Chapter 54: Ear and Hearing Disorders
Linton: Introduction to Medical-Surgical Nursing, 6th Edition
MULTIPLE CHOICE
1. A nurse reads in a patient’s history that the patient has experienced otalgia. How should the
nurse interpret this term?
a.
Difficulty hearing
b.
Buildup of cerumen
c.
Ear pain
d.
Ringing in the ears
2. A nurse is assisting with a caloric test and notes that the specific patient response that
indicates a hearing disorder is a problem in the labyrinth. Which response did the nurse
witness?
a.
Blinking
b.
Grimacing
c.
Headache
d.
Nystagmus
3. A 75-year-old patient has normal age-related changes in his ear. What change should not be
considered a normal change in the aging patient?
a.
Dry and wrinkled skin on the auricle
b.
Otitis externa
c.
Dry cerumen
d.
Hair in the ear canal
4. When making an initial assessment on a patient with a hearing deficit, the patient reports that
he often feels off balance and is dizzy when he stands up. Which diagnosis might explain
these symptoms?
a.
Sinus infection
b.
Rubella
c.
Otalgia
d.
Presbycusis
5. A 94-year-old patient is receiving gentamicin sulfate (Garamycin) in a continuous intravenous
(IV) infusion. The nurse adds to the nursing care plan the diagnosis “Risk for injury.” What
nursing action should be implemented?
a.
Pull side rails in place.
b.
Assist with ambulation.
c.
Measure intake and output.
d.
Provide for a possible seizure.
6. A 75-year-old patient reports to a nurse that although she has cleaned her ears with
cotton-tipped applicators for weeks, she still cannot hear her television unless the volume is
loud, and she misses a great deal of conversations. What should the nurse anticipate when
examining her ears?
a.
Otitis externa
b.
Purulent drainage
c.
Dry cerumen across the canal
d.
Pearly tympanic membrane
7. A patient reports that her hearing loss has become more severe over the past 3 months. The
clinic nurse makes arrangements for an evaluation for a hearing aid. What health care provider
should provide this service?
a.
Otologist
b.
Otolaryngologist
c.
Audiometrist
d.
Audiologist
8. When a patient has a suspected vestibular disorder, the physician orders an
electronystagmography test. Which instruction should the nurse include when educating the
patient about this test?
a.
Use tea or coffee on the morning of test.
b.
Electrodes will be placed on the scalp.
c.
Air will be blown into the external ear.
d.
The patient should have nothing to eat or drink (NPO) 3 hours before the test.
9. A nurse assessing the results of a Rinne test sees the notation of BC > AC. How should the
nurse translate this result?
a.
Conductive hearing loss
b.
Sensorineural hearing loss
c.
Normal hearing
d.
Cochlear defect
10. A patient undergoing a Weber test says that the sound is louder in her left ear. What should
this result indicate?
a.
Normal hearing
b.
Nerve damage from listening to loud music
c.
Blocked ear canal in the right ear
d.
Conductive hearing loss in the left ear
11. Which instruction should a nurse include when providing patient teaching information for a
patient who will be self-administering ear drops for an ear infection?
a.
Tip the affected ear up and keep it in that position for several minutes after
instilling the medication.
b.
Keep the medication in the refrigerator to preserve it. Instill the medication with
the affected ear tilted upward.
c.
Touch the dropper to the opening of the ear canal to ensure that the drops are
correctly instilled.
d.
Warm the ear drops and then tilt the head downward.
12. What nursing action should be implemented when irrigating a patient’s ear?
a.
Straighten the ear canal and irrigate with a large-tipped bulb syringe.
b.
Direct the solution to the middle of the canal to avoid damaging the ear.
c.
Use a body temperature solution and have the patient hold a basin under the ear
while directing the solution toward the top of the canal.
d.
Repeat the irrigation with hotter water.
13. A nursing report on a newly admitted patient who is profoundly deaf says that the patient is
confused and difficult to assess because she does not appropriately respond to questions or
sometimes fails to respond at all. What should be the first action of the oncoming nurse?
a.
Consider asking the physician to assess the patient for dementia.
b.
Assess the patient to determine whether her hearing aids are in.
c.
Report to the physician that the patient is exhibiting signs of the sundown
syndrome.
d.
Assess the patient’s medications to check for an overdose.
14. Which nursing diagnosis is most appropriate for a patient having ear surgery?
a.
Disturbed body image
b.
Risk for injury
c.
Acute confusion
d.
Ineffective protection
15. What significant instruction should a nurse include to a patient being discharged after ear
surgery?
a.
Use stool softeners with caution.
b.
Assume your usual activities.
c.
Avoid blowing your nose.
d.
Shampoo your hair with baby shampoo.
16. A patient with diabetes says that he needs a hearing aid because he cannot hear well, and
everything sounds garbled and distant. What type of hearing loss should the nurse suspect?
a.
Mixed hearing loss
b.
Conductive hearing loss
c.
Central hearing loss
d.
Sensorineural hearing loss
17. Which nursing diagnosis should take priority in a nursing care plan for a patient with Ménière
disease?
a.
Social isolation, related to anxiety
b.
Risk for injury, related to falls
c.
Risk for deficient fluid intake, related to weakness
d.
Nutrition: Less than body requirements, related to fatigue
18. Which nursing diagnosis is most appropriate when considering the impact of a hearing deficit
when planning care for a child who has been diagnosed with a hearing impairment?
a.
Risk for injury, related to hearing impairment
b.
Risk for social isolation, related to hearing impairment
c.
Knowledge deficit, related to hearing impairment
d.
Anxiety, related to hearing impairment
19. What information should a nurse stress when teaching a patient with Ménière disease about
managing the disorder?
a.
Limiting fluid intake
b.
Avoiding the use of alcohol and tobacco
c.
Using antiemetic medications sparingly
d.
Staying active during the day
20. An 85-year-old patient has had age-related changes in the cochlea. What is the most
appropriate nursing action for the nurse to implement?
a.
Speak slowly.
b.
Provide assistance with ambulation.
c.
Speak in a lower tone.
d.
Communicate with the patient in writing.
21. A patient comes to the primary care clinic complaining of a head cold and ear pain with
drainage. What should the nurse suspect this patient is experiencing?
a.
Otitis externa
b.
Hearing loss
c.
Acute otitis media
d.
Mastoiditis
22. A young woman being admitted to the clinic service states that all the members of her family
have been hard of hearing. She says her hearing loss became more pronounced when she was
pregnant. What term explains this type of hearing loss?
a.
Otosclerosis
b.
Ototoxicity
c.
Otalgia
d.
Otitis media
23. What should a nurse include when educating a patient with Ménière disease?
a.
“When you feel dizzy, just stay in bed and take your medications.”
b.
“Decrease your sodium intake and take your diuretic medication between attacks.”
c.
“Vestibular rehabilitation might help, and you can still drink your morning coffee.”
d.
“Your vertigo will get better if you take your medications. You won’t need any
relaxation techniques.”
24. A 75-year-old patient reports having difficulty hearing in crowds but can hear just fine at
home with his wife. What hearing disorder should the nurse suspect?
a.
Otitis media
b.
Presbycusis
c.
Ototoxicity
d.
Central deafness
25. During an intake physical examination, a patient reports that he has been taking 10 aspirin
tablets a day for his arthritis. What question should the nurse ask based on this information?
a.
“Can you hear high-pitched sounds?”
b.
“Have you noticed deafness in just one ear?”
c.
“Do you have ringing in your ears?”
d.
“Do you experience dizziness when you stand?”
MULTIPLE RESPONSE
26. Which patient behaviors should alert a nurse to a possible hearing deficit? (Select all that
apply.)
a.
Watches the speaker’s mouth
b.
Gives inappropriate answers to questions
c.
Pulls at the ears
d.
Fails to respond when spoken to
e.
Turns the good ear to the speaker
27. Which common characteristics might a patient with conductive hearing loss display? (Select
all that apply.)
a.
Hears adequately in noisy settings
b.
Hears sounds but has difficulty understanding speech
c.
Has improved hearing with hearing aids
d.
Has a history of diabetes mellitus
e.
Speaks in a normal volume
28. A patient complains that his hearing aid is not working. What actions should a nurse
implement to assess the device? (Select all that apply.)
a.
Check to see if the device is turned on.
b.
Clean the earpiece and remove cerumen clogged in the vent.
c.
Open the earpiece to see if the microphone wire is connected.
d.
Examine the interior of the earpiece for water.
e.
Validate that the battery is correctly placed.
COMPLETION
29. When planning care for a patient who cannot perceive or interpret sounds, a nurse takes into
consideration that the patient may have a(n) _____ hearing loss.
OTHER
30. A nurse uses a diagram to show the physiologic sequence of hearing. After entering the
external ear, the sound is then conducted through the (Arrange the options in sequence.
Separate letters by a comma and space as follows: A, B, C, D.)
A. tympanic membrane
B. sensory receptors
C. oval window
D. acoustic nerve to the brain
E. malleus, incus, and stapes