Deck 66: Management of Clients with Hearing and Balance Disorders

Question 1

Which action is most appropriate when performing ear irrigation to remove excess wax? The nurse should

A) keep the client's head in an upright position.
B) occlude the ear canal completely with the syringe.
C) spray the external ear with an antiseptic solution.
D) use an irrigation solution that is at body temperature.

Answer 1

use an irrigation solution that is at body temperature.

Question 2

A client's family reports that the client does not hear well. The client becomes angry and defensive and denies having a hearing problem. The best response by the nurse would be

A) "It seems like it's hard to listen to your family when you don't agree with them."
B) "My father has a hearing aid and is really glad he got it."
C) "There's nothing to be ashamed about having poor hearing."
D) "Why don't you believe what your family is saying?"

Answer 2

"It seems like it's hard to listen to your family when you don't agree with them."

Question 3

The occupational health nurse evaluating a factory where the noise level is high would recommend noise abatement or use of earplugs when the noise level exceeds

A) 47 dB.
B) 64 dB.
C) 72 dB.
D) 80 dB.

Answer 3

80 dB.

Question 4

The nurse would explain that a nonsurgical approach to reduce the clinical manifestations of labyrinthitis is injection of an ototoxic drug into the middle ear to

A) clear the eustachian tube.
B) destroy hair cells.
C) equalize pressure.
D) stabilize the ossicles.

Question 5

The school nurse teaches the young swimmer that the earliest manifestation of external otitis is

A) a low-grade fever.
B) a popping sensation in the ears.
C) pain when the external ear is manipulated.
D) humming or buzzing noises in the ear.

Question 6

The nurse caring for a frail 72-year-old client recently diagnosed with Ménière's disease would know that the nursing diagnosis frequently associated with this problem that is the priority for the client is

A) Deficient Knowledge.
B) Ineffective Health Maintenance.
C) Risk for Impaired Skin Integrity.
D) Risk for Injury.

Question 7

The nurse assessing a client with an inner ear disorder would be aware that the presenting clinical manifestation will be

A) conductive hearing disorder.
B) otorrhea.
C) sensorineural hearing loss.
D) severe headache.

Question 8

To provide appropriate instructions to a client who has an ear wick inserted to facilitate medication administration for external otitis, the nurse would advise the client to

A) apply ear drops directly to the wick.
B) eliminate milk from the diet.
C) shower frequently to remove ear secretions.
D) sleep with the affected ear on the pillow.

Question 9

The nurse is assigning an unlicensed assistive personnel (UAP) to work with a client who has a hearing aid. Which action by the UAP is inconsistent with appropriate delegation? The nurse asks the UAP to

A) cleanse the ear mold if needed with mild soap and water.
B) evaluate how well the client understood the nurse's earlier instructions.
C) help the client insert the ear mold into the ear.
D) turn the hearing aid off before removing it at bedtime.

Question 10

When a client who underwent vestibular surgery complains of thirst, the nurse would avoid offering this client

A) cola.
B) ginger ale.
C) lemonade.
D) mineral water.

Question 11

A young client has a perforation of the tympanic membrane that occurred while cleaning the ear with a pointed object. The nurse would advise that

A) a hearing aid is usually necessary after the tympanic membrane heals.
B) perforations often heal spontaneously with no complications.
C) the client should remain in a quiet environment until healed.
D) the client will most likely experience vertigo.

Question 12

After assisting a client with insertion of a hearing aid, the nurse would

A) allow the client to adjust volume before speaking.
B) cup hand over the client's ear to check for feedback.
C) explain that the whistling noise will subside in a few minutes.
D) stand in front of the client and speak loudly.

Question 13

An 82-year-old man tells the nurse he is having difficulty hearing and that he has "too much ear wax." Because of the client's age, the nurse would ask

A) "Did you ever experience impacted cerumen?"
B) "Do you swim in a pool with chlorinated water?"
C) "Have you had an upper respiratory infection?"
D) "Have you noted a change in the color of the ear wax?"

Question 14

The problem with the ear that the nurse would consider to be associated with the aging process is

A) amblyopia.
B) otalgia.
C) presbycusis.
D) tinnitus.

Question 15

The nurse is aware that when speaking with a client who has impaired hearing in the right ear, the behavior that would make it more difficult for the client to understand the communication is

A) directing the voice toward the left ear.
B) speaking in a normal tone.
C) smiling while talking to seem friendly.
D) standing in front of the client.

Question 16

The nurse preparing written discharge instructions for the day-surgery unit where ear surgery is performed would plan to include which instruction?

A) Avoid heavy lifting and do not engage in sports for 3 weeks after surgery.
B) Leave the cotton ball dressing in the ear until your follow-up appointment.
C) Do not sneeze, blow your nose, or cough for 1 week after surgery.
D) Report any decreased hearing in the operative ear.

Question 17

The nurse providing instructions to a client after ear surgery would tell the client that for the next 4 to 6 weeks, he/she should avoid

A) any physical activity.
B) blowing the nose.
C) flying in an aircraft.
D) getting the ear wet.

Question 18

A client has Ménière's disease. Which question by the nurse would elicit the most pertinent information related to client safety?

A) "Are your attacks at certain times of the day?"
B) "Do your attacks come on without warning?"
C) "How long does each attack last?"
D) "What seems to bring on your attacks?"

Question 19

When communicating with a client who has a significant hearing loss, the nurse would

A) obtain the client's attention by hand clapping.
B) speak as loudly as possible.
C) use an intercommunication system.
D) use phrases to convey meaning rather than one-word answers.

Question 20

The most appropriate action that the nurse working at a camp would take to remove an insect from a camper's ear is

A) gently irrigate the ear canal with sterile water.
B) instill a few drops of mineral oil into the ear.
C) instruct the camper to tilt the affected ear downward.
D) occlude the ear with a medicated cotton pledget.

Question 21

The nurse is conducting a wellness seminar on healthy hearing through the life span and would suggest which of the following activities as primary prevention measures for hearing loss? (Select all that apply)

A) "Avoid inserting hard objects into the ear."
B) "Care for your hearing aids according to the manufacturer's directions."
C) "Don't use medications that can cause hearing loss."
D) "See your doctor right away for symptoms of ear infection."
E) "Wear protective head gear when participating in sports."

Question 22

The nurse caring for a client with a conductive hearing loss would enhance communication by facing the client and

A) lowering the pitch of the voice.
B) speaking loudly.
C) speaking slowly.
D) using lip movement to shape words.

Question 23

A client with severe hearing loss has the nursing diagnosis: Ineffective Coping related to recent hearing loss. The nurse would assess that goals for this diagnosis have been met when the client (Select all that apply)

A) engages in more activities within the community.
B) is willing to role-play informing others about the hearing loss.
C) self-refers to a university hospital audiology clinic.
D) stores the new hearing aid properly when not in use.