Chapter 48: Assessment and Care of Patients with Ear and Hearing Problems Test Bank Medical Surgical Nursing 9th Edition Ignatavicius Workman

Test Bank Medical Surgical Nursing 9th Edition Ignatavicius Workman MULTIPLE CHOICE 1. A nurse is teaching a client about ear hygiene and health. What client statement indicates a need for further teaching? a. A soft cotton swab is alright to clean my ears with. b. I make sure my ears are dry after I go swimming. c. I use good earplugs when I practice with the band. d. Keeping my diabetes under control helps my ears. ANS: A Clients should be taught not to put anything larger than their fingertip into their ears. Using a cotton swab, although soft, can cause damage to the ears and cerumen buildup. The other statements are accurate. DIF: Evaluating/Synthesis REF: 993 KEY: Auditory system| auditory assessment MSC: Integrated Process: Nursing Process: Evaluation NOT: Client Needs Category: Health Promotion and Maintenance 2. The student nurse is performing a Weber tuning fork test. What technique is most appropriate? a. Holding the vibrating tuning fork 10 to 12 inches from the clients ear b. Placing the vibrating fork in the middle of the clients head c. Starting by placing the vibrating fork on the mastoid process d. Tapping the vibrating tuning fork against the bridge of the nose ANS: B The Weber tuning fork test includes placing the vibrating tuning fork in the middle of the clients head and asking in which ear the client hears the vibrations louder. The other techniques are incorrect. DIF: Applying/Application REF: 989 KEY: Auditory system| auditory assessment MSC: Integrated Process: Nursing Process: Assessment NOT: Client Needs Category: Physiological Integrity: Reduction of Risk Potential 3. The clients chart indicates a sensorineural hearing loss. What assessment question does the nurse ask to determine the possible cause? a. Do you feel like something is in your ear? b. Do you have frequent ear infections? c. Have you been exposed to loud noises? d. Have you been told your ear bones dont move? ANS: C Sensorineural hearing loss can occur from damage to the cochlea, the eighth cranial nerve, or the brain. Exposure to loud music is one etiology. The other questions relate to conductive hearing loss. DIF: Remembering/Knowledge REF: 989 KEY: Auditory system| auditory assessment| auditory disorders MSC: Integrated Process: Nursing Process: Assessment NOT: Client Needs Category: Physiological Integrity: Reduction of Risk Potential 4. The nurse works with clients who have hearing problems. Which action by a client best indicates goals for an important diagnosis have been met? a. Babysitting the grandchildren several times a week b. Having an adaptive hearing device for the television c. Being active in community events and volunteer work d. Responding agreeably to suggestions for adaptive devices