BRUNNER AND SUDDARTHS TEXTBOOK OF MEDICAL SURGICAL NURSING 14TH EDITION HINKLE TEST BANK
Test Bank - Brunner & Suddarth's Textbook of Medical-Surgical Nursing 14e (Hinkle 2017) 1205
Chapter 64: Assessment and Management of Patients with Hearing and
Balance Disorders
1. The clinic nurse is assessing a child who has been brought to the clinic with signs and symptoms that are
suggestive of otitis externa. What assessment finding is characteristic of otitis externa?
A) Tophi on the pinna and ear lobe
B) Dark yellow cerumen in the external auditory canal
C) Pain on manipulation of the auricle
D) Air bubbles visible in the middle ear
Ans: C
Feedback:
Pain when the nurse pulls gently on the auricle in preparation for an otoscopic examination of the ear
canal is a characteristic finding in patients with otitis externa. Tophi are deposits of generally painless
uric acid crystals; they are a common physical assessment finding in patients diagnosed with gout.
Cerumen is a normal finding during assessment of the ear canal. Its presence does not necessarily
indicate that inflammation is present. Air bubbles in the middle ear may be visualized with the otoscope;
however, these do not indicate a problem involving the ear canal.
2. While reviewing the health history of an older adult experiencing hearing loss the nurse notes the patient
has had no trauma or loss of balance. What aspect of this patients health history is most likely to be
linked to the patients hearing deficit?
A) Recent completion of radiation therapy for treatment of thyroid cancer
B) Routine use of quinine for management of leg cramps
C) Allergy to hair coloring and hair spray
D) Previous perforation of the eardrum
Ans: B
Feedback:
Long-term, regular use of quinine for management of leg cramps is associated with loss of hearing
acuity. Radiation therapy for cancer should not affect hearing; however, hearing can be significantly
compromised by chemotherapy. Allergy to hair products may be associated with otitis externa; however,
NURSINGTB.COM
, BRUNNER AND SUDDARTHS TEXTBOOK OF MEDICAL SURGICAL NURSING 14TH EDITION HINKLE TEST BANK
Test Bank - Brunner & Suddarth's Textbook of Medical-Surgical Nursing 14e (Hinkle 2017) 1206
it is not linked to hearing loss. An ear drum that perforates spontaneously due to the sudden drop in
altitude associated with a high dive usually heals well and is not likely to become infected. Recurrent
otitis media with perforation can affect hearing as a result of chronic inflammation of the ossicles in the
middle ear.
3. A nurse is planning preoperative teaching for a patient with hearing loss due to otosclerosis. The patient
is scheduled for a stapedectomy with insertion of a prosthesis. What information is most crucial to
include in the patients preoperative teaching?
A) The procedure is an effective, time-tested treatment for sensory hearing loss.
B) The patient is likely to experience resolution of conductive hearing loss after the procedure.
C) Several months of post-procedure rehabilitation will be needed to maximize benefits.
D) The procedure is experimental, but early indications suggest great therapeutic benefits.
Ans: B
Feedback:
Stapedectomy is a very successful time-tested procedure, resulting in the restoration of conductive
hearing loss. Lengthy rehabilitation is not normally required.
4. Which of the following nursing interventions would most likely facilitate effective communication with
a hearing-impaired patient?
A) Ask the patient to repeat what was said in order to evaluate understanding.
B) Stand directly in front of the patient to facilitate lip reading.
C) Reduce environmental noise and distractions before communicating.
D) Raise the voice to project sound at a higher frequency.
Ans: C
Feedback:
Communication with the hearing impaired can be facilitated by talking in a quiet space free of
competing noise stimuli and other distractions. Asking the patient to repeat what was said is likely to
provoke frustration in the patient. A more effective strategy would be to repeat the question or
statement, choosing different words. Raising the voice to project sound at higher frequency would make
understanding more difficult. The nurse cannot assume that the patient reads lips. If the patient does read
lips, on average he or she will understand only 50% of words accurately.
NURSINGTB.COM
, BRUNNER AND SUDDARTHS TEXTBOOK OF MEDICAL SURGICAL NURSING 14TH EDITION HINKLE TEST BANK
Test Bank - Brunner & Suddarth's Textbook of Medical-Surgical Nursing 14e (Hinkle 2017) 1207
5. The nurse is providing discharge education for a patient with a new diagnosis of Mnires disease. What
food should the patient be instructed to limit or avoid?
A) Sweet pickles
B) Frozen yogurt
C) Shellfish
D) Red meat
Ans: A
Feedback:
The patient with Mnires disease should avoid foods high in salt and/or sugar; sweet pickles are high in
both. Milk products are not contraindicated. Any type of meat, fish, or poultry is permitted, with the
exception of canned or pickled varieties. In general, the patient with Mnires disease should avoid or
limit canned and processed foods.
6. Following a motorcycle accident, a 17-year-old man is brought to the ED. What physical assessment
findings related to the ear should be reported by the nurse immediately?
A) The malleus can be visualized during otoscopic examination.
B) The tympanic membrane is pearly gray.
C) Tenderness is reported by the patient when the mastoid area is palpated.
D) Clear, watery fluid is draining from the patients ear.
Ans: D
Feedback:
For the patient experiencing acute head trauma, immediately report the presence of clear, watery
drainage from the ear. The fluid is likely to be cerebrospinal fluid associated with skull fracture. The
ability to visualize the malleus is a normal physical assessment finding. The tympanic membrane is
normally pearly gray in color. Tenderness of the mastoid area usually indicates inflammation. This
should be reported, but is not a finding indicating urgent intervention.
7. A patient has been diagnosed with hearing loss related to damage of the end organ for hearing or cranial
nerve VIII. What term is used to describe this condition?
A) Exostoses
NURSINGTB.COM
Test Bank - Brunner & Suddarth's Textbook of Medical-Surgical Nursing 14e (Hinkle 2017) 1205
Chapter 64: Assessment and Management of Patients with Hearing and
Balance Disorders
1. The clinic nurse is assessing a child who has been brought to the clinic with signs and symptoms that are
suggestive of otitis externa. What assessment finding is characteristic of otitis externa?
A) Tophi on the pinna and ear lobe
B) Dark yellow cerumen in the external auditory canal
C) Pain on manipulation of the auricle
D) Air bubbles visible in the middle ear
Ans: C
Feedback:
Pain when the nurse pulls gently on the auricle in preparation for an otoscopic examination of the ear
canal is a characteristic finding in patients with otitis externa. Tophi are deposits of generally painless
uric acid crystals; they are a common physical assessment finding in patients diagnosed with gout.
Cerumen is a normal finding during assessment of the ear canal. Its presence does not necessarily
indicate that inflammation is present. Air bubbles in the middle ear may be visualized with the otoscope;
however, these do not indicate a problem involving the ear canal.
2. While reviewing the health history of an older adult experiencing hearing loss the nurse notes the patient
has had no trauma or loss of balance. What aspect of this patients health history is most likely to be
linked to the patients hearing deficit?
A) Recent completion of radiation therapy for treatment of thyroid cancer
B) Routine use of quinine for management of leg cramps
C) Allergy to hair coloring and hair spray
D) Previous perforation of the eardrum
Ans: B
Feedback:
Long-term, regular use of quinine for management of leg cramps is associated with loss of hearing
acuity. Radiation therapy for cancer should not affect hearing; however, hearing can be significantly
compromised by chemotherapy. Allergy to hair products may be associated with otitis externa; however,
NURSINGTB.COM
, BRUNNER AND SUDDARTHS TEXTBOOK OF MEDICAL SURGICAL NURSING 14TH EDITION HINKLE TEST BANK
Test Bank - Brunner & Suddarth's Textbook of Medical-Surgical Nursing 14e (Hinkle 2017) 1206
it is not linked to hearing loss. An ear drum that perforates spontaneously due to the sudden drop in
altitude associated with a high dive usually heals well and is not likely to become infected. Recurrent
otitis media with perforation can affect hearing as a result of chronic inflammation of the ossicles in the
middle ear.
3. A nurse is planning preoperative teaching for a patient with hearing loss due to otosclerosis. The patient
is scheduled for a stapedectomy with insertion of a prosthesis. What information is most crucial to
include in the patients preoperative teaching?
A) The procedure is an effective, time-tested treatment for sensory hearing loss.
B) The patient is likely to experience resolution of conductive hearing loss after the procedure.
C) Several months of post-procedure rehabilitation will be needed to maximize benefits.
D) The procedure is experimental, but early indications suggest great therapeutic benefits.
Ans: B
Feedback:
Stapedectomy is a very successful time-tested procedure, resulting in the restoration of conductive
hearing loss. Lengthy rehabilitation is not normally required.
4. Which of the following nursing interventions would most likely facilitate effective communication with
a hearing-impaired patient?
A) Ask the patient to repeat what was said in order to evaluate understanding.
B) Stand directly in front of the patient to facilitate lip reading.
C) Reduce environmental noise and distractions before communicating.
D) Raise the voice to project sound at a higher frequency.
Ans: C
Feedback:
Communication with the hearing impaired can be facilitated by talking in a quiet space free of
competing noise stimuli and other distractions. Asking the patient to repeat what was said is likely to
provoke frustration in the patient. A more effective strategy would be to repeat the question or
statement, choosing different words. Raising the voice to project sound at higher frequency would make
understanding more difficult. The nurse cannot assume that the patient reads lips. If the patient does read
lips, on average he or she will understand only 50% of words accurately.
NURSINGTB.COM
, BRUNNER AND SUDDARTHS TEXTBOOK OF MEDICAL SURGICAL NURSING 14TH EDITION HINKLE TEST BANK
Test Bank - Brunner & Suddarth's Textbook of Medical-Surgical Nursing 14e (Hinkle 2017) 1207
5. The nurse is providing discharge education for a patient with a new diagnosis of Mnires disease. What
food should the patient be instructed to limit or avoid?
A) Sweet pickles
B) Frozen yogurt
C) Shellfish
D) Red meat
Ans: A
Feedback:
The patient with Mnires disease should avoid foods high in salt and/or sugar; sweet pickles are high in
both. Milk products are not contraindicated. Any type of meat, fish, or poultry is permitted, with the
exception of canned or pickled varieties. In general, the patient with Mnires disease should avoid or
limit canned and processed foods.
6. Following a motorcycle accident, a 17-year-old man is brought to the ED. What physical assessment
findings related to the ear should be reported by the nurse immediately?
A) The malleus can be visualized during otoscopic examination.
B) The tympanic membrane is pearly gray.
C) Tenderness is reported by the patient when the mastoid area is palpated.
D) Clear, watery fluid is draining from the patients ear.
Ans: D
Feedback:
For the patient experiencing acute head trauma, immediately report the presence of clear, watery
drainage from the ear. The fluid is likely to be cerebrospinal fluid associated with skull fracture. The
ability to visualize the malleus is a normal physical assessment finding. The tympanic membrane is
normally pearly gray in color. Tenderness of the mastoid area usually indicates inflammation. This
should be reported, but is not a finding indicating urgent intervention.
7. A patient has been diagnosed with hearing loss related to damage of the end organ for hearing or cranial
nerve VIII. What term is used to describe this condition?
A) Exostoses
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