NCLEX Review about Ear Infection 41-45

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41. A nurse is preparing a plan of care for a client being admitted to the hospital with exacerbation of Meniere's disease. Which of the following would the nurse include in the plan of care?

a) increase fluid intake to 3000 ml a day
b) tell the client to avoid moving the head suddenly
c) maintain a quiet environment, and allow the client to read and watch TV
d) increase foods high in sodium in the diet

42. A nurse is performing an assessment of a client suspected of having mastoiditis. Which finding would the nurse expect to note if this disorder is present?

a) an elevated temperature
b) a red, dull, thick, and immobile tympanic membrane
c) a clear tympanic membrane
d) a transparent tympanic membrane

43. A nurse is performing an admission assessment of a client with a disorder involving the inner ear. Which of the following questions will the nurse ask the client to determine if the common symptom of this type of ear disorder is present?

a) do you have any hearing loss?
b) do you have any itching around your ear?
c) do you have any ringing in the ears?
d) do you have any pain in the ear?

44. A new nursing graduate has been hired by the health care clinic to assist in conducting hearing tests in a local neighborhood. The clinic nurse is observing the nursing graduate perform a voice test to assess hearing in a client. Which of the following observations indicates that the graduate is performing the procedure correctly?

a) start 10 feet away from the client to determine if the client can hear clearly
b) asks the cleint to block one ear, quietly whispers a statement, and asks the client to repeat it
c) whispers a statement with the back facing the client
d) asks the client to block the ears, faces the client, verbalizes a statement, and asks the client to repeat the statement

45. A clinic nurse receives a telephone call form a client who states that an insect has somehow flown into her ear and that a buzzing sound can be heard. The client asks the nurse how to remove the insect. Which of the following instructions should the nurse initially provide to the client?

a) have her spouse irrigate ear to kill the insect
b) use a flashlight to try to coax the insect out of the ear
c) instill antibiotic eardrops if they are available
d) get into the shower and allow the ear to run into the ear to flush out the insect








NCLEX Review:
Answers and Rationale

41) B

Exacerbation of Ménière's disease is characterized by severe vertigo. 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 are sometimes prescribed. Activities such as reading and watching TV will worsen the vertigo. Clients are advised to stop smoking because of its vasoconstrictive effects.

42) B

- Otoscopic examination in a client with mastoiditis reveals a red, dull, thick, and immobile tympanic membrane with or without perforation. Postauricular lymph nodes are tender and enlarged. Clients also have a low-grade fever, malaise, anorexia, swelling behind the ear, and pain with minimal movement of the head.

43) C

- Tinnitus is the most common complaint of clients with otological disorders, especially those involving the inner ear. This symptom can range from mild ringing in the ear, which can go unnoticed during the day, to a loud roaring in the ear, which can interfere with the client's thinking process and attention span. The client may experience some pain or hearing loss, depending on the disorder, but these are not the most common symptoms. Itching around the ear may be associated with a disorder other than an inner ear disorder.

44) B

- In a voice test, the nurse stands 1 to 2 feet away from the client and asks the client to block one external ear canal. The nurse quietly whispers a statement and asks the client to repeat it. Each ear is tested separately. Options A, C, and D are incorrect procedures.

45) B

- Insects are killed before removal unless they can be coaxed out by a flashlight or a humming noise. Mineral oil or diluted alcohol is instilled into the ear to suffocate the insect, which is then removed with ear forceps in the emergency department. It is not appropriate to ask the spouse to irrigate the ear. Suggesting the use of antibiotics is inappropriate. Option D is also inappropriate and may cause additional discomfort.



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NCLEX Review about Ear Infection 1-5


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NCLEX Review about Ear Infection 46-50