1-25-2012 ENT WARD 2pm to 10 pm Examination Question and Answers 1.
When the nurse reads in the patients history that the patient has experienced otalgia, the nurse knows that the patient has: 1. difficulty hearing. 2. a buildup of cerumen. 3. ear pain. 4. ringing in ears. ANS: 3- Otic- is the root for ear, and -algia is the root term for pain of any type. 2. The nurse assisting with a caloric test notes the specific patient response that indicates that the hearing disorder is a problem in the labyrinth, which is: 1. blinking. 2. grimacing. 3. headache. 4. nystagmus. ANS: 4 - The appearance of nystagmus when warm or cold water is introduced into the ear is a positive indication that the hearing problem has its cause in the labyrinth. 3. The 75-year-old patient has age-related changes in his ear. These changes include all but: 1. dry and wrinkled skin on the auricle. 2. otitis externa. 3. dry cerumen. 4. hair in the ear canal. ANS: 2 - Otitis externa is an outer ear infection. This question requires knowledge of normal age-related changes in the ears. 4. When doing the initial assessment on a patient with a hearing deficit, the patient reports that he often feels off balance and that he is dizzy when he stands up. These symptoms could be explained by: 1. sinus infections. 2. rubella.
3. otalgia. 4. presbycusis. ANS: 1 - Sinus infections can be an acute cause of hearing problems. 5. A patient reports to the outpatient clinic, saying that he cannot hear well any more and was treated recently with gentamicin. The nurse suspects ototoxicity and inquires about: 1. otalgia. 2. ataxia. 3. vertigo. 4. nausea. ANS: 2 - Signs of ototoxicity are tinnitus, hearing loss, dizziness, and ataxia. Gentamicin is an antibiotic with potential for ototoxicity. 6. The 75-year-old patient complains to the nurse that although she has cleaned her ears with cotton-tipped applicators for weeks, she still cant hear her TV unless it is turned up loud, and she misses a great deal of conversations. On examination of the ears, the nurse anticipates that there will be: 1. otitis externa. 2. purulent drainage. 3. dry cerumen across the canal. 4. a pearly tympanic membrane. ANS: 3 - Obstruction of the external canal with cerumen will result in a hearing loss. Cleaning ears with something like an applicator will pack the cerumen in the canal. 7. The clinic patient tells you that her hearing loss has become more severe over the last 3 months. The clinic nurse makes arrangements for an evaluation for a hearing aid by an: 1. otologist. 2. otolaryngologist. 3. audiometrist. 4. audiologist. ANS: 4 - Audiologists assess patients for hearing aids. The other specialties are for ENT diseases.
8. When a patient has a suspected vestibular disorder, the physician orders electronystagmography. The nursing instruction for this test will include: 1. the use of tea or coffee on the morning of test. 2. that electrodes are placed on the scalp. 3. air will be blown into the external ear. 4. NPO 3 hours prior to the test. ANS: 3 - Electronystagmography is used to detect vestibular lesions and requires a 3-hour period of NPO before the test. Coffee and tea should be avoided prior to the test. 9. The nurse assessing the results of a Rinne test sees BC >AC. The nurse translates this to mean that the patient has: 1. conductive hearing loss. 2. sensorineural hearing loss. 3. normal hearing. 4. a cochlear defect. ANS: 1 - When the bone conduction is greater than the air conduction (BC > AC), the patient has a conductive hearing loss. The normal finding for the Rinne test is that air conduction is greater than bone conduction (AC > BC). 10. The patient undergoing a Weber test says that the sound is louder in her left ear. This means that: 1. the patient has normal hearing. 2. the patient has nerve damage from listening to loud music. 3. there is a blocked ear canal in the right ear. 4. there is a conductive hearing loss in the left ear. ANS: 4 - With Webers test, a conductive hearing loss is determined by the sound being heard loudest in the affected ear.
Prepared by:
Ferrer,Ronaflor C.
SN -UDM
1-26-2012 ENT WARD 2pm to 10 pm Examination Question and AnswerS 1. When doing patient teaching for a patient who will be self-administering ear drops for an ear infection, the nurse would instruct the patient to: 1. tip the affected ear up and keep it in that position for several minutes after instilling the medication. 2. keep the medication in the refrigerator to preserve it and instill it with the affected ear tilted upward. 3. touch the dropper to the opening of the ear canal to make sure that the drops are instilled correctly. 4. warm the ear drops and then tilt the head downward. ANS: 1- The head is kept in the position to ensure that the drops penetrate deep into the external ear. 2. When irrigating a patients ear, the nurse will: 1. straighten the ear canal and irrigate with a large-tipped bulb syringe. 2. direct the solution to the middle of the canal to avoid damaging the ear. 3. use a body temperature solution and have the patient hold a basin under the ear while directing the solution toward the top of the canal. 4. repeat the irrigation with hotter water. ANS: 3 - The irrigation is done with warm water using a small-tipped syringe. The flow is directed upward. If the cerumen does not wash out, the procedure can be repeated, but with the same temperature water. 3. The nurse giving you a report on a newly admitted profoundly deaf patient says that the patient is confused and difficult to assess because she does not respond to questions appropriately or sometimes does not respond at all. The oncoming nurse will consider: 1. having a psychiatrist see the patient to determine if the patient has dementia. 2. assessing the patient to determine if her hearing aids are in. 3. reporting to the physician that the patient is sundowning. 4. assessing medications to check for an overdose. ANS: 2 - Profoundly deaf persons can be mistakenly assessed as being confused or disoriented when not wearing their hearing aids.
4. Choose the nursing diagnosis that would be most appropriate for a patient having ear surgery: 1. Disturbed body image 2. Risk for injury 3. Acute confusion 4. Ineffective protection ANS: 2 - Patients who have had ear surgery are at risk for vertigo, fluid accumulation, or pressure in the operative ear. Because of the surgery and potential postoperative conditions, the patient may be at risk for a fall. 15. A significant instruction to a patient being discharged after ear surgery is to: 1. use stool softeners with caution. 2. assume your usual activities. 3. avoid blowing your nose. 4. shampoo your hair with baby shampoo. ANS: 3 - The patient should avoid blowing the nose to prevent backpressure in the eustachian tube. He or she should take stool softeners, limit activity until balance returns, and delay shampooing. 16. A diabetic patient says that he cant hear well anymore. Everything sounds garbled and distant. When he asks if a there is a hearing aid to improve his hearing, the nurse responds that a hearing aid may not help him because he has a: 1. mixed hearing loss. 2. conductive hearing loss. 3. central hearing loss. 4. sensorineural hearing loss. ANS: 4 - The long-term diabetic has a sensorineural hearing loss that is not helped by hearing aids. 17. For the nursing care plan for a patient with Mnires disease, the nursing diagnosis that would take priority would be: 1. Social isolation related to anxiety. 2. Risk for injury related to falls. 3. Risk for deficient fluid intake related to weakness. 4. Nutrition; less than body requirements related to fatigue.
ANS: 2 - The nursing diagnosis that should take priority is that of preventing injury to the patient. The Mnire patient, because of dizziness, is prone to falls. 18. In planning care for a child who has been diagnosed with a hearing impairment, and considering the impact of a hearing deficit, the nursing diagnosis that would be appropriate would be: 1. Risk for injury related to hearing impairment. 2. Risk for social isolation related to hearing impairment. 3. Knowledge deficit related to hearing impairment. 4. Anxiety related to hearing impairment. ANS: 2 - The loss of hearing and the mild stigma associated with hearing impairment puts the newly diagnosed child at risk for social isolation. 19. When teaching the patient with Mnires disease about managing the disease, the nurse will stress: 1. limiting fluid intake. 2. avoiding use of alcohol and tobacco. 3. using antiemetics sparingly. 4. staying active during the day. ANS: 2 - Use of alcohol and tobacco products affect the amount of fluid in the middle ear, making the symptoms of Mnires worse. The patient with Mnires disease should drink adequate fluid, use antiemetics as needed, and conserve energy during the day. 20. The nurse points out to the client that of the activities in which he is regularly involved, the one that contributes to accumulation of cerumen in the external ear is: 1. swimming in a chlorinated pool daily. 2. drinking 1500 mL of fluid a day. 3. trimming hair from the ears every week. 4. washing the ears with a washcloth every day. ANS: 1 - Daily swimming in a chlorinated pool dries the cerumen. All the other options would reduce cerumen accumulation.
Prepared by:
Ferrer,Ronaflor C.
SN -UDM
1-25-2012 ENT WARD 2pm to 10 pm Name: _______________________________ Year/Section: _____________________
Direction: Select the best answer to the following multiple choice questions. Encircle the number that correspond your answer.
1. When the nurse reads in the patients history that the patient has experienced otalgia, the nurse knows that the patient has: 1. difficulty hearing 2. a buildup of cerumen 3. ear pain. 4. ringing in ears 2. The nurse assisting with a caloric test notes the specific patient response that indicates that the hearing disorder is a problem in the labyrinth, which is: 1. blinking 2. grimacing 3. headache 4. nystagmus. 3. The 75-year-old patient has age-related changes in his ear. These changes include all but: 1. dry and wrinkled skin on the auricle 2. otitis externa. 3. dry cerumen 4. hair in the ear canal 4. When doing the initial assessment on a patient with a hearing deficit, the patient reports that he often feels off balance and that he is dizzy when he stands up. These symptoms could be explained by: 1. sinus infections. 2. rubella 3. otalgia 4. presbycusis 5. A patient reports to the outpatient clinic, saying that he cannot hear well any more and was treated recently with gentamicin. The nurse suspects ototoxicity and inquires about: 1. otalgia 2. ataxia. 3. vertigo 4. nausea
6. The 75-year-old patient complains to the nurse that although she has cleaned her ears with cotton-tipped applicators for weeks, she still cant hear her TV unless it is turned up loud, and she misses a great deal of conversations. On examination of the ears, the nurse anticipates that there will be: 1. otitis externa 2. purulent drainage 3. dry cerumen across the canal. 4. a pearly tympanic membrane 7. The clinic patient tells you that her hearing loss has become more severe over the last 3 months. The clinic nurse makes arrangements for an evaluation for a hearing aid by an: 1. otologist 2. otolaryngologist 3. audiometrist 4. audiologist. 8. When a patient has a suspected vestibular disorder, the physician orders electronystagmography. The nursing instruction for this test will include: 1. the use of tea or coffee on the morning of test 2. that electrodes are placed on the scalp 3. air will be blown into the external ear. 4. NPO 3 hours prior to the test 9. The nurse assessing the results of a Rinne test sees BC >AC. The nurse translates this to mean that the patient has: 1. conductive hearing loss. 2. sensorineural hearing loss 3. normal hearing 4. a cochlear defect 10. The patient undergoing a Weber test says that the sound is louder in her left ear. This means that: 1. the patient has normal hearing 2. the patient has nerve damage from listening to loud music 3. there is a blocked ear canal in the right ear 4. there is a conductive hearing loss in the left ear.
1-26-2012 ENT WARD 2pm to 10 pm
Name: _______________________________ Year/Section: _____________________
Direction: Select the best answer to the following multiple choice questions. Encircle the number that correspond your answer.
1. When doing patient teaching for a patient who will be self-administering ear drops for an ear infection, the nurse would instruct the patient to: 1. tip the affected ear up and keep it in that position for several minutes after instilling the medication. 2. keep the medication in the refrigerator to preserve it and instill it with the affected ear tilted upward 3. touch the dropper to the opening of the ear canal to make sure that the drops are instilled correctly 4. warm the ear drops and then tilt the head downward 2. When irrigating a patients ear, the nurse will: 1. straighten the ear canal and irrigate with a large-tipped bulb syringe 2. direct the solution to the middle of the canal to avoid damaging the ear 3. use a body temperature solution and have the patient hold a basin under the ear while directing the solution toward the top of the canal. 4. repeat the irrigation with hotter water 3. The nurse giving you a report on a newly admitted profoundly deaf patient says that the patient is confused and difficult to assess because she does not respond to questions appropriately or sometimes does not respond at all. The oncoming nurse will consider: 1. having a psychiatrist see the patient to determine if the patient has dementia 2. assessing the patient to determine if her hearing aids are in. 3. reporting to the physician that the patient is sundowning. 4. assessing medications to check for an overdose 4. Choose the nursing diagnosis that would be most appropriate for a patient having ear surgery: 1. Disturbed body image 2. Risk for injury. 3. Acute confusion 4. Ineffective protection 5. A significant instruction to a patient being discharged after ear surgery is to : 1. use stool softeners with caution 2. assume your usual activities
3. avoid blowing your nose. 4. shampoo your hair with baby shampoo 6. A diabetic patient says that he cant hear well anymore. Everything sounds garbled and distant. When he asks if a there is a hearing aid to improve his hearing, the nurse responds that a hearing aid may not help him because he has a: 1. mixed hearing loss 2. conductive hearing loss 3. central hearing loss 4. sensorineural hearing loss. 7. For the nursing care plan for a patient with Mnires disease, the nursing diagnosis that would take priority would be: 1. Social isolation related to anxiety 2. Risk for injury related to falls. 3. Risk for deficient fluid intake related to weakness 4. Nutrition; less than body requirements related to fatigue 8. In planning care for a child who has been diagnosed with a hearing impairment, and considering the impact of a hearing deficit, the nursing diagnosis that would be appropriate would be: 1. Risk for injury related to hearing impairment 2. Risk for social isolation related to hearing impairment. 3. Knowledge deficit related to hearing impairment 4. Anxiety related to hearing impairment 9. When teaching the patient with Mnires disease about managing the disease, the nurse will stress: 1. limiting fluid intake 2. avoiding use of alcohol and tobacco. 3. using antiemetics sparingly 4. staying active during the day 10. The nurse points out to the client that of the activities in which he is regularly involved, the one that contributes to accumulation of cerumen in the external ear is: 1. swimming in a chlorinated pool daily. 2. drinking 1500 mL of fluid a day 3. trimming hair from the ears every week 4. washing the ears with a washcloth every day
