Nokea
The nurse is instructing the client with dried cerumen blocking the ear canal on potential methods to reduce symptoms. Which at-home methods of cerumen removal are discouraged?
- A. Instilling 1 to 2 drops of half-strength peroxide in the ear
- B. Using warm glycerin or mineral oil to soften the cerumen
- C. Removing the cerumen by means of a cotton tip applicator
- D. Irrigating the ear with warm water and a rubber-bulb syringe
Correct Answer: C
Rationale: The nurse is an important resource person to consult when a client has an issue with the ear structure or hearing. The nurse is correct to discourage placing anything down the ear canal that could push the cerumen deeper toward or puncture the tympanic membrane. The other options are appropriate to soften and lubricate the cerumen or to irrigate the cerumen from the ear.
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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 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.
The nurse is supervising a family member who is instilling ear drops into the client's ear. Which of the following statements, made by the family member, would prompt further nursing instruction?
- A. Turn your head to the side so I can put these drops in.
- B. These drops are cold from being on the windowsill.
- C. Let me put this cotton ball in your ear because I put the drop in.
- D. I squeeze the dropper to put a drop of medicine in the ear.
Correct Answer: B
Rationale: When the family member states that the drops are cold, the nurse would encourage the family member to place the bottle in a warm bath or warm the bottle in their hands. Cold or hot liquids, instilled in the ear, may cause dizziness and potential for injury.
A nursing instructor is teaching pre-nursing students in a pathophysiology class. What would the instructor teach the students about M?©ni?¨re disease?
- A. It is referred to as endolymphatic hydrops.
- B. It originates in the middle ear.
- C. It is referred to as lymphatic hydrops.
- D. It originates in the outer ear.
Correct Answer: A
Rationale: When a person moves the head, the endolymph also moves, and nerve receptors within the membranous labyrinth send signals to the brain about the movement. In M?©ni?¨re disease, an increase in endolymph causes the membranous labyrinth to dilate like a balloon; this is referred to as endolymphatic hydrops. M?©ni?¨re disease does not originate in either the middle or the outer ear, and it is not referred to as lymphatic hydrops.
The nurse on a cruise ship is assessing clients for motion sickness. Which is a common misconception regarding motion sickness?
- A. Repeated motion is the cause.
- B. Once symptoms occur, they will always be present.
- C. Medications help the symptoms.
- D. Pallor and diaphoresis is a first symptom.
Correct Answer: B
Rationale: When the client experiences motion sickness, the client will use that data to avoid further symptoms in the future. The client can use medication, change location or position, and recognize symptoms earlier for symptom management. The other options are correct and teachable statements.