ch 48 Assessment and Care of Patients with Ear and Hearing Problems

Descripción

ch 48 Assessment and Care of Patients with Ear and Hearing Problems Test sobre ch 48 Assessment and Care of Patients with Ear and Hearing Problems, creado por Megan Pattenaude el 08/04/2019.
Megan Pattenaude
Test por Megan Pattenaude, actualizado hace más de 1 año
Megan Pattenaude
Creado por Megan Pattenaude hace más de 5 años
28
1

Resumen del Recurso

Pregunta 1

Pregunta
A nurse is teaching a client about ear hygiene and health. What client statement indicates a need for further teaching?
Respuesta
  • A soft cotton swab is alright to clean my ears with
  • I make sure my ears are dry after I go swimming
  • Keeping my diabetes under control helps my ears

Pregunta 2

Pregunta
The student nurse is performing a Weber tuning fork test. What technique is most appropriate?
Respuesta
  • Holding the vibrating tuning fork 10 to 12 inches from the clients ear
  • Placing the vibrating fork in the middle of the clients head
  • Starting by placing the vibrating fork on the mastoid process

Pregunta 3

Pregunta
The clients chart indicates a sensorineural hearing loss. What assessment question does the nurse ask to determine the possible cause?
Respuesta
  • Do you feel like something is in your ear?
  • Do you have frequent ear infections?
  • Have you been exposed to loud noises?

Pregunta 4

Pregunta
The nurse works with clients who have hearing problems. Which action by a client best indicates goals for an important diagnosis have been met?
Respuesta
  • Babysitting the grandchildren several times a week
  • Having an adaptive hearing device for the television
  • Being active in community events and volunteer work

Pregunta 5

Pregunta
A client has external otitis. On what comfort measure does the nurse instruct the client?
Respuesta
  • Applying ice four times a day
  • Instilling vinegar-and-water drops
  • Use of a heating pad to the ear

Pregunta 6

Pregunta
An older adult in the family practice clinic reports a decrease in hearing over a week. What action by the nurse is most appropriate?
Respuesta
  • Assess for cerumen buildup
  • Facilitate audiological testing.
  • Perform tuning fork tests.

Pregunta 7

Pregunta
. A client had a myringotomy. The nurse provides which discharge teaching?
Respuesta
  • Buy dry shampoo to use for a week.
  • Drink liquids through a straw.
  • Hot water showers will help the pain.

Pregunta 8

Pregunta
A client is going on a cruise but has had motion sickness in the past. What suggestion does the nurse make to this client?
Respuesta
  • Avoid alcohol on the cruise ship.
  • Change positions slowly on the ship.
  • Try scopolamine (Transderm Scop).

Pregunta 9

Pregunta
A nurse is teaching a community group about noise-induced hearing loss. Which client who does not use ear protection should the nurse refer to an audiologist as the priority?
Respuesta
  • Client with an hour car commute on the freeway each day
  • Client who rides a motorcycle to work 20 minutes each way
  • Client who is a tree-trimmer and uses a chainsaw 6 to 7 hours a day

Pregunta 10

Pregunta
A nursing student is instructed to remove a clients ear packing and instill eardrops. What action by the student requires intervention by the registered nurse?
Respuesta
  • Assessing the eardrum with an otoscope
  • Inserting a cotton ball in the ear after the drops
  • Washing the hands and removing the packing

Pregunta 11

Pregunta
A nurse is irrigating a clients ear when the client becomes nauseated. What action by the nurse is most appropriate for client comfort?
Respuesta
  • Have the client tilt the head back.
  • Re-position the client on the other side.
  • Stop the irrigation immediately

Pregunta 12

Pregunta
A client hospitalized for a wound infection has a blood urea nitrogen of 45 mg/dL and creatinine of 4.2 mg/dL. What action by the nurse is best? a
Respuesta
  • Assess the ordered antibiotics for ototoxicity
  • Explain how kidney damage causes hearing loss
  • Use ibuprofen (Motrin) for pain control

Pregunta 13

Pregunta
A nurse is teaching a community group about preventing hearing loss. What instruction is best?
Respuesta
  • Always wear a bicycle helmet.
  • Avoid swimming in ponds or lakes
  • Dont go to fireworks displays.

Pregunta 14

Pregunta
A client has severe tinnitus that cannot be treated adequately. What action by the nurse is best?
Respuesta
  • Advise the client to take antianxiety medication.
  • Educate the client on nerve cutting procedures.
  • Refer the client to online or local support groups.

Pregunta 15

Pregunta
A client has labyrinthitis and is prescribed antibiotics. What instruction by the nurse is most important for this client?
Respuesta
  • Immediately report headache or stiff neck
  • Keep all follow-up appointments
  • Take the antibiotics with a full glass of water.

Pregunta 16

Pregunta
A client with Menires disease is in the hospital when the client has an attack of this disorder. What action by the nurse takes priority?
Respuesta
  • Assess vital signs every 15 minutes.
  • Dim or turn off lights in the clients room.
  • Place the client in bed with the upper siderails up

Pregunta 17

Pregunta
A client is scheduled to have a tumor of the middle ear removed. What teaching topic is most important for the nurse to cover?
Respuesta
  • Expecting hearing loss in the affected ear
  • Managing postoperative pain
  • Maintaining NPO status prior to surgery

Pregunta 18

Pregunta
A nursing student studying the auditory system learns about the structures of the inner ear. What structures does this include?
Respuesta
  • Cochlea
  • Epitympanum
  • Organ of Corti
  • Semicircular canals
  • Vestibule

Pregunta 19

Pregunta
A client has Menires disease with frequent attacks. About what drugs does the nurse plan to teach the client?
Respuesta
  • Broad-spectrum antibiotics
  • Chlorpromazine hydrochloride (Thorazine)
  • Diphenhydramine (Benadryl)
  • Meclizine (Antivert)
  • Nonsteroidal anti-inflammatory drugs (NSAIDs)

Pregunta 20

Pregunta
A client is scheduled for a tympanoplasty. What actions by the nurse are most appropriate?
Respuesta
  • Administer preoperative antibiotics
  • Assess for allergies to local anesthetics
  • Ensure that informed consent is on the chart
  • Give ordered antivertigo medications
  • Teach that hearing improves immediately. ANS: A, C Preoperatively, the nurs

Pregunta 21

Pregunta
A client has a hearing aid. What care instructions does the nurse provide the unlicensed assistive personnel (UAP) in the care of this client? (Select all that apply.
Respuesta
  • Be careful not to drop the hearing aid when handling
  • Soak the hearing aid in hot water for 20 minutes.
  • Turn the hearing aid off when the client goes to bed.
  • Use a toothpick to clean debris from the device.
  • Wash the device with soap and a small amount of warm water.

Pregunta 22

Pregunta
A hospitalized client has Mnires disease. What menu selections demonstrate good knowledge of the recommended diet for this disorder?
Respuesta
  • Chinese stir fry with vegetables
  • Broiled chicken breast
  • Chocolate espresso cookies
  • Deli turkey sandwich and chips
  • Green herbal tea with meals

Pregunta 23

Pregunta
A client is scheduled for a stapedectomy in 2 weeks. What teaching instructions are most appropriate?
Respuesta
  • Avoid alcohol use before surgery
  • Blow the nose gently if needed
  • Clean the telephone often
  • Sneeze with the mouth open
  • Wash the external ear daily

Pregunta 24

Pregunta
A client is admitted to the nursing unit after having a tympanoplasty. What activities does the nurse delegate to the unlicensed assistive personnel (UAP)?
Respuesta
  • Administer prescribed antibiotics.
  • Keep the head of the clients bed flat
  • Remind the client to lie on the operative side
  • Remove the iodoform gauze in 8 hours
  • Take and record postoperative vital signs.
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