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The nurse is obtaining a history from a client who indicates hearing loss due to drug toxicity. Which type of hearing loss is noted?
- A. Conductive
- B. Sensorineural
- C. Mixed
- D. Central
Correct Answer: B
Rationale: Sensorineural hearing loss involves damage to the inner ear from etiologies including drug toxicity. Conductive hearing loss occurs from an obstruction in the middle to outer ear. Mixed hearing loss includes a combination of conductive and sensorineural hearing loss. Central hearing loss involves injury or damage to the nerves or the nuclei of the central nervous system.
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The nurse is obtaining subjective data from a client with difficulty hearing. What should the nurse do to facilitate communication with the client? Select all that apply.
- A. Speak clearly at a normal pace.
- B. Avoid gesturing.
- C. Ensure there is adequate natural or artificial light.
- D. Exaggerate pronunciations.
- E. Promote a clear image of the nurse's mouth.
- F. Face the client when speaking.
Correct Answer: A,C,E,F
Rationale: In order to facilitate communication with the client with difficulty hearing, the nurse should speak clearly at a normal pace, ensure there is adequate natural or artificial light, promote a clear image of the nurse's mouth, and face the client when speaking. The nurse should use gestures and facial expressions to enhance what is being said orally. The nurse should not exaggerate pronunciations.
A nursing student is presenting a report on M?©ni?¨re disease to other members of the class. What symptom would the student list?
- A. Pinkish-orange eardrum
- B. Nystagmus of the eyes
- C. Enlarged lymph nodes behind the ear
- D. Swelling and redness in the auditory canal
Correct Answer: B
Rationale: Nystagmus of the eyes may occur in a client with M?©ni?¨re disease caused by an imbalance in vestibular control of eye movements. Pinkish-orange eardrums, enlarged lymph nodes, or swelling and redness in the auditory canal are not observed in a client with M?©ni?¨re disease.
The nurse is evaluating the independent care of a client recovering from a stapedectomy. Which action made by the client indicates a need for further teaching?
- A. The client turns head slowly when family approaches.
- B. The client uses clean technique to clean the wound.
- C. The client takes antibiotics on schedule
- D. The client asks for assistance upon ambulation.
Correct Answer: B
Rationale: The client needs further instructions on using aseptic technique when completing wound care. Using aseptic technique reduces the introduction and transmission of microorganisms and protects the client from introduction of pathogens. The other options are appropriate actions for the client recovering from a stapedectomy to take.
What aspect should the nurse closely monitor for in clients who have been administered salicylates, loop diuretics, quinidine, quinine, or aminoglycosides?
- A. Signs of hypotension
- B. Reduced urinary output
- C. Tinnitus and sensorineural hearing loss
- D. Impaired facial movement
Correct Answer: C
Rationale: It is important that nurses are knowledgeable about the ototoxic effects of certain medications such as salicylates, loop diuretics, quinidine, quinine, and aminoglycosides. Signs and symptoms of ototoxicity include tinnitus and sensorineural hearing loss. Hypotension, reduced urinary output, and impaired facial movement are not signs of ototoxicity.
The nurse, employed in an ear, nose, and throat (ENT) physician's office, is obtaining a client history. The nurse documents the client's statements. Which symptom(s) may indicate a diagnosis of otosclerosis? Select all that apply.
- A. It seems that I increasingly could not hear my kids talk to me.'
- B. I woke up on Monday and had ear pain with a marked decrease in hearing.'
- C. I now notice a ringing in my ears especially when I lay down to sleep at night.'
- D. I can hear better when someone speaks in low tones.'
- E. I can hear best when you put the tuning fork behind my ear.'
Correct Answer: A,C,E
Rationale: Although the cause of otosclerosis is unknown, there are specific symptoms because of the interference of the vibrations in the ear. The symptoms of diagnosis of otosclerosis include a progressive, bilateral hearing loss; tinnitus especially noted at night; and the outcome of the Rinne test as being that sound is heard best with the tuning fork behind the ear. The nurse would not identify an abrupt onset of hearing loss or improvement of hearing in low tones.