NCLEX Exam: Ear Disorders and Care (19

1. The nurse is performing a voice test to assess hearing. Which of the following describes
the accurate procedure for performing this test?
1. Stand 4 feet away from the client to ensure that the client can hear at this distance.
2. Whisper a statement and ask the client to repeat it.
3. Whisper a statement with the examiners back facing the client
4. Whisper a statement while the client blocks both ears.
2. During a hearing assessment, the nurse notes that the sound lateralizes to the clients left
ear with the Weber test. The nurse analyzes this result as:
1. A normal finding
2. A conductive hearing loss in the right ear
3. A sensorineural or conductive loss
4. The presence of nystagmus
3. The nurse is caring for a client that is hearing impaired. Which of the following
approaches will facilitate communication?
1. Speak frequently
2. Speak loudly
3. Speak directly into the impaired ear
4. Speak in a normal tone
4. The nurse has conducted discharge teaching for a client who had a fenestration
procedure for the treatment of otosclerosis. Which of the following, if stated by the client,
would indicate that teaching was effective?

Irrigation of the ear 2. Which intervention would the nurse anticipate to be prescribed initially? 1. Lie still and watch the television 4. Instillation of corticosteroids ear drops 6. “I can resume my tennis lessons starting next week.” 5. Instillation of diluted alcohol 3. Which diet will most likely be prescribed? .” 2. The nurse is reviewing the physician’s orders for a client with Meniere’s disease. Increase fluid intake to 3000 ml a day 2. Tinnitus that occurs with aging 4. “I should drink liquids through a straw for the next 2-3 weeks.” 4. The nurse has notes that the physician has a diagnosis of presbycusis on the client’s chart. A client arrives at the emergency room with a foreign body in the left ear that has been determined to be an insect.” 3.1. A sensorineural hearing loss that occurs with aging 2. Instillation of antibiotic ear drops 4. Nystagmus that occurs with aging 7. “I will take stool softeners as prescribed by my doctor. The nurse plans care knowing the condition is: 1. A client with Meniere’s disease is experiencing severe vertigo. “It’s ok to take a shower and wash my hair. Avoid sudden head movements 3. Increase sodium in the diet 8. Which instruction would the nurse give to the client to assist in controlling the vertigo? 1. 3. A conductive hearing loss that occurs with aging.

A nurse would question an order to irrigate the ear canal in which of the following circumstances? 1. Burning of the ear 10. Ear pain 2. Low-cholesterol diet 2. Perforated tympanic membrane 11. Warming the solution to prevent dizziness 3. A client is diagnosed with a disorder involving the inner ear. Tinnitus 4. Low-carbohydrate diet 4. Hearing loss 3. Which of the following is the most common client complaint associated with a disorder in this part of the ear? 1. Positioning the client in the semi-fowlers position 12. Hearing loss 2. Otitis externa 4. Which of the following interventions is essential when instilling Cortisporin suspension. Holding an emesis basin under the client’s ear 4. 2 gtt right ear? 1. Pruritus 3. Low-sodium diet 3. Drive in daylight hours only . Report dizziness at once 2. When teaching the client about Meniere’s disease.1. which of the following instructions would a nurse give about vertigo? 1. Verifying the proper client and route 2. Low-fat diet 9.

Vestibular nerve 4. This procedure results in: 1. Get up slowly. Cochlea 3. Outer ear 3.3. Inner ear 2. The part of the ear that contains the receptors for hearing is the: 1. Absence of pain 3. Reduction in cerumen 4. turning the entire body 4. Utricle 2. Middle ear 4. Change your position using the logroll method 13. Permanent irreversible deafness . Tympanic cavity 14. Cochlear nerve 3. Trigeminal nerve 16. Middle ear 4. Nerve deafness would most likely result from an injury or infection that damaged the: 1. Vagus nerve 2. Anosmia 2. The ear bones that transmit vibrations to the oval window of the cochlea are found in the: 1. Eustachian tube 15. A labyrinthectomy can be performed to treat Meniere’s syndrome.

Answer: 3. The examiner stands 1-2 feet away from the client and asks the client to block one external ear canal. The client is usually unable to hear bass tones 4. Air conduction is more effective than bone conduction 18. The nurse whispers a statement and asks the client to repeat it. Communicate with the throat via the Eustachian tube.17. serves primarily to: 1. In the Weber tuning fork test the nurse places the vibrating tuning fork in the middle of the client’s head. 2. If the client has a sensorineural . Prodromal 19. Translate sound waves into nerve impulses 3. Answers and Rationale 1. Amplify the energy of sound waves entering the ear 4. Answer: 2. Otosclerosis is a common cause of conductive hearing loss. A client who is complaining of tinnitus is describing a symptom that is: 1. or above the upper lip over the teeth. Subjective 3. the middle ear. Normally. Functional 4. Each ear is tested separately. at the midline of the forehead. Hearing aids usually restore some hearing 3. the sound is heard in equally in both ears by bone conduction. Maintain balance 2. Which such a partial hearing loss: 1. Objective 2. containing the three ossicles. Stapedectomy is the procedure of choice 2. Physiologically.

but the nurse should avoid talking directly into the impaired ear. 4. If the client has a conductive hearing loss in one ear. 5. Presbycusis is a gradual sensorineural loss caused by nerve degeneration in the inner ear or auditory nerve. Moving closer to the client and toward the better ear may facilitate communication. which then is removed by using forceps.hearing loss in one ear. 6. the client needs to avoid straining while having a bowel movement. and bending over for 3 weeks. air travel. 3. the sound is heard in that ear. Mineral oil or diluted alcohol is instilled into the ear to suffocate the insect. bouncing. Presbycusis is a type of hearing loss that occurs with aging. Answer: 3. If the client does not seem to understand what is said. and coughing excessively. the nurse should express it differently. The nurse instructs the client to make slow head movements to prevent worsening of the vertigo. Dietary changes such as salt and fluid restrictions that reduce the amount of endolymphatic fluid sometimes are prescribed. washing hair. Speaking in a normal tone to the client with impaired hearing and not shouting are important. When the foreign object is vegetable matter. Answer: 2. Answer: 2. the sound is heard in the other ear. Lying still and watching television will not control vertigo. . The client needs to be instructed to avoid drinking through a straw for 2-3 weeks. and rapidly moving the head. Insects are killed before removal unless they can be coaxed out by a flashlight or a humming noise. The client needs to avoid getting his or her hair wet. Following ear surgery. Answer: 1. irrigation is not used because this material expands with hydration and the impaction becomes worse. showering for 1 week. 7. The nurse should talk directly to the client while facing the client and speak clearly. Answer: 4.

The dendrites of the cochlear nerve terminate on the hair cells of the organ of Corti in the cochlea. Answer: 2. nausea. Answer: 2. and infection. 12. 9. Answer: 3. 11. Tinnitus is the most common complaint of clients with otological disorders. Turning the entire body. When giving medications. Symptoms of tinnitus range from mild ringing in the ear. not the head. which can go unnoticed during the day. The tympanic membrane separates the other from the middle ear. The drops may be warmed to prevent pain or dizziness. Put the client in the lateral position to prevent the drops from draining out for 5 minutes. Answer: 3. 13. which can interfere with the client’s thinking process and attention span. vomiting. An emesis basin would be used for irrigation of the ear.8. a nurse follows the five R’s of medication administration. Answer: 4. especially disorders involving the inner ear. The client shouldn’t drive as he may reflexively turn the wheel to correct vertigo. to a loud roaring in the ear. 10. Turning the client in bed slowly and smoothly will be helpful. will prevent vertigo. Dizziness is expected but can be prevented. The bones in the middle ear transmit and amplify air pressure waves from the tympanic membrane to the oval window of the cochlea. Dietary changes such as salt and fluid restrictions that reduce the amount of endolymphatic fluid sometimes are prescribed. not semi-fowlers position. Answer: 3. which is the inner ear. but this action is not essential. . logrolling isn’t needed. Answer: 1. Irrigation of the ear canal is contraindicated with perforation of the tympanic membrane because the solution entering the inner ear may cause dizziness. 14.

and stapes—which. 17. 16. Answer: 2. A subjective symptom such as ringing in the ears can be felt only by the client. .15. cochlear duct. saccule. Because the organ of hearing is the organ of Corti. Answer: 2. as long as vibrations occur. nerve deafness would most likely accompany damage to the cochlear nerve. A labyrinthectomy is performed to alleviate the symptoms of vertigo but results in deafness. located in the cochlea. form an amplifying system. Answer: 3. Answer: 4. semicircular canals. The middle ear contains the three ossicles—malleus. and membranous semicircular canals. utricle. 18. 19. because the organ of Corti and cochlear nerve are located in the inner ear. Answer: 2. The labyrinth is the inner ear and consists of the vestibule. With a partial hearing loss that auditory ossicles have not yet become fixed. along with the tympanic membrane and oval window. cochlea. a hearing aid may be beneficial. incus.