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A hospitalized client has Ménière's disease. What menu selections demonstrate good knowledge of the recommended diet for this disorder? (Select all that apply.)
- A. Chinese stir fry with vegetables.
- B. Broiled chicken breast.
- C. Chocolate espresso cookies.
- D. Chili with tortilla chips.
- E. Green herbal tea with meals.
Correct Answer: B,E
Rationale: The diet recommendations for Ménière's disease include low-sodium, caffeine-free foods and fluids distributed evenly throughout the day. Plenty of water is also needed. The broiled chicken breast and herbal tea are the best selections. The stir fry is high in sodium and possibly monosodium glutamate (MSG, also not recommended). The cookies and chili with tortilla chips are high in sodium.
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During ear irrigation, what action should the nurse take if the client becomes nauseated?
- A. Continue the procedure slowly.
- B. Stop the procedure immediately.
- C. Administer an antiemetic medication.
- D. Encourage the client to breathe deeply.
Correct Answer: B
Rationale: During ear irrigation, if the client becomes nauseated, the nurse should stop the procedure immediately to prevent further discomfort or complications. The other options are not appropriate in this context.
The nurse works with clients who have hearing problems. Which action by a client best indicates goals for an important diagnosis have been met?
- A. Babysitting the grandchildren several times a week
- B. Having an adaptive hearing device for the television
- C. Being active in community groups and volunteer work
- D. Responding agreeably to suggestions for adaptive devices
Correct Answer: C
Rationale: Clients with hearing problems can become frustrated and withdrawn.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 being actively engaged outside the home. Responding agreeably does not indicate the client will actually follow through.
A client with Ménière's disease is in the hospital when the client has an attack of this disorder. What action by the nurse takes priority?
- A. Assess vital signs every 15 minutes.
- B. Dim or turn off lights in the client's room.
- C. Place the client in bed with the upper siderails up.
- D. Provide a cool, wet cloth for the client's face.
Correct Answer: C
Rationale: Clients with Ménière's disease can have vertigo so severe that they can fall. The nurse should assist the client into bed and raise the upper siderails to prevent falls due to the intense whirling feeling. The other actions are not warranted for clients with Ménière's disease.
A client has external otitis. On what comfort measure does the nurse instruct the client?
- A. Applying ice four times a day
- B. Instilling vinegar-and-water drops
- C. Using a home humidifier
- D. Wearing ear plugs during sleep
Correct Answer: C
Rationale: A heating pad on low or a warm moist pack can provide comfort to the client with otitis externa. The other options are not warranted.
A client is scheduled to have a tumor of the middle ear removed. What teaching topic is most important for the nurse to cover?
- A. Expecting hearing loss in the affected ear
- B. Managing postoperative pain
- C. Ensuring proper wound care
- D. Understanding which medications are allowed the day of surgery
Correct Answer: A
Rationale: Removal of an inner ear tumor will likely destroy hearing in the affected ear. The other teaching topics are appropriate for any surgical client but are not the most critical in this case.