Chapter 48: Assessment and Care of Patients with Ear and Hearing Problems

Chapter 48: Assessment and Care of Patients with Ear and Hearing Problems

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE

1. A nurse is teaching a client about ear hygiene and health. What client statement indicates a need for further teaching?
   1. “A soft cotton swab is alright to clean my ears with.”
   2. “I make sure my ears are dry after I go swimming.”
   3. “I use good earplugs when I practice with the band.”
   4. “Keeping my diabetes under control helps my ears.”

ANS:   A

Clients should be taught not to put anything larger than their fingertip into their ears. Using a cotton swab, although soft, can cause damage to the ears and cerumen buildup. The other statements are accurate.

DIF:     Evaluating/Synthesis                          REF: 1005                   KEY: Auditory system| auditory assessment                                                                   MSC:             Integrated Process: Nursing Process: Evaluation                                         NOT: Client Needs Category: Health Promotion and Maintenance

2. The student nurse is performing a Weber tuning fork test. What technique is most appropriate?
   1. Holding the vibrating tuning fork 10 to 12 inches from the client’s ear
   2. Placing the vibrating fork in the middle of the client’s head
   3. Starting by placing the vibrating fork on the mastoid process
   4. Tapping the vibrating tuning fork against the bridge of the nose

ANS:   B

The Weber tuning fork test includes placing the vibrating tuning fork in the middle of the client’s head and asking in which ear the client hears the vibrations louder. The other techniques are incorrect.

DIF:     Applying/Application                         REF: 1001                   KEY: Auditory system| auditory assessment                                                                   MSC:             Integrated Process: Nursing Process: Assessment                                       NOT: Client Needs Category: Physiological Integrity: Reduction of Risk Potential

3. The client’s chart indicates a sensorineural hearing loss. What assessment question does the nurse ask to determine the possible cause?
   1. “Do you feel like something is in your ear?”
   2. “Do you have frequent ear infections?”
   3. “Have you been exposed to loud noises?”
   4. “Have you been told your ear bones don’t move?”

ANS:   C

Sensorineural hearing loss can occur from damage to the cochlea, the eighth cranial nerve, or the brain. Exposure to loud music is one etiology. The other questions relate to conductive hearing loss.

DIF:            Remembering/Knowledge                 REF:    1001                 KEY: Auditory system| auditory assessment| auditory disorders  MSC:                   Integrated Process: Nursing Process: Assessment      NOT:          Client Needs Category: Physiological Integrity: Reduction of Risk Potential

4. The nurse works with clients who have hearing problems. Which action by a client best indicates goals for an important diagnosis have been met?
   1. Babysitting the grandchildren several times a week
   2. Having an adaptive hearing device for the television
   3. Being active in community events and volunteer work
   4. Responding agreeably to suggestions for adaptive devices

ANS:           C

Clients with hearing problems can become frustrated and withdrawn. The client who is actively engaged in the community shows the best evidence of psychosocial adjustment to hearing loss. Babysitting the grandchildren is a positive sign but does not indicate involvement outside the home. Having an adaptive device is not the same as using it, and watching TV without evidence of other activities can also indicate social isolation. Responding agreeably does not indicate the client will actually follow through.

DIF:            Evaluating/Synthesis                          REF:    1002

KEY:          Auditory system| auditory disorders| psychosocial response| coping

MSC:          Integrated Process: Nursing Process: Evaluation

NOT:          Client Needs Category: Psychosocial Integrity