Furosemide (Lasix) b) Cortisporin otic solution c) Meclizine (Antivert) d) Gentamicin (Garamycin) intravenously
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Meclizine (Antivert)
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Which of the following instructions regarding swimming should the nurse give to the client who is recovering from otitis externa? Choose the correct option. a) Wear a scarf. b) Avoid cold water. c) Wear soft plastic earplugs. d) Insert a loose cotton earplug in the external ear.
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wear soft plastic earplugs
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Which of the following is hearing loss associated with degenerative changes? a) Strabismus b) Myopia c) Presbycusis d) Presbyopia
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Presbycusis
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A client complains of vertigo. The nurse anticipates that the client may have a problem with which portion of the ear? a) Middle ear b) External ear c) Tympanic membrane d) Inner ear
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Inner ear
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A client is diagnosed as having serous otitis media. When describing this condition to the client, which of the following would be most accurate? a) "You have a common infection in one of the bones of your face." b) "Your eardrum has ruptured because of the extreme pressure in your middle ear from the infection." c) "It has resulted from the several recurrent episodes of acute otitis media you've had." d) "You have some fluid that has collected in your middle ear but no infection."
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You have some fluid that has collected inyour middle ear but no infection
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A client who comes to the ambulatory care facility states, "It feels like things are moving or spinning around me." The nurse interprets this as indicating which of the following? a) Vertigo b) Dizziness c) Motion sickness d) Nystagmus
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Vertigo
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A patient is newly diagnosed with otitis externa. Which of the following should the nurse teach the patient before the patient leaves the clinic? a) Cleaning ear canal with cotton-tip applicator after showering b) Proper instillation of prescribed ear drops c) Side effects of oral antibiotics d) Strategies to cope with the temporary sensorineural hearing loss
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Proper instillation of prescribed ear drops
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The nurse on a cruise ship is assessing clients for motion sickness. Which of the following is a common misconception? a) Repeated motion is the cause. b) Pallor and diaphoresis is a first symptom. c) Medications help the symptoms. d) Once symptoms occur, they will always be present.
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Once symptoms occur, they will always be present
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Loud, persistent noise has been found to cause all of the following symptoms except a) increased blood pressure. b) increased heart rate. c) decreased GI activity. d) constriction of peripheral blood vessels.
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Decreased GI activity
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Which of the following preattack symptoms may a patient with Meniere's disease report prior to an attack? a) Nystagmus b) Photosensitivity c) A full feeling in the ear d) Low blood pressure
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A full feeling in the ear
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Acoustic neuromas are benign tumors of which of the following cranial nerves? a) VIII b) VI c) VII d) V
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VIII
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A client with a conductive hearing disorder caused by ankylosis of the stapes in the oval window undergoes a stapedectomy to remove the stapes and replace the impaired bone with a prosthesis. After the stapedectomy, the nurse should provide which client instruction? a) "Shampoo your hair every day for 10 days to help prevent ear infection." b) "Lie in bed with your head elevated, and refrain from blowing your nose for 24 hours." c) "Don't fly in an airplane, climb to high altitudes, make sudden movements, or expose yourself to loud sounds for 30 days." d) "Try to ambulate independently after about 24 hours."
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don't fly in an airplanes, climb to high altitudes, make sudden movements, or expose yourself to loud sounds for 30 days
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What kind of otitis media is a pathogen-free fluid behind the tympanic membrane, resulting from irritation associated with respiratory allergies and enlarged adenoids? a) Purulent otitis media b) Sterile otitis media c) Infectious otitis media d) Serous otitis media
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serous otitis media
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Which of the following is an involuntary rhythmic movement of the eyes that is also associated with vestibular dysfunction? a) Presbycusis b) Tinnitus c) Nystagmus d) Vertigo
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Nystagmus
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When caring for a client status post ear surgery, what is an important aspect of nursing care? a) Assess social support. b) Feed small frequent meals to minimize nausea. c) Fit for a hearing aid. d) Validate client's feelings of discomfort.
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Validate client's feelings of discomfort
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Which nursing diagnosis takes highest priority for a client admitted for evaluation for Ménière's disease? a) Imbalanced nutrition: Less than body requirements related to nausea and vomiting b) Risk for deficient fluid volume related to vomiting c) Acute pain related to vertigo d) Risk for injury related to vertigo
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Risk for injury related to vertigo
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Which of the following describes a condition characterized by abnormal spongy bone formation around the stapes? a) Chronic otitis media b) Otitis externa c) Middle ear effusion d) Otosclerosis
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Otosclerosis
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A client you are caring for has a hearing loss. The client tells you they are self-conscious about their hearing loss. What advice should the nurse give a self-conscious client with hearing loss to protect his or her self-esteem? a) Avoid excess socializing. b) Pretend to follow conversations by nodding the head. c) Follow lip movements closely. d) Be forthright and inform others about the hearing deficit.
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Be forthright and inform others about the hearing deficit
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You are admitting a 30-year-old who has a hearing impairment. The client is accompanied by family members. What information would be important to ask the family members to help you care for your client? a) How the client lost their hearing b) The client's preferred method of communication c) How much the client weighs d) What allergies the client has
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The client's preferred method of communication
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Kotoyo has been diagnosed with otosclerosis. The nurse explains to the client that this is a common cause of hearing impairment among adults and is the result of a bony overgrowth of which of the following? a) Tympanic membrane b) Labyrinth c) Incus d) Stapes
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Stapes
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A client comes to the walk-in clinic complaining of a "bug in my ear." What action should be taken when there is an insect in the ear? a) Instillation of mineral oil b) Use of a small forceps c) Instillation of hot water d) Instillation of carbamide peroxide
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Instillation of mineral oil
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The nurse is assessing a client for objective symptoms of hearing difficulties. Which symptom leads the nurse to take alternate measures to ensure client understanding of teaching? a) The client is quiet and responds appropriately. b) The client quietly reads the instructional literature. c) The client leans forward and turns the head. d) The client interrupts by asking the nurse to repeat instruction.
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The client leans forward and turns the head
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Which of the following statements describes benign paroxysmal positional vertigo (BPPV)? a) BPPV is caused by tympanic membrane infection. b) The vertigo is usually accompanied by nausea and vomiting; however, hearing impairment does not generally occur. c) BPPV is stimulated by the use of certain medication such as acetaminophen. d) The onset of BPPV is gradual.
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The vertigo is usually accompanied by nausea and vomiting; however, hearing impairment does not generally occur
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Which portion of the middle ear equalizes pressure? a) Auricle b) Eustachian tube c) Ossicles d) Cochlea
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Eustachian tube
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A mother brings her daughter to the clinic for an evaluation because the child is complaining of ear pain. Which of the following would lead the nurse to suspect that the child is experiencing otitis externa and not otitis media? a) Aural tenderness b) Fever c) Bulging eardrum d) Ear drainage
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Aural tenderness
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The nurse is assessing a client's hearing using the Rinne test. When providing instruction to elicit client feedback, which instruction is essential? a) Raise your hand when you hear the vibration. b) Raise your hand when the vibration exceeds the sound. c) Raise your hand when the sound exceeds the vibration. d) Raise your hand when you no longer hear sound.
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Raise your hand when you no longer hear sound
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Which of the following is the treatment of choice for acoustic neuromas? a) Radiation b) Surgery c) Palliation d) Chemotherapy
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Surgery
