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The nurse is teaching a class on diseases of the ear. What would the nurse teach the class is the most characteristic symptom of otosclerosis?
- A. The client being distressed in the mornings
- B. A progressive, bilateral loss of hearing
- C. A red and swollen ear drum
- D. The client describing a recent upper respiratory infection
Correct Answer: B
Rationale: A progressive, bilateral loss of hearing is the characteristic symptom of otosclerosis. Tinnitus appears as the loss of hearing progresses; it is especially noticeable at night, when surroundings are quiet, and may be quite distressing to the client. The eardrum appears pinkish-orange from structural changes in the middle ear. The client often describes a history of having had a recent upper respiratory infection in case of otitis media, not otosclerosis.
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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.
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.
Which symptom reported by a client would the nurse relate to a tentative diagnosis of objective vertigo?
- A. Frequency of a headache
- B. Pain in the outer ear
- C. Hearing ability fluctuations
- D. A sensation of things moving
Correct Answer: D
Rationale: Objective vertigo includes the sensation that the environment is moving or a sense that things are moving around oneself. The symptoms do not include a headache, pain in the outer ear, or difficulty hearing.
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.
A client comes to the walk-in clinic reporting feeling a 'bug in my ear.' What action should be taken when there is an insect in the ear?
- A. Instillation of mineral oil
- B. Instillation of carbamide peroxide
- C. Instillation of hot water
- D. Use of a small forceps
Correct Answer: A
Rationale: Mineral oil is instilled into the ear to smother an insect. Carbamide peroxide is used to soften dried cerumen, and small forceps are used to remove solid objects. Hot liquids cause dizziness and should not be instilled in the ear.