LEWIS 12e Chapter 23: Assessment and Management: Auditory Problems

1. To decrease the risk for future hearing loss, which action would the nurse implement with well college students at the on-campus health clinic?

a. Perform annual tympanometry.

b. Schedule otoscopic examinations.

c. Administer influenza immunizations.

d. Discuss exposure to amplified music.

d. Discuss exposure to amplified music.

2. A patient diagnosed with external otitis is being discharged from the emergency department with an ear wick in place. Which statement by the patient indicates a need for further teaching?

a. ―I will apply the eardrops to the cotton wick in the ear canal.‖

b. ―I can use aspirin or acetaminophen (Tylenol) for pain relief.‖

c. ―I will clean the ear canal daily with a cotton-tipped applicator.‖

d. ―I can use warm compresses to the outside of the ear for comfort.‖

c. ―I will clean the ear canal daily with a cotton-tipped applicator.‖

3. Which instruction would the nurse include when teaching a patient who has undergone a left tympanoplasty?

a. ―Remain on bed rest.‖

b. ―Keep your head elevated.‖

c. ―Avoid blowing your nose.‖

d. ―Irrigate your left ear canal.‖

c. ―Avoid blowing your nose.‖

4. The nurse is assessing a patient who was recently treated with amoxicillin for acute otitis media of the right ear. Which finding is a priority to report to the health care provider?

a. The patient has a temperature of 100.6F.

b. The patient reports frequent ―popping‖ in the ear.

c. Clear fluid is visible through the tympanic membrane.

d. The patient frequently asks the nurse to repeat information.

a. The patient has a temperature of 100.6F.

5. A patient who has Ménière's disease is admitted with vertigo, nausea, and vomiting. Which intervention would the nurse include in the care plan?

a. Dim the lights in the patient's room.

b. Encourage increased oral fluid intake.

c. Change the patient's position every 2 hours.

d. Keep the head of the bed elevated 45 degrees.

a. Dim the lights in the patient's room.

6. Which statement by the patient to the nurse indicates a need for further teaching about self-administering eardrops?

a. ―I will leave the ear wick in place while administering the drops.‖

b. ―I will hold the tip of the dropper above the ear to administer the drops.‖

c. ―I will refrigerate the medication until I am ready to administer the drops.‖

d. ―I should lie down before and for 5 minutes after administering the drops.‖

c. ―I will refrigerate the medication until I am ready to administer the drops.‖

7. An older patient who is being admitted to the hospital repeatedly asks the nurse to ―speak up so that I can hear you.‖ Which action would the nurse take?

a. Increase the speaking volume.

b. Overenunciate while speaking.

c. Speak normally but more slowly.

d. Use more facial expressions when talking.

c. Speak normally but more slowly.

8. Which information will the nurse include when teaching a patient with presbycusis how to use new hearing aids?

a. Keep the volume low on the hearing aids for the first week.

b. Experiment with volume and hearing in a quiet environment.

c. Add the second hearing aid after making adjustments to the first hearing aid.

d. Begin wearing the hearing aids for an hour a day, gradually increasing the use.

b. Experiment with volume and hearing in a quiet environment.

9. Which information will the nurse include when teaching a patient considering cochlear implants?

a. They are not useful for patients with congenital deafness.

b. They are most helpful as an early intervention for presbycusis.

c. They improve hearing in patients with conductive hearing loss.

d. They require extensive training in order to reach the full benefit.

d. They require extensive training in order to reach the full benefit.

10. Assistive personnel (AP) perform the following actions when caring for a patient with Ménière's disease who is experiencing an acute attack. Which action by AP indicates that the nurse should intervene?

a. AP reminds the patient to call for help before ambulating.

b. AP turns on the patient's television.

c. AP places an emesis basin and tissues at the bedside.

d. AP helps the patient turn to the right side.

a. AP reminds the patient to call for help before ambulating.

11. Which clinical problem at is the priority problem for a patient experiencing an acute attack with Meniere's disease?

a. Risk for falls

b. Sensory deficit

c. Personal care problem

d. Impaired communication

a. Risk for falls

12. Which information about a patient who had a stapedotomy yesterday is most important for the nurse to communicate to the health care provider?

a. The patient reports ear ―fullness.‖

b. Oral temperature is 100.8F (38.1C).

c. The patient reports that hearing has gotten worse.

d. A small amount of dried drainage is on the dressing.

b. Oral temperature is 100.8F (38.1C).

13. Which action would the nurse take when performing ear irrigation for a patient with cerumen impaction?

a. Assist the patient to a supine position for the irrigation.

b. Fill the irrigation syringe with body-temperature solution.

c. Use a sterile applicator to clean the ear canal before irrigating.

d. Occlude the ear canal completely with the syringe while irrigating.

b. Fill the irrigation syringe with body-temperature solution.

14. The charge nurse is observing a new nurse who is preparing to perform an ear examination for a 30-year-old patient. Which action by the new nurse indicates that the charge nurse should intervene?

a. Pulls the auricle of the ear up and posterior.

b. Chooses a speculum larger than the ear canal.

c. Stabilizes the hand holding the otoscope on the patient's head.

d. Stops inserting the otoscope after observing impacted cerumen.

b. Chooses a speculum larger than the ear canal.

15. A patient reports dizziness when bending over and nausea and dizziness associated with physical activities. Which exam would thenurse expect to prepare thepatient to undergo?

a. Tympanometry

b. Rotary chair testing

c. Pure-tone audiometry

d. Bone-conduction testing

b. Rotary chair testing

16. When the nurse is taking a health history of a new patient, the patient states, ―I have to sleep with music on.‖ Which follow-up question would the nurse ask to obtain more information about possible hearing problems?

a. ―Do you grind your teeth at night?‖

b. ―What time do you usually fall asleep?‖

c. ―Have you noticed ringing in your ears?‖

d. ―Are you ever dizzy when you are lying down?‖

c. ―Have you noticed ringing in your ears?‖

17. When the patient turns his head quickly during the admission assessment, the nurse observes nystagmus. Which action would the nurse take?

a. Assess the patient with a Rinne test.

b. Place a fall-risk bracelet on the patient.

c. Ask the patient to watch the mouths of staff when they speak.

d. Remind health care team members to speak loudly to the patient.

b. Place a fall-risk bracelet on the patient.

18. The nurse recording health histories in the outpatient clinic would plan a focused hearing assessment for adult patients taking which medication?

a. Atenolol

b. Albuterol

c. Ibuprofen

d. Acetaminophen

c. Ibuprofen

19. The charge nurse is observing a new nurse who is caring for a patient with vestibular disease. Which action by the nurse would indicate that the charge nurse intervene?

a. Facing the patient directly when speaking

b. Speaking slowly and distinctly to the patient

c. Administering both the Rinne and Weber tests

d. Encouraging the patient to ambulate independently

d. Encouraging the patient to ambulate independently

20. Which assessment finding would the nurse report to the health care provider?

a. Visible cone of light

b. Dry skin in the ear canal

c. A blue-tinged tympanum

d. Cerumen in the auditory canal

c. A blue-tinged tympanum

21. Which equipment does the nurse need to perform a Rinne test?

a. Otoscope

b. Tuning fork

c. Audiometer

d. Ticking watch

b. Tuning fork

22. Which action would the nurse take when teaching a patient with mild presbycusis?

a. Use patient education handouts rather than discussion.

b. Use a high-pitched tone of voice to provide instructions.

c. Ask for permission to turn off the television before teaching.

d. Wait until family members have left before initiating teaching.

c. Ask for permission to turn off the television before teaching.