Chapter 40Auditory Dysfunction: Nursing Management My Nursing Test Banks

Chapter 40Auditory Dysfunction: Nursing Management

MULTIPLE CHOICE

1.A client is not able to successfully pass the whisper test. Which of the following would be indicated for this client?

1.

Head CT scan

2.

Audiometry

3.

MRI of the brain

4.

Electroencephalogram

ANS: 2

Failure to pass the whisper test would indicate the need for formal audiometry testing. The client would not need a head CT or MRI at this time. An electroencephalogram is not necessary.

PTS:1DIF:Analyze

REF:Auditory Dysfunction: Assessment with Clinical Manifestations

2.A client is prescribed a medication that is ototoxic. The nurse realizes that this medication may cause:

1.

permanent or temporary vision loss.

2.

permanent or temporary hearing loss.

3.

nausea and vomiting.

4.

central nervous system (CNS) depression.

ANS: 2

Although many drugs cause nausea and vomiting and central nervous system (CNS) depression, ototoxic drugs cause hearing loss and the risks must be considered prior to suggesting these types of medications.

PTS:1DIF:Analyze

REF: Auditory Dysfunction: Ototoxic Medications and Auditory Dysfunction

3.The nurse is trying to communicate with a hearing-impaired client. The best way to do this is to:

1.

write down all of the message.

2.

shout in the impaired ear.

3.

speak slowly and clearly while facing the client.

4.

talk in a regular voice in the good ear.

ANS: 3

When trying to communicate with the hearing-impaired client, the nurse should speak slowly and clearly while facing the client to give her the opportunity to see and hear the words being spoken. The nurse should not write down all of the messages. Shouting in the impaired ear will not improve the clients hearing. Talking in a regular voice into the good ear will not improve hearing.

PTS:1DIF:Apply

REF:Nursing Strategy: Communicating with the Hearing Impaired

4.A client is diagnosed with a conductive hearing loss. The nurse realizes type of hearing loss is not associated with:

1.

cerumen.

2.

brain damage.

3.

otitis media.

4.

otosclerosis.

ANS: 2

Conductive hearing loss results in a blockage of sound waves in the external or middle portions of the ear. Wax (cerumen) buildup and infections are a large part of conductive hearing loss. Otosclerosis is associated with conductive hearing loss. Brain damage is not a cause of conductive hearing loss.

PTS: 1 DIF: Analyze REF: Conductive Hearing Loss

5.A client is complaining of dizziness, unilateral ringing in the ear, feeling of pressure or fullness in the ear, and unilateral hearing loss. The nurse would suspect the client is experiencing:

1.

Mnires disease.

2.

osteosclerosis.

3.

otitis media.

4.

mastoiditis.

ANS: 1

All of the clients complaints are signs and symptoms of Mnires disease. Although hearing disorders may have similar signs and symptoms, they do not include all of them.

PTS:1DIF:AnalyzeREF:Menieres Disease

6.A client complains of a slight itching, slight pain, and a scratching sound in the ear. The nurse suspects that an insect may have entered the ear. Which of the following should not be done?

1.

Add water to flush out the insect.

2.

Add mineral oil to kill the insect.

3.

Add lidocaine to kill the insect.

4.

Call an otologist for a referral.

ANS: 1

Avoid placing water in the ear canal, which will only make the insect swell, thereby making it more difficult to remove. An otologist should be called for the removal. The audiologist may prescribe mineral oil or lidocaine to be applied to the ear canal.

PTS:1DIF:ApplyREF:Foreign Body

7.The hearing of an unresponsive client needs to be assessed. Which of the following will be used to assess the hearing of this client?

1.

Audiometer

2.

Brainstem auditory evoked responses (BAER) test

3.

Rinne test

4.

Weber test

ANS: 2

The BAER test calculates the ability to hear in a client who is unresponsive. The BAER measures the sound impulse needed to evoke a brain response, which will indicate the clients ability to hear. The other tests need the cooperation of the client and cannot be done at this time.

PTS: 1 DIF: Apply REF: Brainstem Auditory Evoked Response Test

8.The nurse is planning to assess a client diagnosed with conductive hearing loss. When performing the Weber test, the nurse would expect which of the following findings?

1.

The sound will be louder in the affected ear.

2.

The sound will be louder in the good ear.

3.

Air conduction is shorter than bone conduction.

4.

No sounds will be heard.

ANS: 1

During a Weber test, which tests bone conduction, a client with a conductive hearing loss hears louder sounds on the affected side. Hearing louder sounds on the unaffected side is sensorineural loss. The Rinne test compares bone with air conduction. The client will hear sounds louder in the affected ear.

PTS: 1 DIF: Apply REF: Rinne and Weber Tests

9.The nurse is performing postoperative teaching with a client recovering from a stapedectomy. Which of the following instructions would the nurse want to include in the teaching?

1.

It is okay to resume exercise the next day.

2.

It is okay to resume work the same day.

3.

It is okay to shower and shampoo the next day.

4.

It is okay to blow the nose gently one side at a time.

ANS: 4

Care must be taken not to disturb the ossicles from their position, so exercise and work should not be resumed until healing is complete. It is also important to keep the ear dry. The client should be taught to blow the nose gently on one side at a time so as not to increase the pressure in the ear.

PTS: 1 DIF: Apply REF: Repair of Inner Ear Disorders

10.After a mastoidectomy, the most important complication for the nurse to assess for is:

1.

vomiting.

2.

headache.

3.

fever.

4.

stiff neck.

ANS: 3

All are complications that can occur following this type of surgery. Fever is of extra importance because of its possible link to infection. The mastoid bone is in direct contact with the brain, and therefore any infection can travel to the brain.

PTS: 1 DIF: Analyze REF: Repair of Inner Ear Disorders

11.When instructing a client on cleaning the ear, the nurse should instruct the client to clean:

1.

only the outer ear.

2.

all the way to the middle ear.

3.

all parts of the ear outer, middle, and inner ear.

4.

just the tympanic membrane.

ANS: 1

Only the outer portion of the ear should be cleaned. Inserting different objects into the ear canal may result in injury and damage.

PTS: 1 DIF: Apply REF: Planning and Implementation

12.Which of the following would prohibit an elderly client from wanting to obtain and use a hearing aid?

1.

Fears sounds will be too loud

2.

Thinks not necessary for a temporary problem

3.

Fears the cost

4.

Prefers silence

ANS: 3

Some of the problems encountered by clients obtaining hearing aids include appearance, cost, education, unrealistic expectations, and difficulty with the care and maintenance of the hearing aids. The other choices are not problems encountered by clients obtaining hearing aids.

PTS:1DIF:AnalyzeREF:Hearing Aids

13.Which of the following should the nurse instruct a client who is being fitted for a hearing aid?

1.

Keep the appliance turned on at all times.

2.

Store the hearing aid in a warm, moist place.

3.

Batteries last for at least 1 month.

4.

Clean ear molds at least once a week.

ANS: 4

The nurse should instruct the client to turn off the appliance when not in use; store in a cool, dry place; change the batteries at least once per week; and clean ear molds at least once per week.

PTS: 1 DIF: Apply REF: Patient Playbook: Care of Hearing Aids

MULTIPLE RESPONSE

1.The nurse is instructing a client diagnosed with otitis media on management during the acute phase. Which of the following should the nurse include in the teaching? (Select all that apply.)

1.

Take the antibiotics as ordered.

2.

Take over-the-counter analgesics for mild pain as recommended.

3.

It is okay to go swimming.

4.

It is okay to go on vacation and trips that require flying.

5.

If excruciating pain develops, seek medical care.

6.

Limit fluids.

ANS: 1, 2, 5

Clients must complete the medication as ordered to kill the infection. Mild analgesics for pain are often needed. If excruciating ear pain develops, the client should seek medical care to rule out perforation of the eardrum. It is important to keep the ear dry, so the client should not swim at this time. Flying is not recommended at this time. Limiting fluids is not necessary with otitis media.

PTS: 1 DIF: Apply REF: Otitis Media

2.When caring for a client with total hearing loss, the nurse is instructing the client about the many options that are available to function in a hearing world. Which of the following should the nurse include? (Select all that apply.)

1.

Flashing lights for alarms

2.

TV with closed captions

3.

Talking computer

4.

Lip reading and sign language

5.

Cell phones with headsets

6.

Loud ringers on telephones

ANS: 1, 2, 4

Patients who have no hearing have access to various mechanisms to alert them to various sounds. Flashing lights for alarms to phones and doorbells, TV with closed captions for the hearing impaired, and classes in lip reading and sign language are some options. Talking computers and cell phones with headsets are advancements for the hearing, not for the hearing impaired. Loud ringers on telephones would also be helpful to the client with some hearing and not a total hearing loss.

PTS: 1 DIF: Apply REF: Communication Tools

3.A client is diagnosed with a congenital hearing loss. Which causes does the nurse realize are reasons for this type of hearing loss? (Select all that apply.)

1.

Genetics

2.

Natal infections

3.

Physical deformities

4.

Noise levels

5.

Maternal ototoxic drugs

6.

Maternal TORCH infections

ANS: 1, 2, 3, 5, 6

Congenital hearing loss can be derived from genetics, natal infections, or physical deformities of the ear in addition to maternal ototoxic drug use and maternal TORCH infections that include toxoplasmosis, rubella, cytomegalovirus, and herpes virus type 2. Noise levels do not cause a congenital hearing loss.

PTS: 1 DIF: Analyze REF: Auditory Dysfunction: Genetics

4.A client with a family history of hearing loss asks the nurse what he can do to prevent this disorder as he ages. Which of the following should the nurse instruct this client? (Select all that apply.)

1.

Turn down radio and television volume.

2.

Avoid noisy areas such as rock concerts.

3.

Wear protective devices.

4.

Use plain cotton balls in the ears.

5.

Avoid sun exposure.

6.

Flush the ears daily with mineral oil.

ANS: 1, 2, 3

Measures to prevent hearing loss include turning down the volume on the radio and television, avoiding noisy areas such as rock concerts, and wearing protective devices. Using cotton balls in the ears does not decrease noise from reaching the middle ear. Sun exposure does not impact hearing. Flushing the ears daily with mineral oil might decrease the buildup of cerumen; however, it will not improve hearing.

PTS:1DIF:ApplyREFrimary Prevention

5.Which of the following are indications that a client has been exposed to excessive noise? (Select all that apply.)

1.

Raising the voice to talk in normal conversation

2.

Clear drainage from the ears

3.

Inability to hear a conversation 2 feet away

4.

Sounds are muffled

5.

Ringing of the ears

6.

Short periods of pain in the ears

ANS: 1, 3, 4, 5, 6

Warning signs of excessive noise exposure include raising the voice to talk in normal conversation, inability to hear a conversation 2 feet away, muffled sounds, ear ringing, and short periods of ear pain. Clear drainage from the ears does not occur with excessive noise exposure.

PTS:1DIF:AnalyzeREF:Noise Pollution

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