Chapter 63 Medical Surgical Nursing 2nd Edition By Osborn Wraa Watson

Chapter 63 Medical Surgical Nursing 2nd Edition By Osborn Wraa Watson

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

A patient is admitted with a ruptured tympanic membrane (TM). This may result in a hearing loss due to the disruption of which function of the TM?

1. Separating the outer and inner ear
2. Vibrating with sound waves
3. Covering the eustachian tube
4. Covering the mastoid process

Correct Answer: 2

Rationale 1: The tympanic membrane separates the outer and middle ear, not the outer and inner ear.

Rationale 2: The TM vibrates in response to sound waves. If the TM is perforated, vibration is diminished.

Rationale 3: The tympanic membrane does not cover the eustachian tube, which connects with the middle ear.

Rationale 4: The mastoid process is part of the outer ear but is not covered by the TM.

Global Rationale:

 

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 63-1

 

Question 2

Type: MCSA

A patient complains of feeling “off balance.” The nurse should consider that the patient might have a disorder affecting which structure?

1. Organ of Corti
2. Vestibular system
3. Middle ear
4. Cochlea

Correct Answer: 2

Rationale 1: The organ of Corti is located in the cochlea, which is responsible for hearing.

Rationale 2: The vestibular system, which is part of the inner ear, is responsible for balance.

Rationale 3: The bones in the middle ear vibrate with sound and do not affect balance.

Rationale 4: The cochlea, which is located in the inner ear, is responsible for hearing.

Global Rationale:

 

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 63-1

 

Question 3

Type: MCSA

A diver is admitted complaining of ear pain and hearing loss. On examination, the nurse notes a rupture in the tympanic membrane. The nurse would conduct further assessment for which type of hearing loss?

1. Conductive hearing loss
2. Sensorineural hearing loss
3. Noise-induced hearing loss
4. Mixed hearing loss

Correct Answer: 1

Rationale 1: A rupture in the tympanic membrane interferes with sound conduction, so this is a conductive hearing loss.

Rationale 2: Sensorineural hearing loss occurs when the nerves of the inner ear are damaged. Another type of hearing loss is more likely.

Rationale 3: The most obvious reason for the perforation of this patient’s tympanic membrane is barotrauma from diving. There is no information to implicate noise as the etiology of this loss.

Rationale 4: There is no assessment data supporting sensorineural hearing loss, one of the components of mixed hearing loss.

Global Rationale:

 

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 63-2

 

Question 4

Type: MCSA

A patient is diagnosed with otosclerosis. The nurse plans interventions related to which type of hearing loss?

1. Sensorineural
2. Mixed
3. Conductive
4. Cochlear

Correct Answer: 3

Rationale 1: Sensorineural losses are caused by damage to auditory nerves or small hair cells in the inner ear. Otosclerosis is not associated with this type of damage.

Rationale 2: A mixed hearing loss refers to both a conductive and sensorineural loss at the same time. Otosclerosis is not associated with mixed hearing loss.

Rationale 3: A conductive hearing loss occurs when there is a problem conducting sound waves through the outer ear, tympanic membrane, or middle ear. Otosclerosis is a condition in which the structures of the ear begin to harden, which would interfere with their ability to vibrate.

Rationale 4: Cochlear does not describe a type of hearing loss.

Global Rationale:

 

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 63-2

 

Question 5

Type: MCSA

An older patient has been diagnosed with presbycusis. The nurse would plan interventions to address which kind of hearing loss that is a common result of aging?

1. Sensorineural
2. Air conduction
3. Conductive
4. Mixed

Correct Answer: 1

Rationale 1: Presbycusis is usually a sensorineural hearing disorder caused by gradual changes in the inner ear resulting from the loss of hair cells in the organ of Corti.

Rationale 2: Interference of air conduction is not the result of aging.

Rationale 3: Presbycusis is usually another type of hearing loss.

Rationale 4: Presbycusis is usually another type of hearing loss.

Global Rationale:

 

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 63-6