Nokea
A nurse is teaching a client about ear hygiene and health. What client statement indicates a need for further teaching?
- A. A soft cotton swab is alright to clean my ears with.
- B. I make sure my ears are dry after I go swimming.
- C. I stop good ear plugs when I practice with the band.
- D. Keeping my diabetes under control helps my ears.
Correct Answer: A
Rationale: 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.
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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?
- A. Client with an hour car commute on the freeway each day.
- B. Client who rides a motorcycle daily.
- C. Client who sat in the back at a rock concert recently.
- D. Client who uses a chainsaw for 6 to 7 hours a day.
Correct Answer: D
Rationale: A chainsaw becomes dangerous to hearing after 2 hours of exposure without hearing protection. This client needs to be referred as the priority. Normal car traffic is safe for longer than 2 hours. Motorcycle noise is safe for about 8 hours. The safe exposure time for a front-row rock concert seat is 3 minutes, but this client was in the back, and so had less exposure. In addition, a one-time exposure is less damaging than chronic exposure.
A client with labyrinthitis is prescribed antibiotics. What instruction is most important for the nurse to include?
- A. Immediately report headache or stiff neck.
- B. Keep all follow-up appointments.
- C. Take the antibiotics with a full glass of water.
- D. Take the antibiotic on an empty stomach.
Correct Answer: A
Rationale: Meningitis is a complication of labyrinthitis. The client should be taught to take all antibiotics as prescribed and to report manifestations of meningitis such as fever, headache, or stiff neck. Keeping follow-up appointments is important for all clients. Without knowing what antibiotic was prescribed, the nurse cannot instruct the client on how to take it.
A client is scheduled for a stapedectomy in 2 weeks. What teaching instructions are most appropriate? (Select all that apply.)
- A. Avoid alcohol use before surgery.
- B. Blow the nose gently if needed.
- C. Use ear drops daily to prevent infection.
- D. Stop taking aspirin 1 week before surgery.
- E. Keep the ear dry after surgery.
Correct Answer: B,D,E
Rationale: Clients undergoing a stapedectomy should blow the nose gently if needed, stop taking aspirin 1 week before surgery to reduce bleeding risk, and keep the ear dry after surgery to prevent infection. Avoiding alcohol is not specific to this surgery, and prophylactic ear drops are not typically required.
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?
- A. Assessing the eardrum with an otoscope.
- B. Warming the eardrops in water for 5 minutes.
- C. Using a cotton swab to clean the ear canal.
- D. Instilling eardrops at room temperature.
Correct Answer: A
Rationale: Assessing the eardrum with an otoscope requires specialized training and is not within the scope of a nursing student. Warming eardrops and instilling them at room temperature are appropriate. Using a cotton swab is not ideal but does not require immediate intervention.
The student nurse is performing a Weber tuning fork test. What technique is most appropriate?
- A. Holding the vibrating tuning fork 10 to 12 inches from the clients ear
- B. Placing the vibrating fork in the middle of the clients head
- C. Placing the vibrating fork in the middle of the clients head
- D. Tapping the vibrating tuning fork against the bridge of the nose
Correct Answer: B
Rationale: The Weber tuning fork test involves placing the vibrating tuning fork in the middle of the client's head and asking in which ear the client hears the vibrations loudest. The other techniques are incorrect.