Nokea
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.
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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Rationale: Clients with hearing problems can become frustrated and withdrawn.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 has Ménière's disease with frequent attacks. About what drugs does the nurse plan to teach the client? (Select all that apply.)
- A. Broad-spectrum antibiotics
- B. Chlorpromazine hydrochloride (Thorazine)
- C. Diphenhydramine (Benadryl)
- D. Meclizine (Antivert)
- E. Nonsteroidal anti-inflammatory drug (NSAID)
Correct Answer: B,C,D
Rationale: Drugs such as chlorpromazine, diphenhydramine, and meclizine can all be used to treat Ménière's disease. Antibiotics and NSAIDs are not used.
A nursing student studying the auditory system learns about the structures of the inner ear. What structures does this include? (Select all that apply.)
- A. Cochlea
- B. Epitympanum
- C. Organ of Corti
- D. Semicircular canals
- E. Vestibule
Correct Answer: A,C,D,E
Rationale: The cochlea, organ of Corti, semicircular canals, and vestibule are all part of the inner ear. The epitympanum is in the middle ear.
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.
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.