Test Bank - Lewis's Medical Surgical Nursing (11th Edition by Harding) 216
Chapter 21: Assessment and Management: Auditory Problems
Test Bank
MULTIPLE CHOICE
1. To decrease the risk for future hearing loss, which action should the nurse who is working with college
students at the on-campus health clinic implement?
a. Arrange to include otoscopic examinations for all patients.
b. Administer influenza immunizations to all students at the clinic.
c. Discuss the importance of limiting exposure to amplified music.
d. Perform tympanometry on all patients between the ages of 18 to 24.
ANS: C
The nurse should discuss the impact of amplified music on hearing with young adults and discourage listening
to very amplified music, especially for prolonged periods. Tympanometry measures the ability of the eardrum
to vibrate and would not help prevent future hearing loss. Although students are at risk for the influenza virus,
being vaccinated does not help prevent future hearing loss. Otoscopic examinations are not necessary for all
patients.
DIF: Cognitive Level: Apply (application)
TOP: Nursing Process: Implementation MSC: NCLEX: Health Promotion and Maintenance
2. A patient diagnosed with external otitis is being discharged from the emergency department with an ear
wick in place. Which statement by the patient indicates a need for further teaching?
a. I will apply the eardrops to the cotton wick in the ear canal.
b. I can use aspirin or acetaminophen (Tylenol) for pain relief.
c. I will clean the ear canal daily with a cotton-tipped applicator.
d. I can use warm compresses to the outside of the ear for comfort.
ANS: C
Insertion of instruments such as cotton-tipped applicators into the ear should be avoided. The other patient
statements indicate that the teaching has been successful.
DIF: Cognitive Level: Apply (application)
TOP: Nursing Process: Evaluation MSC: NCLEX: Physiological Integrity
3. A patient who has undergone a left tympanoplasty should be instructed to
,Test Bank - Lewis's Medical Surgical Nursing (11th Edition by Harding) 217
a. remain on bed rest.
b. keep the head elevated.
c. avoid blowing the nose.
d. irrigate the left ear canal.
ANS: C
Coughing or blowing the nose increases pressure in the eustachian tube and middle ear cavity and disrupts
postoperative healing. There is no postoperative need for prolonged bed rest, elevation of the head, or
continuous antibiotic irrigation.
DIF: Cognitive Level: Apply (application)
TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity
4. The nurse is assessing a patient who has recently been treated with amoxicillin for acute otitis media of the
right ear. Which finding is a priority to report to the health care provider?
a. The patient has a temperature of 100.6 F.
b. The patient complains of popping in the ear.
c. The patient frequently asks the nurse to repeat information.
d. The patient states that the right ear has a feeling of fullness.
ANS: A
The fever indicates that the infection may not be resolved and the patient might need further antibiotic therapy.
A feeling of fullness, popping of the ear, and decreased hearing are symptoms of otitis media with effusion.
These symptoms are normal for weeks to months after an episode of acute otitis media and usually resolve
without treatment.
DIF: Cognitive Level: Apply (application)
OBJ: Special Questions: Prioritization TOP: Nursing Process: Evaluation
MSC: NCLEX: Physiological Integrity
5. A 42-year-old woman with Meniere's disease is admitted with vertigo, nausea, and vomiting. Which nursing
intervention will be included in the care plan?
a. Dim the lights in the patients room.
b. Encourage increased oral fluid intake.
c. Change the patients position every 2 hours.
,Test Bank - Lewis's Medical Surgical Nursing (11th Edition by Harding) 218
d. Keep the head of the bed elevated 30 degrees.
ANS: A
A darkened, quiet room will decrease the symptoms of the acute attack of Meniere's disease. Because the
patient will be nauseated during an acute attack, fluids are administered IV. Position changes will cause vertigo
and nausea. The head of the bed can be positioned for patient comfort.
DIF: Cognitive Level: Apply (application)
TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity
6. Which statement by the patient to the home health nurse indicates a need for more teaching about self-
administering eardrops?
a. I will leave the ear wick in place while administering the drops.
b. I should lie down before and for 5 minutes after administering the drops.
c. I will hold the tip of the dropper above the ear while administering the drops.
d. I should keep the medication refrigerated until I am ready to administer the drops.
ANS: D
Administration of cold eardrops can cause dizziness because of stimulation of the semicircular canals. The
other patient actions are appropriate.
DIF: Cognitive Level: Apply (application)
TOP: Nursing Process: Evaluation MSC: NCLEX: Physiological Integrity
7. An 82-year-old patient who is being admitted to the hospital repeatedly asks the nurse to speak up so that I
can hear you. Which action should the nurse take?
a. Overenunciate while speaking.
b. Speak normally but more slowly.
c. Increase the volume when speaking.
d. Use more facial expressions when talking.
ANS: B
Patient understanding of the nurses speech will be enhanced by speaking at a normal tone, but more slowly.
Increasing the volume, overenunciating, and exaggerating facial expressions will not improve the patients
ability to comprehend the nurse.
DIF: Cognitive Level: Apply (application)
, Test Bank - Lewis's Medical Surgical Nursing (11th Edition by Harding) 219
TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity
8. A 75-year-old patient with presbycusis is fitted with binaural hearing aids. Which information will the nurse
include when teaching the patient how to use the hearing aids?
a. Experiment with volume and hearing ability in a quiet environment initially.
b. Keep the volume low on the hearing aids for the first week while adjusting to them.
c. Add a second hearing aid after making the initial adjustment to the first hearing aid.
d. Wear the hearing aids for about an hour a day at first, gradually increasing the time of use.
ANS: A
Initially the patient should use the hearing aids in a quiet environment like the home, experimenting with
increasing and decreasing the volume as needed. There is no need to gradually increase the time of wear. The
patient should experiment with the level of volume to find what works well in various situations. Both hearing
aids should be used.
DIF: Cognitive Level: Apply (application)
TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity
9. Which information will the nurse include for a patient contemplating a cochlear implant?
a. Cochlear implants require training in order to receive the full benefit.
b. Cochlear implants are not useful for patients with congenital deafness.
c. Cochlear implants are most helpful as an early intervention for presbycusis.
d. Cochlear implants improve hearing in patients with conductive hearing loss.
ANS: A
Extensive rehabilitation is required after cochlear implants in order for patients to receive the maximum
benefit. Hearing aids, rather than cochlear implants, are used initially for presbycusis. Cochlear implants are
used for sensorineural hearing loss and would not be helpful for conductive loss. They are appropriate for
some patients with congenital deafness.
DIF: Cognitive Level: Understand (comprehension)
TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity
10. Unlicensed assistive personnel (UAP) perform all the following actions when caring for a patient with
Meniere's disease who is experiencing an acute attack. Which action by UAP indicates that the nurse should
interveneimmediately?
a. UAP raise the side rails on the bed.
Chapter 21: Assessment and Management: Auditory Problems
Test Bank
MULTIPLE CHOICE
1. To decrease the risk for future hearing loss, which action should the nurse who is working with college
students at the on-campus health clinic implement?
a. Arrange to include otoscopic examinations for all patients.
b. Administer influenza immunizations to all students at the clinic.
c. Discuss the importance of limiting exposure to amplified music.
d. Perform tympanometry on all patients between the ages of 18 to 24.
ANS: C
The nurse should discuss the impact of amplified music on hearing with young adults and discourage listening
to very amplified music, especially for prolonged periods. Tympanometry measures the ability of the eardrum
to vibrate and would not help prevent future hearing loss. Although students are at risk for the influenza virus,
being vaccinated does not help prevent future hearing loss. Otoscopic examinations are not necessary for all
patients.
DIF: Cognitive Level: Apply (application)
TOP: Nursing Process: Implementation MSC: NCLEX: Health Promotion and Maintenance
2. A patient diagnosed with external otitis is being discharged from the emergency department with an ear
wick in place. Which statement by the patient indicates a need for further teaching?
a. I will apply the eardrops to the cotton wick in the ear canal.
b. I can use aspirin or acetaminophen (Tylenol) for pain relief.
c. I will clean the ear canal daily with a cotton-tipped applicator.
d. I can use warm compresses to the outside of the ear for comfort.
ANS: C
Insertion of instruments such as cotton-tipped applicators into the ear should be avoided. The other patient
statements indicate that the teaching has been successful.
DIF: Cognitive Level: Apply (application)
TOP: Nursing Process: Evaluation MSC: NCLEX: Physiological Integrity
3. A patient who has undergone a left tympanoplasty should be instructed to
,Test Bank - Lewis's Medical Surgical Nursing (11th Edition by Harding) 217
a. remain on bed rest.
b. keep the head elevated.
c. avoid blowing the nose.
d. irrigate the left ear canal.
ANS: C
Coughing or blowing the nose increases pressure in the eustachian tube and middle ear cavity and disrupts
postoperative healing. There is no postoperative need for prolonged bed rest, elevation of the head, or
continuous antibiotic irrigation.
DIF: Cognitive Level: Apply (application)
TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity
4. The nurse is assessing a patient who has recently been treated with amoxicillin for acute otitis media of the
right ear. Which finding is a priority to report to the health care provider?
a. The patient has a temperature of 100.6 F.
b. The patient complains of popping in the ear.
c. The patient frequently asks the nurse to repeat information.
d. The patient states that the right ear has a feeling of fullness.
ANS: A
The fever indicates that the infection may not be resolved and the patient might need further antibiotic therapy.
A feeling of fullness, popping of the ear, and decreased hearing are symptoms of otitis media with effusion.
These symptoms are normal for weeks to months after an episode of acute otitis media and usually resolve
without treatment.
DIF: Cognitive Level: Apply (application)
OBJ: Special Questions: Prioritization TOP: Nursing Process: Evaluation
MSC: NCLEX: Physiological Integrity
5. A 42-year-old woman with Meniere's disease is admitted with vertigo, nausea, and vomiting. Which nursing
intervention will be included in the care plan?
a. Dim the lights in the patients room.
b. Encourage increased oral fluid intake.
c. Change the patients position every 2 hours.
,Test Bank - Lewis's Medical Surgical Nursing (11th Edition by Harding) 218
d. Keep the head of the bed elevated 30 degrees.
ANS: A
A darkened, quiet room will decrease the symptoms of the acute attack of Meniere's disease. Because the
patient will be nauseated during an acute attack, fluids are administered IV. Position changes will cause vertigo
and nausea. The head of the bed can be positioned for patient comfort.
DIF: Cognitive Level: Apply (application)
TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity
6. Which statement by the patient to the home health nurse indicates a need for more teaching about self-
administering eardrops?
a. I will leave the ear wick in place while administering the drops.
b. I should lie down before and for 5 minutes after administering the drops.
c. I will hold the tip of the dropper above the ear while administering the drops.
d. I should keep the medication refrigerated until I am ready to administer the drops.
ANS: D
Administration of cold eardrops can cause dizziness because of stimulation of the semicircular canals. The
other patient actions are appropriate.
DIF: Cognitive Level: Apply (application)
TOP: Nursing Process: Evaluation MSC: NCLEX: Physiological Integrity
7. An 82-year-old patient who is being admitted to the hospital repeatedly asks the nurse to speak up so that I
can hear you. Which action should the nurse take?
a. Overenunciate while speaking.
b. Speak normally but more slowly.
c. Increase the volume when speaking.
d. Use more facial expressions when talking.
ANS: B
Patient understanding of the nurses speech will be enhanced by speaking at a normal tone, but more slowly.
Increasing the volume, overenunciating, and exaggerating facial expressions will not improve the patients
ability to comprehend the nurse.
DIF: Cognitive Level: Apply (application)
, Test Bank - Lewis's Medical Surgical Nursing (11th Edition by Harding) 219
TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity
8. A 75-year-old patient with presbycusis is fitted with binaural hearing aids. Which information will the nurse
include when teaching the patient how to use the hearing aids?
a. Experiment with volume and hearing ability in a quiet environment initially.
b. Keep the volume low on the hearing aids for the first week while adjusting to them.
c. Add a second hearing aid after making the initial adjustment to the first hearing aid.
d. Wear the hearing aids for about an hour a day at first, gradually increasing the time of use.
ANS: A
Initially the patient should use the hearing aids in a quiet environment like the home, experimenting with
increasing and decreasing the volume as needed. There is no need to gradually increase the time of wear. The
patient should experiment with the level of volume to find what works well in various situations. Both hearing
aids should be used.
DIF: Cognitive Level: Apply (application)
TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity
9. Which information will the nurse include for a patient contemplating a cochlear implant?
a. Cochlear implants require training in order to receive the full benefit.
b. Cochlear implants are not useful for patients with congenital deafness.
c. Cochlear implants are most helpful as an early intervention for presbycusis.
d. Cochlear implants improve hearing in patients with conductive hearing loss.
ANS: A
Extensive rehabilitation is required after cochlear implants in order for patients to receive the maximum
benefit. Hearing aids, rather than cochlear implants, are used initially for presbycusis. Cochlear implants are
used for sensorineural hearing loss and would not be helpful for conductive loss. They are appropriate for
some patients with congenital deafness.
DIF: Cognitive Level: Understand (comprehension)
TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity
10. Unlicensed assistive personnel (UAP) perform all the following actions when caring for a patient with
Meniere's disease who is experiencing an acute attack. Which action by UAP indicates that the nurse should
interveneimmediately?
a. UAP raise the side rails on the bed.
