NCLEX Review about Ear Infection (11-15)

NCLEX Review about Ear Infection

11.The nurse is caring for a client following craniotomy for removal of an acoustic neuroma. Assessment of which of the following cranial nerves would identify a complication specifically associated with this surgery?

a) cranial nerve I, olfactory
b) cranial nerve IV, trochlear
c) cranial nerve III, oculomotor
d) cranial nerve VII, facial nerve

12. The nurse assesses the client with a blunt injury sustained from a motor vehicle accident. Which assessment sign would indicate a basal skull fracture as a result of the injury?

a) epistaxis
b) periorbital edema
c) purulent drainage from the auditory canal
d) bloody or clear drainage from the auditory canal

13. A client was just admitted to the hospital to rule out a gastrointestinal (GI) bleed. The client has brought several bottles of medications prescribed by different specialists. During the admission assessment, the client states, "Lately, I have been hearing some roaring sounds in my ears, especially when I am alone." Which medication would the nurse determine could be the cause of the client's complaint?

a) doxycycline (Vibramycin)
b) acetazolamide (Diamox)
c) acetylsalicylic acid (aspirin)
d) diltiazem hydrochloride (Cardizem)

14. The nurse prepares the client for an ear irrigation as prescribed by the physician. In performing the procedure, the nurse:

a) warms the irrigating solution to 98F
b) position the client with the affected side up following the irrigation
c) directs a slow steady stream of irrigation solution toward the eardrum
d) assists the client to turn his or her head so that the ear to be irrigated is facing upward

15. Ear drops are prescribed for an infant with otitis media. The most appropriate method to administer the ear drops to the infant is to:

a) pull up and back on the pinna and direct the solution onto the eardrum
b) pull down and back on the pinna and direct the solution onto the eardrum
c) pull down and back on the pinna and direct he solution toward the wall of the canal
d) pull up and back on the ear lobe and direct the solution toward the wall of the canal





NCLEX Review about Ear Infection:
ANSWERS AND RATIONALE

11) D

- Treatment for acoustic neuroma is surgical removal via a craniotomy. Extreme care is taken to preserve remaining hearing and preserve the function of the facial nerve. Acoustic neuromas rarely recur following surgical removal.

12) D

- Bloody or clear watery drainage from the auditory canal indicates a cerebrospinal fluid leak following trauma and suggests a basal skull fracture. This warrants immediate attention. Options A, B, and C are not specific to a basal skull fracture.

13) C

- Aspirin is contraindicated for gastrointestinal bleed and is potentially ototoxic. The client should be advised to notify the prescribing physician so the medication can be discontinued and/or a substitute that is less toxic to the ear can be taken instead. Options A, B, and D do not have side effects that are potentially associated with hearing difficulties.

14) A

- Irrigation solutions that are not close to the client’s body temperature can be uncomfortable and may cause injury, nausea, and vertigo. The client is positioned so that the ear to be irrigated is facing downward, because this allows gravity to assist in the removal of the ear wax and solution. Following the irrigation, the client is to lie on the affected side to finish draining the irrigating solution. A slow steady stream of solution should be directed toward the upper wall of the ear canal and not toward the eardrum. Too much force could cause the tympanic membrane to rupture.

15) C

- In a child younger than 3 years, the pinna is pulled down and straight back. The infant should be turned on the side with the affected ear uppermost. With the nondominant hand, the pinna is pulled down and back. The medication is administered by aiming it at the wall of the canal rather than directly onto the eardrum. The infant should remain with the affected ear uppermost for 10 to 15 minutes to retain the solution. In the adult or a child older than 3 years, the pinna is pulled up and back to straighten the auditory canal.

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Related Topics:

• Fundamentals of Nursing  Concepts
• Medical-Surgical Concepts
• Maternal and Child Concepts