Nokea
The nurse is instructing a client on the benefits of a cochlear implant. The client asks, 'How am I able to interpret sound?' The nurse credits which of the following as significant in the production of hearing?
- A. External microphone
- B. Internal processor
- C. Amplifier
- D. Auditory nerve
Correct Answer: D
Rationale: The nurse credits stimulation of the auditory nerve in the transmission of the electrical signals to the brain for interpretation. The external processor and internal processor bring the sounds from the environment and send them to the internal processor, which converts to the electrical signal. An amplifier is used with typical hearing aids.
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A nurse anticipates that an 8-year-old client has otitis externa from symptoms stated on the history. Which symptom(s), from the history and physical examination, would confirm the diagnosis? Select all that apply.
- A. Discomfort in the ear
- B. Redness of the ear canal
- C. Pus noted in the ear canal
- D. Conductive hearing loss
- E. Tympanic membrane may appear normal
Correct Answer: A,B,C,D,E
Rationale: The diagnosis of otitis externa (inflammation of the tissue of the outer ear) is confirmed by reports of pain, discharge from the external auditory canal, aural tenderness (usually not present in middle ear infections), and occasionally fever, cellulitis, and lymphadenopathy. Other symptoms may include pruritus and conductive hearing loss or a feeling of fullness in the ear. On otoscopic examination, the ear canal is erythematous and edematous. Discharge may be yellow or green and foul smelling. In fungal infections, hairlike black spores may be visible.
The nurse is instructing a client's family members on the most incapacitating symptom of M?©ni?¨re disease. Which nursing instruction associated with the symptom is most helpful?
- A. Assist the client when ambulating.
- B. Keep a bucket beside the bed.
- C. Ensure low lighting in the room.
- D. Sit in front of the client when speaking.
Correct Answer: A
Rationale: The most incapacitating symptom of M?©ni?¨re disease is vertigo. When the client is experiencing vertigo or dizziness, gait becomes unsteady. Having a person assist the client when ambulating is most helpful in preventing falls. Keeping a bucket at the bedside is helpful if the client is experiencing nausea. Photophobia is not a main symptom of M?©ni?¨re disease. If the client experiences hearing loss, being able to see the nurse's lips may be helpful.
The nurse is caring for a client who is post-stapedectomy. What would the nurse include in the nursing care?
- A. Place the client on the operative side.
- B. Keep the affected ear packed with cotton.
- C. Encourage the client to exercise within 24 hours.
- D. Assess the facial nerve.
Correct Answer: D
Rationale: After surgery, the nurse positions the client on the nonoperative side and takes care to prevent dislodgment of the prosthesis as a result of coughing, sneezing, or vomiting. Nausea and dizziness are common problems. The nurse assesses facial nerve function by checking symmetry when the client smiles or frowns. The nurse does not keep the ear packed with cotton or encourage the client to exercise.
The occupational nurse is advising a client on options to enhance workplace communication because the client has progressive hearing loss. The client works as a customer service representative. In discussing the options with the client, which type would be the last option offered by the nurse?
- A. Battery-operated hearing aid
- B. American sign language
- C. Headsets with amplifiers
- D. Text-based telecommunications
Correct Answer: B
Rationale: Although American sign language is an asset to use for communication, a client with an occupation of customer service representative needs accommodations to be able to understand the spoken word.
The nurse is caring for a client with symptoms of ototoxicity from aminoglycoside administration. On which structure does the medication produce the ototoxic effect?
- A. The auditory canal
- B. The eighth cranial nerve
- C. The tympanic membrane
- D. The cochlear nerve
Correct Answer: B
Rationale: Ototoxicity describes the detrimental effect of aminoglycosides on the eighth cranial nerve. Signs and symptoms include tinnitus and sensorineural bearing. The other options are not related to the ototoxic effects.