Description
Medical Surgical Nursing 1st Edition Hoffman Sullivan Test Bank
ISBN-13: 978-0803644175
ISBN-10: 0803644175
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Chapter 48: Coordinating Care for Patients With Hearing Disorders
Multiple Choice
Identify the choice that best completes the statement or answers the question.
____ 1. During a home visit the nurse suspects that someone in the family has hearing loss. What did the nurse observe to come to this conclusion?
| 1) | Television volume on loud |
| 2) | Patient sitting in the kitchen |
| 3) | Music playing in the background |
| 4) | Family member cooking at the stove |
____ 2. A patient with a hearing loss is wearing headphones as a part of a diagnostic test. What test is being completed with this patient?
| 1) | Tympanometry |
| 2) | Pure-tone threshold |
| 3) | MRI with gadolinium |
| 4) | Speech reception threshold |
____ 3. A patient is scheduled for a cochlear implant. Which patient statement indicates that teaching about this surgery has been effective?
| 1) | “This implant will not restore my hearing.” |
| 2) | “I will be able to hear perfectly after this surgery.” |
| 3) | “This surgery will drain fluid from my middle ear.” |
| 4) | “This surgery will rebuild my damaged tympanic membrane.” |
____ 4. The nurse is planning care for a patient recovering from a tympanoplasty. Which action should the nurse include to ensure the ear packing stays intact?
| 1) | Increase fluid intake |
| 2) | Administer tobramycin |
| 3) | Maintain nothing by mouth status |
| 4) | Position flat with the operative side up |
____ 5. A patient who swims several times a week asks why the ears are becoming frequently infected. What should the nurse explain to this patient?
| 1) | “The pool water is entering your Eustachian tubes.” |
| 2) | “The pool water has microorganisms that are entering your ears.” |
| 3) | “The pool water is drying out your ears causing skin breakdown.” |
| 4) | “The pool water has chlorine that is killing all of the good bacteria.” |
____ 6. A patient with external otitis has a ruptured tympanic membrane. Which medication should the nurse expect to be prescribed for this patient?
| 1) | Tobramycin |
| 2) | Fluoroquinolone |
| 3) | 2.0% Acetic acid (Vosol) |
| 4) | 90% to 95% isopropyl alcohol |
____ 7. A patient with external otitis rates pain as 8 on a scale of 0 to 10. What should the nurse do to improve this patient’s comfort?
| 1) | Apply warm, dry heat to the ear |
| 2) | Apply a cool compress to the ear |
| 3) | Position supine with the affected ear down |
| 4) | Obtain an order for an opioid pain medication |
____ 8. During a well-child visit the nurse suspects that a two-year-old is experiencing otitis media. What finding did the nurse use to make this clinical determination?
| 1) | Drowsiness |
| 2) | Tugging at the ear |
| 3) | Tearing of the eyes |
| 4) | Clear mucous from the nose |
____ 9. A patient with a low-grade fever is diagnosed with otitis media. Which medication should the nurse expect to be prescribed as a priority for this patient?
| 1) | Cefixime (Suprax) |
| 2) | Ibuprofen (Motrin) |
| 3) | Acetaminophen (Tylenol) |
| 4) | Normal saline nose drops |
____ 10. A patient being treated for otitis media is experiencing reduced hearing and dizziness. Which complication should the nurse suspect is occurring with this patient?
| 1) | Petrositis |
| 2) | Meningitis |
| 3) | Mastoiditis |
| 4) | Labyrinthitis |
____ 11. A patient seeking medical attention for “buzzing in the ears” asks why the blood pressure is being measured. How should the nurse respond to this patient?
| 1) | “Blood pressure measurement is done on every patient.” |
| 2) | “The ear buzzing means your blood vessels are constricted.” |
| 3) | “Elevated blood pressure makes the buzzing more noticeable.” |
| 4) | “The blood pressure is used to determine what medication you will need.” |
____ 12. A patient asks what can be done to stop the “noises” in the ears. What should the nurse ask to determine if the patient is experiencing tinnitus?
| 1) | “What does the noise sound like?” |
| 2) | “How often do the noises occur?” |
| 3) | “What are the noises saying to you?” |
| 4) | “Do the noises occur mostly at night?” |
____ 13. A patient with tinnitus is prescribed diphenhydramine. What should the nurse explain to the patient about this medication?
| 1) | “This is an antibiotic that will cure the problem.” |
| 2) | “This is a decongestant to help reduce the symptoms.” |
| 3) | “This is an anticonvulsant that will stop the aura of the noises.” |
| 4) | “This is a vitamin supplement that will improve blood flow to the ears.” |
____ 14. A middle-aged patient is experiencing tinnitus. What should the nurse suggest to help determine the reason for this health problem?
| 1) | Increase the intake of fresh fruit |
| 2) | Write down when the noises occur |
| 3) | Sleep a few extra hours each night |
| 4) | Reduce fluid intake after 1800 hours |
____ 15. After an assessment the nurse suspects a patient is experiencing vertigo. Which data caused the nurse to come to this conclusion?
| 1) | Nasal congestion |
| 2) | Spinning sensation at rest |
| 3) | Feeling of fullness in the ears |
| 4) | Mucopurulent drainage from the nose |
____ 16. During a home visit the nurse notes that a patient continues to experience vertigo. On what should the nurse focus care during this visit?
| 1) | Safety |
| 2) | Nutrition |
| 3) | Perfusion |
| 4) | Fluid balance |
____ 17. The nurse is evaluating teaching provided to a patient with vertigo. Which observation indicates that teaching has been effective?
| 1) | Sips a cup of coffee |
| 2) | Changes positions slowly |
| 3) | Prepares canned soup for lunch |
| 4) | Drinks diet soda during the day |
____ 18. The nurse is reviewing data in a patient’s medical record. Which information increases the patient’s risk for developing Ménière’s disease?
| 1) | Follows a gluten-free diet |
| 2) | Allergic to house dust and pet dander |
| 3) | Works as a computer science technician |
| 4) | Treated for a pinched nerve in the lower back |
____ 19. A patient with Ménière’s disease is admitted for intravenous fluid administration. What additional manifestation is seen in this disease process?
| 1) | Muscle cramps |
| 2) | Drop in blood pressure |
| 3) | Capillary glucose 90 mg/dL |
| 4) | Uncontrollable eye movements |
____ 20. A patient with Ménière’s disease is experiencing severe nausea and vomiting. Which medication should the nurse expect to be prescribed for this patient?
| 1) | Diazepam (Valium) |
| 2) | Meclizine (Antivert) |
| 3) | Promethazine (Phenergan) |
| 4) | Dimenhydrinate (Dramamine) |
____ 21. A patient with severe Ménière’s disease is considering a labyrinthectomy. What should the nurse emphasize as a complication of this procedure?
| 1) | Long-term tinnitus |
| 2) | Chronic otitis media |
| 3) | Rupture of the tympanic membrane |
| 4) | Complete hearing loss of the affected ear |
____ 22. The nurse suspects that patient is experiencing undiagnosed Ménière’s disease. Which assessment finding supports the nurse’s clinical decision?
| 1) | Facial pain |
| 2) | Nasal drainage |
| 3) | Positive Romberg test |
| 4) | Decreased deep tendon reflexes |
Multiple Response
Identify one or more choices that best complete the statement or answer the question.
____ 23. The nurse is preparing teaching materials for a group of senior citizens. What information should the nurse include as risk factors for hearing loss? Select all that apply.
| 1) | Diet |
| 2) | Heredity |
| 3) | Medications |
| 4) | Recreational noise |
| 5) | Occupational noise |
____ 24. A patient seeks medical attention for ear pain. What findings indicate that this patient is experiencing external otitis? Select all that apply.
| 1) | Edema of the ear canal |
| 2) | External ear tender to touch |
| 3) | Pain when moving the auricle |
| 4) | Purulent drainage from the ear |
| 5) | Swelling around the external ear |
____ 25. The nurse is preparing information to share during a community health fair. What should the nurse include about risk factors for the development of otitis media? Select all that apply.
| 1) | Chronic illnesses |
| 2) | Exposed to smoking |
| 3) | Genetic predisposition |
| 4) | Flat Eustachian tube in children |
| 5) | Current upper respiratory infection |
____ 26. The nurse is preparing to assess a patient experiencing tinnitus. What should the nurse include in this assessment? Select all that apply.
| 1) | Current age |
| 2) | Nutritional status |
| 3) | Presence of earwax |
| 4) | Current medications |
| 5) | Exposure to loud noises |
____ 27. A patient is diagnosed with peripheral inner ear disorder causing vertigo. On which areas should the nurse focus when assessing this patient? Select all that apply.
| 1) | Pinna |
| 2) | CN VIII |
| 3) | Inner ear |
| 4) | Nasopharynx |
| 5) | Tympanic membrane |
Numeric Response
- A patient with vertigo is prescribed prochlorperazine (Compro) 10 mg intramuscularly four times a day. A vial containing 250 mg/10 mL of the medication is delivered by the pharmacy. How many mL of the medication should the nurse provide for each dose? Record your answer to the nearest tenth decimal point. ______
Chapter 48: Coordinating Care for Patients With Hearing Disorders
Answer Section
MULTIPLE CHOICE
- ANS: 1
Chapter number and title: 48, Coordinating Care for Patients With Hearing Disorders
Chapter learning objective: Correlating clinical manifestations to pathophysiological processes of: Hearing loss
Chapter page reference: 988
Heading: Hearing Loss > Clinical Manifestations
Integrated Processes: Nursing Process–Assessment
Client Need: Physiological Integrity/Reduction of Risk Potential
Cognitive level: Application [Applying]
Concept: Sensory Perception
Difficulty: Easy
| Feedback | |
| 1 | Manifestations of increasing difficulty in hearing include turning up the volume on electronics such as televisions and radios. |
| 2 | The patient sitting in the kitchen does not indicate a hearing loss. |
| 3 | More information is needed about music playing in the background because the volume of the music is not addressed. |
| 4 | A family member’s actions do not indicate a hearing loss. |
PTS: 1 CON: Sensory Perception
- ANS: 2
Chapter number and title: 48, Coordinating Care for Patients With Hearing Disorders
Chapter learning objective: Describing the diagnostic results used to confirm the diagnoses of selected disorders of the ear
Chapter page reference: 989
Heading: Hearing Loss > Medical Management > Diagnostic Tests
Integrated Processes: Nursing Process–Assessment
Client Need: Physiological Integrity/Reduction of Risk Potential
Cognitive level: Application [Applying]
Concept: Sensory Perception
Difficulty: Easy
| Feedback | |
| 1 | Tympanometry is a test that measures the impedance of the middle ear to the acoustic energy. |
| 2 | Pure-tone threshold is an audiological test conducted with air and bone conduction assessment to quantify hearing loss. To complete this test, the patient wears headphones. |
| 3 | Standard MRI with gadolinium enhancement is usually performed with patients who present with an abnormal neurological examination and/or when a cerebellopontine-angle lesion is suspected. |
| 4 | Speech reception threshold is used to measure the intensity at which speech is recognized by a patient. This test is used to determine the softest level at which the patient is able to recognize speech. |
PTS: 1 CON: Sensory Perception
- ANS: 1
Chapter number and title: 48, Coordinating Care for Patients With Hearing Disorders
Chapter learning objective: Discussing the medical management of selected disorders of the ear
Chapter page reference: 990
Heading: Hearing Loss > Medical Management > Treatment
Integrated Processes: Teaching and Learning
Client Need: Physiological Integrity/Reduction of Risk Potential
Cognitive level: Analysis [Analyzing]
Concept: Sensory Perception; Perioperative
Difficulty: Medium
| Feedback | |
| 1 | The cochlear implant does not restore normal hearing. |
| 2 | The cochlear implant does not restore normal hearing. |
| 3 | A myringotomy drains fluid from the middle ear. |
| 4 | A myringoplasty reconstructs the eardrum. |
PTS: 1 CON: Sensory Perception | Perioperative
- ANS: 4
Chapter number and title: 48, Coordinating Care for Patients With Hearing Disorders
Chapter learning objective: Developing a comprehensive plan of nursing care for patients with ear disorders
Chapter page reference: 991
Heading: Hearing Loss > Nursing Management > Action
Integrated Processes: Nursing Process–Implementation
Client Need: Physiological Integrity/Reduction of Risk Potential
Cognitive level: Application [Applying]
Concept: Sensory Perception; Perioperative
Difficulty: Medium
| Feedback | |
| 1 | Increasing the fluid intake may decrease the thickening of the earwax. |
| 2 | Tobramycin is an identified ototoxic medication and should be questioned. |
| 3 | There is no need to keep the patient NPO. |
| 4 | The patient should be positioned flat, turned on the side with the operative side facing up after tympanoplasty. This decreases the chance of packing being displaced. |
PTS: 1 CON: Sensory Perception | Perioperative
- ANS: 3
Chapter number and title: 48, Coordinating Care for Patients With Hearing Disorders
Chapter learning objective: Explaining the pathophysiological process of hearing disorders
Chapter page reference: 993
Heading: External Otitis > Pathophysiology
Integrated Processes: Nursing Process–Implementation
Client Need: Physiological Integrity/Reduction of Risk Potential
Cognitive level: Application [Applying]
Concept: Sensory Perception; Infection
Difficulty: Medium
| Feedback | |
| 1 | The pool water is not entering the patient’s Eustachian tubes. |
| 2 | The pool water is not causing the patient’s ear infections. |
| 3 | External otitis develops in swimmers as a result of excessive water exposure yielding a decrease in cerumen. The decrease in cerumen can lead to drying of the external auditory canal resulting in potential skin breakdown, providing an excellent entry port for bacterial or fungal infections. |
| 4 | The pool water is not killing off the patient’s good bacteria. |
PTS: 1 CON: Sensory Perception | Infection
- ANS: 2
Chapter number and title: 48, Coordinating Care for Patients With Hearing Disorders
Chapter learning objective: Discussing the medical management of selected disorders of the ear
Chapter page reference: 993
Heading: External Otitis > Medical Management
Integrated Processes: Nursing Process–Planning
Client Need: Physiological Integrity/Pharmacological and Parenteral Therapies
Cognitive level: Application [Applying]
Concept: Sensory Perception; Infection; Medication
Difficulty: Medium
| Feedback | |
| 1 | Tobramycin is used for an acute bacterial infection; however, it is not identified as being safe for a ruptured tympanic membrane. |
| 2 | Fluoroquinolone is the only medication approved with tympanic membrane rupture. |
| 3 | 2.0% Acetic acid (Vosol) is not identified as being safe for a ruptured tympanic membrane. |
| 4 | 90% to 95% isopropyl alcohol is not identified as being safe for a ruptured tympanic membrane. |
PTS: 1 CON: Sensory Perception | Infection | Medication
- ANS: 1
Chapter number and title: 48, Coordinating Care for Patients With Hearing Disorders
Chapter learning objective: Developing a comprehensive plan of nursing care for patients with ear disorders
Chapter page reference: 994
Heading: External Otitis > Nursing Management > Actions
Integrated Processes: Nursing Process–Implementation
Client Need: Physiological Integrity/Basic Care and Comfort
Cognitive level: Application [Applying]
Concept: Sensory Perception; Infection; Comfort
Difficulty: Medium
| Feedback | |
| 1 | Dry, warm heat may provide some comfort when applied to the ear directly. |
| 2 | Dry heat is preferred over a cool compress. |
| 3 | Sitting or semi-sitting with the affected ear on a soft object provides comfort. Supine with the affected ear down may increase pain. |
| 4 | Pain relief is usually accomplished by over-the-counter (OTC) medications. An opioid is not required. |
PTS: 1 CON: Sensory Perception | Infection | Comfort
- ANS: 2
Chapter number and title: 48, Coordinating Care for Patients With Hearing Disorders
Chapter learning objective: Correlating clinical manifestations to pathophysiological processes of: Otitis media
Chapter page reference: 996
Heading: Otitis Media > Clinical Manifestations
Integrated Processes: Nursing Process–Assessment
Client Need: Safe and Effective Care Environment/Safety and Infection Control
Cognitive level: Application [Applying]
Concept: Sensory Perception; Infection; Assessment
Difficulty: Easy
| Feedback | |
| 1 | Drowsiness is not a clinical manifestation of otitis media. |
| 2 | Tugging or pulling at the ear is a clinical manifestation of otitis media seen in children. |
| 3 | Eye tearing is not a clinical manifestation of otitis media. |
| 4 | Clear mucous draining from the nose is not a clinical manifestation of otitis media. |
PTS: 1 CON: Sensory Perception | Infection | Assessment
- ANS: 1
Chapter number and title: 48, Coordinating Care for Patients With Hearing Disorders
Chapter learning objective: Discussing the medical management of selected disorders of the ear
Chapter page reference: 996
Heading: Otitis Media > Medical Management
Integrated Processes: Nursing Process–Planning
Client Need: Physiological Integrity/Pharmacological and Parenteral Therapies
Cognitive level: Application [Applying]
Concept: Sensory Perception; Infection; Medication
Difficulty: Moderate
| Feedback | |
| 1 | Cefixime (Suprax) is an antibiotic. Oral antimicrobial therapy is the most effective treatment for acute otitis media. |
| 2 | Ibuprofen (Motrin) can be used as an antipyretic and analgesic; however, this would not be the priority. |
| 3 | Acetaminophen (Tylenol) can be used as an antipyretic and analgesic; however, this would not be the priority. |
| 4 | Normal saline nose drops would be used for nasal congestion; however, there is no information to support that the patient is experiencing nasal congestion. |
PTS: 1 CON: Sensory Perception | Infection | Medication
- ANS: 4
Chapter number and title: 48, Coordinating Care for Patients With Hearing Disorders
Chapter learning objective: Describing complications associated with selected disorders of the ear
Chapter page reference: 996
Heading: Otitis Media > Medical Management > Complications
Integrated Processes: Nursing Process–Assessment
Client Need: Physiological Integrity/Reduction of Risk Potential
Cognitive level: Application [Applying]
Concept: Sensory Perception; Infection
Difficulty: Moderate
| Feedback | |
| 1 | Petrositis develops when there is inflammation of the temporal bone that penetrates deep into the ear. |
| 2 | Meningitis is an inflammation of the meninges, which is the outer covering of the brain. |
| 3 | Mastoiditis is the spread of infection to the mastoid bone that causes an inflammation of the mastoid air cells of the temporal bone. |
| 4 | Labyrinthitis is an inflammatory disorder of the inner ear labyrinth that occurs as a complication of otitis media, which results in a disturbance in balance and hearing. This complication may be unilateral or bilateral. |
PTS: 1 CON: Sensory Perception | Infection
- ANS: 3
Chapter number and title: 48, Coordinating Care for Patients With Hearing Disorders
Chapter learning objective: Explaining the pathophysiological process of hearing disorders
Chapter page reference: 1000
Heading: Tinnitus > Pathophysiology
Integrated Processes: Nursing Process–Assessment
Client Need: Physiological Integrity/Reduction of Risk Potential
Cognitive level: Application [Applying]
Concept: Sensory Perception
Difficulty: Moderate
| Feedback | |
| 1 | Blood pressure measurement might be done on every patient; however, this does address the patient’s problem. |
| 2 | Ear buzzing does not necessarily mean that the patient’s blood vessels are constricted. |
| 3 | Elevated blood pressure and factors contributing to elevated blood pressure, such as stress, alcohol consumption, and caffeine, make tinnitus more noticeable. |
| 4 | The blood pressure measurement for tinnitus is not used to determine the medications that should be prescribed. |
PTS: 1 CON: Sensory Perception
- ANS: 1
Chapter number and title: 48, Coordinating Care for Patients With Hearing Disorders
Chapter learning objective: Correlating clinical manifestations to pathophysiological processes of: Tinnitus
Chapter page reference: 999
Heading: Tinnitus > Clinical Manifestations
Integrated Processes: Nursing Process–Assessment
Client Need: Physiological Integrity/Reduction of Risk Potential
Cognitive level: Application [Applying]
Concept: Sensory Perception
Difficulty: Moderate
| Feedback | |
| 1 | The nurse should ask the patient to describe the noises. The most common bothersome sensations of sound described by patients, when no sound is actually present, include ringing, buzzing, roaring, clicking, whistling, and hissing sounds in the ear. These sounds may be present consistently or intermittently. |
| 2 | Asking how often the noises occur will not help determine if the patient is experiencing tinnitus. |
| 3 | Asking what the noises are saying to the patient would help determine if the patient is experiencing a mental health disorder. |
| 4 | Asking if the noises occur at night is a closed-ended question and would not provide the best information to determine if the patient is experiencing tinnitus. |
PTS: 1 CON: Sensory Perception
- ANS: 2
Chapter number and title: 48, Coordinating Care for Patients With Hearing Disorders
Chapter learning objective: Discussing the medical management of selected disorders of the ear
Chapter page reference: 1000
Heading: Tinnitus > Medical Management
Integrated Processes: Nursing Process–Implementation
Client Need: Physiological Integrity/Pharmacological and Parenteral Therapies
Cognitive level: Application [Applying]
Concept: Sensory Perception; Medication
Difficulty: Moderate
| Feedback | |
| 1 | Antibiotics are not prescribed for tinnitus. Antibiotics will not cure the disorder. |
| 2 | Decongestants might be prescribed for tinnitus to reduce the symptoms. |
| 3 | Anticonvulsants have been used to reduce the symptoms. Tinnitus is not identified as being an aura before a seizure. |
| 4 | Vitamin supplements have been shown to reduce the symptoms; however, there is no information to support that the supplement will improve the blood flow to the ears. |
PTS: 1 CON: Sensory Perception | Medication
- ANS: 2
Chapter number and title: 48, Coordinating Care for Patients With Hearing Disorders
Chapter learning objective: Developing a teaching plan for a patient with an ear disorder
Chapter page reference: 1001
Heading: Tinnitus > Nursing Management > Teaching
Integrated Processes: Nursing Process–Implementation
Client Need: Physiological Integrity/Reduction of Risk Potential
Cognitive level: Application [Applying]
Concept: Sensory Perception; Assessment
Difficulty: Moderate
| Feedback | |
| 1 | Lack of fresh fruit is not identified as a risk factor for tinnitus. |
| 2 | Instructing patients to keep a diary of clinical manifestations may help to identify a causative agent. This diary should include date/time/symptoms experienced to see if an identifiable trend is present. |
| 3 | Lack of sleep is not identified as a risk factor for tinnitus. |
| 4 | Excess fluid is not identified as a risk factor for tinnitus. |
PTS: 1 CON: Sensory Perception | Assessment
- ANS: 2
Chapter number and title: 48, Coordinating Care for Patients With Hearing Disorders
Chapter learning objective: Correlating clinical manifestations to pathophysiological processes of vertigo
Chapter page reference: 1002
Heading: Vertigo > Pathophysiology
Integrated Processes: Nursing Process–Assessment
Client Need: Physiological Integrity/Reduction of Risk Potential
Cognitive level: Application [Applying]
Concept: Sensory Perception; Assessment
Difficulty: Moderate
| Feedback | |
| 1 | Nasal congestion is not a clinical manifestation of vertigo. |
| 2 | Clinical manifestations of vertigo include a spinning sensation at rest. |
| 3 | Feeling of fullness in the ears is not a clinical manifestation of vertigo. |
| 4 | Mucopurulent drainage from the nose is not a clinical manifestation of vertigo. |
PTS: 1 CON: Sensory Perception | Assessment
- ANS: 1
Chapter number and title: 48, Coordinating Care for Patients With Hearing Disorders
Chapter learning objective: Describing complications associated with selected disorders of the ear
Chapter page reference: 1002
Heading: Vertigo > Medical Management > Complications
Integrated Processes: Nursing Process–Planning
Client Need: Physiological Integrity/Reduction of Risk Potential
Cognitive level: Application [Applying]
Concept: Sensory Perception; Safety
Difficulty: Moderate
| Feedback | |
| 1 | Injuries from falls in the patient with vertigo are not uncommon and may be of particular concern to elderly patients, who can suffer catastrophic effects from a fall. |
| 2 | Nutrition is not an issue with vertigo. |
| 3 | Perfusion is not an issue with vertigo. |
| 4 | Fluid balance is not an issue with vertigo. |
PTS: 1 CON: Sensory Perception | Safety
- ANS: 2
Chapter number and title: 48, Coordinating Care for Patients With Hearing Disorders
Chapter learning objective: Developing a teaching plan for a patient with an ear disorder
Chapter page reference: 1003
Heading: Vertigo > Nursing Management > Teaching
Integrated Processes: Teaching and Learning
Client Need: Physiological Integrity/Reduction of Risk Potential
Cognitive level: Analysis [Analyzing]
Concept: Sensory Perception; Safety; Promoting Health
Difficulty: Moderate
| Feedback | |
| 1 | Avoiding caffeine is most likely associated to the stimulant effects of caffeine. The patient would need more teaching for this observation. |
| 2 | Instructions to plan slow, methodical position changes help to decrease vertigo in patients. Decreasing vertigo symptoms with changes of position may also decrease the patient’s risk of falling. |
| 3 | Decreasing salt intake probably decreases tinnitus based upon its impact on fluid retention and blood pressure. Limiting salt intake is particularly important in the patient with hypertension who experiences tinnitus. The patient would need more teaching about the sodium content of canned foods. |
| 4 | Aspartame may have a toxic effect on the inner ear and brain. The patient would need more teaching about the intake of diet soda. |
PTS: 1 CON: Sensory Perception | Safety | Promoting Health
- ANS: 2
Chapter number and title: 48, Coordinating Care for Patients With Hearing Disorders
Chapter learning objective: Describing the epidemiology of hearing disorders
Chapter page reference: 1003
Heading: Ménière’s Disease > Epidemiology
Integrated Processes: Nursing Process–Assessment
Client Need: Physiological Integrity/Reduction of Risk Potential
Cognitive level: Analysis [Analyzing]
Concept: Sensory Perception
Difficulty: Moderate
| Feedback | |
| 1 | A gluten-free diet is not a risk factor for Ménière’s disease. |
| 2 | Risk factors for Ménière’s disease include allergies. |
| 3 | Vocation is not identified as a risk factor for Ménière’s disease. |
| 4 | Lower spinal cord disorders are not identified as risk factors for Ménière’s disease. |
PTS: 1 CON: Sensory Perception
- ANS: 4
Chapter number and title: 48, Coordinating Care for Patients With Hearing Disorders
Chapter learning objective: Correlating clinical manifestations to pathophysiological processes of Meniere’s disease
Chapter page reference: 1004
Heading: Ménière’s Disease > Clinical Manifestations
Integrated Processes: Nursing Process–Assessment
Client Need: Physiological Integrity/Reduction of Risk Potential
Cognitive level: Analysis [Analyzing]
Concept: Sensory Perception
Difficulty: Moderate
| Feedback | |
| 1 | Muscle cramps are not associated with Ménière’s disease. |
| 2 | Hypotension is not a manifestation of Ménière’s disease. |
| 3 | Blood glucose level is not typically assessed in Ménière’s disease. |
| 4 | Uncontrollable eye movements are manifestations of Ménière’s disease. |
PTS: 1 CON: Sensory Perception
- ANS: 3
Chapter number and title: 48, Coordinating Care for Patients With Hearing Disorders
Chapter learning objective: Discussing the medical management of selected disorders of the ear
Chapter page reference: 1005
Heading: Ménière’s Disease > Medical Management
Integrated Processes: Nursing Process–Planning
Client Need: Physiological Integrity/Pharmacological and Parenteral Therapies
Cognitive level: Application [Applying]
Concept: Sensory Perception; Medication
Difficulty: Moderate
| Feedback | |
| 1 | Diazepam (Valium) depresses all levels of the central nervous system and thereby decreases symptoms. |
| 2 | Meclizine (Antivert) decreases excitability of the inner ear labyrinth and blocks conduction of the inner ear vestibular cerebellar pathways. |
| 3 | Promethazine (Phenergan) blocks histamine at the site to decrease symptoms of nausea and vomiting. |
| 4 | Dimenhydrinate (Dramamine) decreases the exaggerated sense of motion. |
PTS: 1 CON: Sensory Perception | Medication
- ANS: 4
Chapter number and title: 48, Coordinating Care for Patients With Hearing Disorders
Chapter learning objective: Describing complications associated with selected disorders of the ear
Chapter page reference: 1005
Heading: Ménière’s Disease > Surgical Management
Integrated Processes: Nursing Process–Implementation
Client Need: Physiological Integrity/Reduction of Risk Potential
Cognitive level: Application [Applying]
Concept: Sensory Perception; Perioperative
Difficulty: Moderate
| Feedback | |
| 1 | Tinnitus is not a complication after a labyrinthectomy. |
| 2 | Chronic otitis media is not a complication after a labyrinthectomy. |
| 3 | Tympanic membrane rupture is not a complication after a labyrinthectomy. |
| 4 | A more radical surgery reserved for very severe cases includes removal of part of the inner ear called a labyrinthectomy. Although this surgery also improves the vertigo symptoms, complete hearing loss in the ear on the affected side is a result of the procedure. |
PTS: 1 CON: Sensory Perception | Perioperative
- ANS: 3
Chapter number and title: 48, Coordinating Care for Patients With Hearing Disorders
Chapter learning objective: Developing a comprehensive plan of nursing care for patients with ear disorders
Chapter page reference: 1006
Heading: Ménière’s Disease > Nursing Management > Assessment
Integrated Processes: Nursing Process–Assessment
Client Need: Physiological Integrity/Reduction of Risk Potential
Cognitive level: Analysis [Analyzing]
Concept: Sensory Perception; Assessment
Difficulty: Moderate
| Feedback | |
| 1 | Facial pain is not associated with Ménière’s disease. |
| 2 | Nasal drainage is not a primary symptom of Ménière’s disease. |
| 3 | In Ménière’s disease, patients may exhibit a positive Romberg test on examination (meaning they have a disturbance in balance) and may also have nystagmus. |
| 4 | Changes in deep tendon reflexes do not occur in Ménière’s disease. |
PTS: 1 CON: Sensory Perception | Assessment
MULTIPLE RESPONSE
- ANS: 2, 3, 4, 5
Chapter number and title: 48, Coordinating Care for Patients With Hearing Disorders
Chapter learning objective: Describing the epidemiology of hearing disorders
Chapter page reference: 988
Heading: Hearing Loss > Epidemiology
Integrated Processes: Teaching and Learning
Client Need: Health Promotion and Maintenance
Cognitive level: Application [Applying]
Concept: Sensory Perception; Promoting Health
Difficulty: Easy
| Feedback | |
| 1. | Diet is not identified as placing a person at higher risk for developing hearing loss. |
| 2. | Heredity is identified as placing a person at higher risk for developing hearing loss. |
| 3. | Medications are identified as placing a person at higher risk for developing hearing loss. |
| 4. | Recreational noise is identified as placing a person at higher risk for developing hearing loss. |
| 5. | Occupational noise is identified as placing a person at higher risk for developing hearing loss. |
PTS: 1 CON: Sensory Perception | Promoting Health
- ANS: 1, 2, 3, 5
Chapter number and title: 48, Coordinating Care for Patients With Hearing Disorders
Chapter learning objective: Correlating clinical manifestations to pathophysiological processes of: External otitis
Chapter page reference: 993
Heading: External Otitis > Clinical Manifestations
Integrated Processes: Nursing Process–Assessment
Client Need: Safe and Effective Care Environment/Safety and Infection Control
Cognitive level: Comprehension [Understanding]
Concept: Sensory Perception; Infection; Assessment
Difficulty: Easy
| Feedback | |
| 1. | Common clinical manifestations of external otitis include edema of the ear canal. |
| 2. | Common clinical manifestations of external otitis include external ear is tender to touch. |
| 3. | Common clinical manifestations of external otitis include pain when moving the auricle of the ear. |
| 4. | Common clinical manifestations of external otitis include scant drainage from the ear. |
| 5. | Common clinical manifestations of external otitis include swelling around the external ear. |
PTS: 1 CON: Sensory Perception | Infection | Assessment
- ANS: 2, 3, 4, 5
Chapter number and title: 48, Coordinating Care for Patients With Hearing Disorders
Chapter learning objective: Describing the epidemiology of hearing disorders
Chapter page reference: 995
Heading: Otitis Media > Epidemiology
Integrated Processes: Teaching and Learning
Client Need: Health Promotion and Maintenance
Cognitive level: Application [Applying]
Concept: Sensory Perception; Infection; Promoting Health
Difficulty: Easy
| Feedback | |
| 1. | Chronic illnesses is not an identified risk factor for otitis media. |
| 2. | Smoking can cause chronic inflammation to the airways, increasing a person’s risk of developing otitis media. |
| 3. | Patients with family members who have an identified genetic predisposition for otitis media are at greater risk of developing this disorder. |
| 4. | The Eustachian tube is more flat in children or other congenital features can accentuate infection. This flattening of the Eustachian tube prevents drainage and makes fluid in the ear more likely to stagnate or to accumulate. |
| 5. | Inflammation from an upper respiratory infection can cause narrowing of passages in the ear, predisposing the patient to fluid accumulation and infection. |
PTS: 1 CON: Sensory Perception | Infection | Promoting Health
- ANS: 1, 3, 4, 5
Chapter number and title: 48, Coordinating Care for Patients With Hearing Disorders
Chapter learning objective: Describing the epidemiology of hearing disorders
Chapter page reference: 998
Heading: Tinnitus > Epidemiology
Integrated Processes: Nursing Process–Assessment
Client Need: Physiological Integrity/Reduction of Risk Potential
Cognitive level: Application [Applying]
Concept: Sensory Perception; Assessment
Difficulty: Moderate
| Feedback | |
| 1. | Advanced age is a risk factor for the development of tinnitus. |
| 2. | Nutritional status is not identified as a risk factor for the development of tinnitus. |
| 3. | Earwax blockage is identified as a risk factor for tinnitus. |
| 4. | Certain medications such as salicylates, NSAIDs, and some antihypertensives, antidepressants, and chemotherapeutic agents can increase the risk of developing tinnitus. |
| 5. | Exposure to loud noises can increase the patient’s risk of developing tinnitus. |
PTS: 1 CON: Sensory Perception | Assessment
- ANS: 2, 3
Chapter number and title: 48, Coordinating Care for Patients With Hearing Disorders
Chapter learning objective: Explaining the pathophysiological process of hearing disorders
Chapter page reference: 1002
Heading: Vertigo > Pathophysiology
Integrated Processes: Nursing Process–Assessment
Client Need: Physiological Integrity/Reduction of Risk Potential
Cognitive level: Application [Applying]
Concept: Sensory Perception; Assessment
Difficulty: Moderate
| Feedback | |
| 1. | The pinna is part of the outer ear. |
| 2. | Disorders of the inner ear and CN VIII are termed peripheral disorders. |
| 3. | Disorders of the inner ear and CN VIII are termed peripheral disorders. |
| 4. | The nasopharynx is not a part of the inner ear. |
| 5. | The tympanic membrane separates the external from the middle ear. |
PTS: 1 CON: Sensory Perception | Assessment
NUMERIC RESPONSE
- ANS:
0.4 mL
Chapter number and title: 48, Coordinating Care for Patients With Hearing Disorders
Chapter learning objective: Discussing the medical management of selected disorders of the ear
Chapter page reference: 1002
Heading: Vertigo > Medical Management > Treatment
Integrated Processes: Nursing Process–Implementation
Client Need: Physiological Integrity/Pharmacological and Parenteral Therapies
Cognitive level: Application [Applying]
Concept: Sensory Perception; Medication
Difficulty: Moderate
Feedback: First determine the amount of medication in each mL by dividing 250 mg/10 mL = 25 mg. Then divide the dose prescribed by the dose available or 10 mg/25 mg x 1 mL = 0.4 mL. The patient should receive 0.4 mL of medication in each dose.
PTS: 1 CON: Sensory Perception | Medication
