NCLEX Review about Ear Infection (31-35)

NCLEX Review about Ear Infection

31. A clinic nurse is preparing to perform a Romberg test on a client being seen in the clinic. The nurse performs this test for the purpose of determining:

a) the client's ability to ambulate
b) the functional status of the vestibular apparatus in the inner ear
c) the intactness of the retinal structure of the eye
d) the intactness of the tympanic membrane

32. A clinic nurse is performing an otoscopic examination on an adolescent who was hit in the ear with a basketball during a neighborhood game. A perforated eardrum is suspected. Which of the following would the nurse expect to observe if the eardrum is perforated?

a) a colony of black dots on the eardrum
b) dense white patches on the eardrum
c) a red bulging eardrum
d) a round or oval darkened area on the eardrum

33. A caloric test is ordered for a client suspected of having disease of the labyrinth. The nurse would obtain which of the following essential items in preparation for this test?

a) an otoscope
b) an opthalmoscope
c) a tongue blade
d) an emesis basin

34. A nurse educator is conducting an in-service education session to the nurses employed in the eye and ear surgical unit of a large trauma center. In discussing the topic of cochlear implants, the educator notes that this surgical procedure is contraindicated in which of the following clients?

a) a client who became deaf before learning to speak
b) a client with bilateral profound hearing loss
c) a client who communicates primarily by speech
d) a client who received no benefit from conventional hearing aids

35. A nurse is observing a nursing assistant communicating with a client who is deaf. The nurse will intervene if which of the following behaviors is observed?

a) the nursing assistant is speaking directly to the client
b) the nursing assistant touches the client's arm to gain his or her attention
c) the nursing assistant faces the client when speaking to the client
d) the nursing assistant overenunciates words when speaking




NCLEX Review about Ear Infection:
ANSWERS AND RATIONALE

31) B

- The Romberg test assesses the ability of the vestibular apparatus in the inner ear to help maintain standing balance. The Romberg test also assesses intactness of the cerebellum and proprioception. Options A, C, and D are incorrect.

 32) D

A round or oval darkened area on the eardrum would be seen in a client with a perforated eardrum. A red and bulging eardrum is indicative of acute purulent otitis media. Dense white patches are seen on the eardrum of a client with sequelae of repeated ear infections. A colony of black dots on the eardrum suggests a yeast or fungal infection.

33) A

- A caloric test is contraindicated in a client with a perforated tympanic membrane (air may be used as a substitute) or if the client has an acute disease of the labyrinth. An otoscopic examination should be performed before the caloric test to rule out perforation and to determine if the ear canal contains cerumen, which must be removed before the test. An ophthalmoscope, a tongue blade, and an emesis basin are not essential items.

34) A

- Adults who were born deaf or became deaf before learning to speak usually are not candidates for this type of surgery. Criteria for a cochlear implant procedure are bilateral profound hearing loss, use of speech as the primary mode of communication, lack of benefit from conventional hearing aids, evidence of strong family and social support, and realistic client expectations for the outcome of the implant procedure.

35) D

- Overenunciating words does not make lip reading easier and is demeaning to the deaf person. It is best to speak in a normal manner. Options A, B, and C are appropriate communication strategies for the client who is deaf.


Related Topics:

• NCLEX Review about Ear Infection (36-40)

Or go back to NCLEX Review about Ear Infection (1-5)

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