Professional Documents
Culture Documents
A tuning fork is needed to perform the Weber test, A round or oval darkened area on the eardrum would
during which the nurse places the vibrating tuning fork at be seen in a client with a perforated eardrum. A red and
the midline of the client’s forehead or above the upper lip bulging eardrum is indicative of acute purulent otitis
over the teeth. Normally, the sound is heard equally in media. Dense white patches are seen on the eardrum of a
both ears by bone conduction. If the client has a client with sequelae of repeated ear infections. A colony
sensorineural hearing loss in one ear, the sound is heard of black dots on the eardrum suggests a yeast or fungal
in the other ear. If the client has a conductive hearing infection.
loss in one ear, the sound is heard in that ear. The items
identified in options A, B, and D are not needed to 33. A caloric test is ordered for a client suspected of having
perform the Weber test. disease of the labyrinth. The nurse would obtain which of
the following essential items in preparation for this test?
29. The home care nurse is visiting a client who was recently a) an otoscope
diagnosed with a hearing impairment. The nurse prepares b) an opthalmoscope
to instruct the client's spouse in which measure that will c) a tongue blade
facilitate communication? d) an emesis basin
a) speak frequently to the client to provide sensory
stimulation A caloric test is contraindicated in a client with a
b) speak loudly to the client to facilitate hearing perforated tympanic membrane (air may be used as a
substitute) or if the client has an acute disease of the
labyrinth. An otoscopic examination should be performed
before the caloric test to rule out perforation and to The battery of the hearing aid should be checked
determine if the ear canal contains cerumen, which must before use. The hearing aid should be removed for
be removed before the test. An ophthalmoscope, a showering, because it should not get wet. It also should
tongue blade, and an emesis basin are not essential be put away in its case at night. It should be cleaned
items. according to manufacturer’s directions, which usually
consist of washing with warm soapy water, followed by
34. A nurse educator is conducting an in-service education thorough drying. Lubricants or other solvents are not
session to the nurses employed in the eye and ear used on the hearing aid.
surgical unit of a large trauma center. In discussing the
topic of cochlear implants, the educator notes that this 38. A nurse has given a client at risk for motion sickness
surgical procedure is contraindicated in which of the suggestions about medications that can prevent an
following clients? occurrence. The nurse determines that the client has
a) a client who became deaf before learning to correctly learned the information if the client states to
speak take medication at what time before the triggering event?
b) a client with bilateral profound hearing loss a) at least 1/2 day before
c) a client who communicates primarily by speech b) at least 1 hour before
d) a client who received no benefit from conventional c) at least the day before
hearing aids d) at least 2 days before
Adults who were born deaf or became deaf before To be maximally effective, medications to prevent
learning to speak usually are not candidates for this type motion sickness should be taken at least 1 hour before
of surgery. Criteria for a cochlear implant procedure are the triggering event. Medications that are commonly used
bilateral profound hearing loss, use of speech as the for this purpose include dimenhydrinate (Dramamine),
primary mode of communication, lack of benefit from scopolamine (Transderm-Scop), promethazine
conventional hearing aids, evidence of strong family and (Phenergan), and prochlorperazine (Compazine). Options
social support, and realistic client expectations for the A, C, and D are incorrect.
outcome of the implant procedure.
39. An adult client makes an appointment with an ear
35. A nurse is observing a nursing assistant communicating specialist because of the frequent recurrence of middle
with a client who is deaf. The nurse will intervene if which ear infections. In performing an intake assessment of the
of the following behaviors is observed? client, the nurse would ask about which of the following
a) the nursing assistant is speaking directly to the client as a risk factor related to infection of the ears?
b) the nursing assistant touches the client's arm to gain a) exposure to loud noise
his or her attention b) use of drilling and other power tools
c) the nursing assistant faces the client when speaking c) congenital abnormalities
to the client d) occupational noise
d) the nursing assistant overenunciates words
when speaking Otitis media (middle ear infection) is associated with
colds, allergies, sore throats, and blockage of the
Overenunciating words does not make lip reading eustachian tube. Risk factors include a young age
easier and is demeaning to the deaf person. It is best to (usually a childhood disease), congenital abnormalities,
speak in a normal manner. Options A, B, and C are immune deficiencies, exposure to cigarette smoke, family
appropriate communication strategies for the client who history of otitis media, recent upper respiratory
is deaf. infections, and allergies. Options A, B, and D can cause
hearing loss. Hearing loss can occur as a result of an
36. A nurse is planning a presentation on noise prevention acute loud noise (acoustic trauma) or by the chronic
and ear protection for a display booth at a local health exposure to loud noise (noise-induced hearing loss).
fair. The nurse plans to incorporate which important
concept regarding hearing loss in the presentation? 40. A nurse is planning to instruct a client with chronic
a) siting near loud music is not harmful vertigo about safety measures to prevent exacerbation of
b) ear plugs or other protectors are necessary only symptoms or injury. Teaching for this client will include
when use of power tools which of the following statements?
c) prolonged ringing in the ears after loud noises is a) drive only when feelings of dizziness have not been
normal experienced for several hours
d) cup the hands over the ears if loud noise is b) go to the bedroom and lie down when vertigo is
expected suddenly experienced
c) remove throw rugs and clutter in the home
A variety of ear protective devices are available d) turn the head slowly when spoken to
commercially. These include disposable and reusable
plugs, headbands, and foam-filled muffs. They should be The client with chronic vertigo should avoid driving
used around any type of loud noise, such as from power and using public transportation. The sudden movements
tools, machinery, lawn mowers, chain saws, or other involved in each could precipitate an attack. To further
equipment. Sitting near loud music should be avoided prevent vertigo attacks, the client should change
whenever possible. If a loud noise is suddenly positions slowly and should turn the entire body, not just
anticipated, the ears should be covered for protection. the head, when spoken to. If vertigo does occur, the
The client should see a physician for tinnitus or hearing client should immediately sit down or grasp the nearest
loss after exposure to a loud noise. piece of furniture. The client should maintain the home
without throw rugs and in a state that is free of clutter,
37. A nurse instructs a client in the use of a hearing aid. The because the effort of trying to regain balance after
nurse includes which of the following in the instructions? slipping could trigger the onset of vertigo.
a) check the battery to ensure that it is working
before use
b) leave the hearing aid in place while showering
c) hearing aids do not require any care
d) a water-soluble lubricant is used on the hearing aid
before insertion