EAR DISORDERS In the Weber tuning fork test, the nurse places the
vibrating tuning fork in the middle of the client’s head, at
1. The nurse is providing instructions to a nursing assistant
regarding care of an older client with hearing loss. The
nurse tells the assistant that clients with a hearing loss:
a) are often distracted
b) have middle ear changes
c) respond to low-pitched tones
d) develop moist cerumen production
Presbycusis refers to the age-related irreversible
degenerative changes of the inner ear that lead to
decreased hearing ability. As a result of these changes,
the older client has a decreased response to high-
frequency sounds. Low-pitched voice tones are heard
more easily and can be interpreted by the older client.
Options A, B, and D are not accurate.
2. The nurse is performing an otoscopic examination on a
client with mastoiditis. On examination of the tympanic
membrane, which of the following would the nurse expect
to observe?
a) a pink-colored tympanic membrane
b) a pearly colored tympanic membrane
c) a transparent and clear tympanic membrane
d) a red, dull, thick and immobile tympanic
membrane
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.
3. The client is diagnosed with a disorder involving the inner
ear. Which of the following is the most common client
complaint associated with a disorder involving this part of
the ear?
a) pruritus
b) tinnitus
c) hearing loss
d) burning in the ear
Tinnitus is the most common complaint of clients
with otological disorders, especially disorders involving
the inner ear. Symptoms of tinnitus 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. Options A, C,
and D are not associated specifically with disorders of the
inner ear.
4. The nurse is performing a voice test to assess hearing.
Which of the following describes the accurate procedure
for performing this test?
a) whisper a statement while the client blocks both ears
b) whisper a statement with the examiner's back facing
the client
c) whisper a statement and ask the client to
repeat it while blocking one ear
d) stand 4 feet away from the client to ensure that the
client can hear at this distance
In the voice test, the examiner stands 1 to 2 feet
away from the client and asks the client to block one
external ear canal. The nurse whispers a statement and
asks the client to repeat it. Each ear is tested separately.
5. During a hearing assessment, the nurse notes that the
sound lateralizes to the client's left ear with the Weber
test. The nurse analyzes these results as:
a) a normal finding
b) the presence of nystagmus
c) a sensorineural or conductive loss
d) a conductive loss in the right ear
the midline of the forehead, or above the upper lip over
the teeth. Normally, the sound is heard equally in both
ears by bone conduction. If the client has a sensorineural
hearing loss in one ear, the sound is heard in the other
ear. If the client has a conductive hearing loss in one ear,
the sound is heard in that ear.
6. The nurse is caring for a hearing-impaired client. Which of
the following approaches will facilitate communication?
a) speak loudly
b) speak frequently
c) speak at a normal volume
d) speak directly into the impaired ear
Speaking in a normal tone to the client with impaired
hearing and not shouting are important. The nurse should
talk directly to the client while facing the client and speak
clearly. If the client does not seem to understand what is
said, the nurse should express it differently. Moving
closer to the client and toward the better ear may
facilitate communication, but the nurse should avoid
talking directly into the impaired ear.
7. A client arrives at the emergency room with a foreign
body in the left ear that has been determined to be an
insect. Which intervention would the nurse anticipate to
be prescribed initially?
a) irrigation of the ear
b) instillation of diluted alcohol
c) instillation of antibiotic ear drops
d) instillation of corticosteroid ointment
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 then is removed using ear forceps. When
the foreign object is vegetable matter, irrigation is not
used, because this material expands with hydration and
the impaction becomes worse.
8. The nurse notes that the physician has documented a
diagnosis of presbycusis on the client's chart. The nurse
plans care knowing that the condition is:
a) tinnitus that occurs with aging
b) nystagmus that occurs with aging
c) a conductive hearing loss that occurs with aging
d) a sensorineural hearing loss that occurs with
aging
Presbycusis is a type of hearing loss that occurs with
aging. Presbycusis is a gradual sensorineural loss caused
by nerve degeneration in the inner ear or auditory nerve.
Options A, B, and C are incorrect.
9. The nurse has conducted discharge teaching for a client
who has had a fenestration procedure for the treatment
of otosclerosis. Which of the following, if stated by the
client, would indicate that teaching was effective?
a) it is okay to take a shower and wash my hair
b) I can resume my tennis lessons starting next week
c) I will take stool softeners as prescribed by my
doctor
d) I should drink liquids through a straw fo the next 2 to
3 weeks
Following ear surgery, the client needs to avoid
straining when having a bowel movement. The client
needs to be instructed to avoid drinking with a straw for 2
to 3 weeks, air travel, and coughing excessively. The
client needs to avoid getting his or her head wet, washing
hair, showering for 1 week, and rapidly moving the head,
bouncing, and bending over for 3 weeks.
10. A client with Meniere's disease is experiencing severe
vertigo. Which instruction should the nurse give to the
client to assist in controlling the vertigo?
a) increase sodium in the diet
b) avoid sudden head movements
c) lie still and watch the television
d) increase fluid intake to 3L a day
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.
Lying still and watching television will not control vertigo.
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
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. 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
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. 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)
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. 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) ssists the client to turn his or her head so that the
ear to be irrigated is facing upward
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. 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
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.
16. The nurse is preparing to perform an otoscopic
examination on an adult client. The nurse does which of
the following to perform this examination?
a) pulls the pinna up and back before inserting
the speculum
b) pulls the earlobe down and back before inserting the
speculum
c) uses the smallest speculum available to decrease the
discomfort of the exam
d) tilts the clients head forward and down before
inserting the speculum
The nurse tilts the client’s head slightly away and
holds the otoscope upside down as if it were a large pen.
The pinna is pulled up and back and the nurse visualizes
the external canal while slowly inserting the speculum.
Options B, C, and D are incorrect.
17. A nurse is providing diet instructions to a client with
Meniere's disease who is being discharged from the
hospital after admission for an acute attack. Which
statement if made by the client indicates an
understanding of the dietary measures to take to prevent
further attacks?
a) I need to drink at least 3 liters of fluid per day
b) I need to restrict my carbohydrates intake
c) I need to maintain a low-fat and low-cholesterol diet
d) I need to be sure to consume foods that are
low in sodium
Dietary changes such as salt and fluid restrictions
that reduce the amount of endolymphatic fluid are
sometimes prescribed for the client with Ménière’s
disease. The client should be instructed to consume a
low-sodium diet and restrict fluids as prescribed. Low-fat,
low-carbohydrate, and low-cholesterol diets are not
specifically prescribed for the client with Ménière’s
disease.
18. A nurse in the health care clinic is providing instructions
to a client regarding the use of a hearing aid. Which of
 the following statements would be appropriate for the
nurse to include?
a) the ear mold for the hearing aid should be washed
with mild soap and water once a month
b) the hearing aid should be removed from the ear at
the end of the day then turned off after removal
c) the hearing aid contains a lifelong battery so you will
not need to be concerned about changing batteries
d) the hearing aid should not be worn if an ear
infection is present
The client should be instructed that the hearing aid
should not be worn if an ear infection is present. The
client should be instructed to turn the hearing aid off
before removing it from the ear to prevent any squealing
feedback. The hearing aid should be turned off when not
in use and the client should keep extra batteries on hand
at all times. The client should wash the ear mold
frequently with mild soap and water, with the use of a
pipe cleaner to clean the cannula of the hearing aid.
19. A nurse is caring for a client with acute otitis media. In
order to reduce pressure and allow fluid to drain, the
nurse anticipates that which of the following would most
likely be recommended to the client?
a) the administration of diphenhydramine (Benadryl)
capsules
b) a myringotomy
c) strict bedrest
d) a mastoidectomy
A myringotomy is a surgical procedure that will allow
fluid to drain from the middle ear. Benadryl is an
antihistamine with antiemetic properties. Strict bedrest is
not necessary, although activity may be restricted.
Additionally, bedrest would not assist in reducing
pressure or allowing fluid to drain. In some cases, the
mastoid bone is removed or partially removed for chronic
otitis media.
20. A nurse is developing a plan of care for a client with a
diagnosis of Meniere's disease who is being admitted to
the hospital. The priority nursing intervention in the plan
of care should focus on:
a) safety measures
b) self-care measures
c) knowledge about medication therapy
d) food items to avoid
Ménière’s disease can cause severe vertigo in the
client. The priority in the nursing care plan should focus
on safety issues to prevent falls or injury in the client.
Although self-care measures, medication therapy, and
dietary therapy may be components of the plan of care,
safety is the priority issue.
21. A nurse is assigned to care for a client after a
mastoidectomy. Which nursing intervention would be
appropriate in the care of this client?
a) maintain a supine position
b) position the client on the affected side to promote
drainage
c) change the ear dressing daily
d) monitor for signs of facial nerve injury
After mastoidectomy, the nurse should monitor vital
signs and inspect the dressing for drainage or bleeding.
The nurse also should assess for signs of facial nerve
injury (cranial nerve VII). The nurse also should monitor
for signs of pain, dizziness, or nausea. The head of the
bed should be elevated at least 30 degrees, and the
client should be instructed to lie on the unaffected side.
The client probably will have sutures, an outer ear
packing, and a bulky dressing, which is removed on
approximately the sixth day postoperatively.
22. A nurse is performing an assessment on a client with a
diagnosis of Meniere's disease. The nurse anticipates that
the client is most likely to report which of the following
symptoms during an acute attack?
a) tinnitus
b) headache
c) fatigue
d) insomnia
Ménière’s disease results in a disturbance of the fluid
of the endolymphatic system. The cause of the
disturbance is not known. Attacks may be preceded by
feelings of fullness in the ear or by tinnitus. Headaches,
fatigue, and insomnia are not associated with this
disorder.
23. A nurse has admitted a client with a diagnosis of an acute
attack of Meniere's disease to the hospital. The nurse
reviews the physician's orders for the client. Which order
should the nurse question?
a) diphenhydramine (Benadryl)
b) diazepam (Valium)
c) atropine sulfate
d) ambulation 4 times daily
Medical interventions during the acute phase of
Ménière’s disease include using atropine sulfate or
diazepam to decrease the autonomic nervous system
function. Diphenhydramine may be prescribed for its
antihistamine effects, and a vasodilator also will be
prescribed. The client will remain on bedrest during the
acute attack. When allowed out of bed, the client will
need assistance with walking, sitting, or standing.
24. A nurse in the health care clinic is preparing to perform
an otoscopic examination on adult client. In performing
the examination, the nurse should:
a) position the client lying flat on the side of the ear be
examined
b) pull the ear lobe down and back before inserting the
speculum
c) tilt the client's head forward before inserting the
speculum
d) pull the pinna up and back before inserting the
speculum
The correct procedure for performing an otoscopic
examination on an adult is to pull the pinna up and back
to allow visualization of the external canal while slowly
inserting the speculum. The nurse would tilt the client’s
head slightly away and hold the otoscope upside down as
if it were a large pen. The examination would be
performed with the client in a sitting position. If the client
were lying on the side to be examined, examination of
the affected ear would not be possible.
25. A nurse is providing discharge instructions to the client
being discharged after a fenestration procedure for the
treatment of otosclerosis. Which statement if made by
the client indicates a need for further instruction?
a) I should take stool softeners to avoid straining when
having a bowel movement
b) I need to avoid washing my hair and showering for at
least 1 week
c) I should avoid movements requiring bending over for
at least 3 weeks
d) I should use a straw to drink liquids for the
next 2 to 3 weeks
After ear surgery, clients need to be instructed to
avoid drinking with a straw for 2 to 3 weeks, to avoid air
travel, and to avoid coughing excessively. The client also
should be instructed to avoid straining when having a
bowel movement and should be instructed to take stool
softeners as prescribed. The client should avoid getting
the head wet, washing the hair, or showering for at least
1 week, and to avoid rapidly moving the head, bouncing,
and bending over for at least 3 weeks.
26. The clinic nurse is preparing to provide care for a client
who will need an ear irrigation to remove impacted
cerumen. Which of the following will the nurse avoid
when performing the irrigation?
a) position the client to turn the head so that the
ear be irrigated is facing upward
b) warm the irrigating solution to a temperature that is
close to body temperature
c) direct a slow steady stream of irrigation solution
toward the upper wall of the ear canal
d) position the client with the affected side down after
irrigation
During the irrigation, 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 earwax and
solution. Delivery of irrigation solutions at temperatures
that are not close to body temperature can cause
discomfort for the client and may result in tissue injury,
nausea, and vertigo. A slow, steady stream of solution
should be directed toward the upper wall of the ear canal,
not toward the tympanic membrane. After the irrigation,
the client should lie on the affected side for a period of
time that is necessary to allow the irrigating solution to
finish draining (usually 10 to 15 minutes). Too much force
could cause the tympanic membrane to rupture.
27. A nursing student is performing an otoscopic examination
in an adult client. The nursing instructor observes the
student perform this procedure. Which observation by the
instructor indicates that the student is using correct
technique for the procedure?
a) pulling the pinna down and back before inserting the
speculum
b) pulling the earlobe down and back before inserting
the speculum
c) using the smallest speculum available
d) tilting the client's head slightly away and
holding the otoscope upside before inserting
the speculum
In the otoscopic examination, the nurse tilts the
client’s head slightly away and holds the otoscope upside
down as if it were a large pen. The pinna is pulled up and
back and the nurse visualizes the external canal while
slowly inserting the speculum. A small speculum is used
in pediatric clients. The nurse may not be able to
adequately visualize the ear canal if a small speculum is
used in the adult client.
28. A nurse is preparing to perform a Weber test on a client.
The nurse obtains which item needed to perform this
test?
a) a tongue blade
b) a stethoscope
c) a tuning fork
d) a reflex hammer
A tuning fork is needed to perform the Weber test,
during which the nurse places the vibrating tuning fork at
the midline of the client’s forehead or above the upper lip
over the teeth. Normally, the sound is heard equally in
both ears by bone conduction. If the client has a
sensorineural hearing loss in one ear, the sound is heard
in the other ear. If the client has a conductive hearing
loss in one ear, the sound is heard in that ear. The items
identified in options A, B, and D are not needed to
perform the Weber test.
29. The home care nurse is visiting a client who was recently
diagnosed with a hearing impairment. The nurse prepares
to instruct the client's spouse in which measure that will
facilitate communication?
a) speak frequently to the client to provide sensory
stimulation
b) speak loudly to the client to facilitate hearing
c) speak in a normal tone and face the client
when speaking
d) speak directly into the impaired ear to facilitate
hearing
Measures that facilitate hearing in the client with a
hearing impairment problem include speaking in a normal
tone; avoiding shouting; talking directly to the client while
facing the client; and speaking clearly. If the client does
not seem to understand what is said, the statement
should be expressed differently. Moving closer to the
client and toward the better ear may facilitate
communication, but talking directly into the impaired ear
should be avoided.
30. A nurse is providing discharge instructions to a client who
had a fenestration procedure for the treatment of
otosclerosis. The nurse instructs the client to:
a) drink liquids through a straw for the next 2 to 3
weeks
b) shower daily to prevent infection
c) avoid air travel
d) resume all normal activities in 1 week
After ear surgery, the client needs to be instructed to
avoid air travel, avoid drinking through a straw for 2 to 3
weeks, and to avoid coughing excessively. In addition,
the client should avoid straining when having a bowel
movement, as well as washing the hair, getting the head
wet, or showering for 1 week. The client also needs to
avoid rapidly moving the head, bouncing, and bending
over for 3 weeks.
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
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. 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
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 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
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 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
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. 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
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.
36. A nurse is planning a presentation on noise prevention
and ear protection for a display booth at a local health
fair. The nurse plans to incorporate which important
concept regarding hearing loss in the presentation?
a) siting near loud music is not harmful
b) ear plugs or other protectors are necessary only
when use of power tools
c) prolonged ringing in the ears after loud noises is
normal
d) cup the hands over the ears if loud noise is
expected suddenly
A variety of ear protective devices are available
commercially. These include disposable and reusable
plugs, headbands, and foam-filled muffs. They should be
used around any type of loud noise, such as from power
tools, machinery, lawn mowers, chain saws, or other
equipment. Sitting near loud music should be avoided
whenever possible. If a loud noise is suddenly
anticipated, the ears should be covered for protection.
The client should see a physician for tinnitus or hearing
loss after exposure to a loud noise.
37. A nurse instructs a client in the use of a hearing aid. The
nurse includes which of the following in the instructions?
a) check the battery to ensure that it is working
before use
b) leave the hearing aid in place while showering
c) hearing aids do not require any care
d) a water-soluble lubricant is used on the hearing aid
before insertion
The battery of the hearing aid should be checked
before use. The hearing aid should be removed for
showering, because it should not get wet. It also should
be put away in its case at night. It should be cleaned
according to manufacturer’s directions, which usually
consist of washing with warm soapy water, followed by
thorough drying. Lubricants or other solvents are not
used on the hearing aid.
38. A nurse has given a client at risk for motion sickness
suggestions about medications that can prevent an
occurrence. The nurse determines that the client has
correctly learned the information if the client states to
take medication at what time before the triggering event?
a) at least 1/2 day before
b) at least 1 hour before
c) at least the day before
d) at least 2 days before
To be maximally effective, medications to prevent
motion sickness should be taken at least 1 hour before
the triggering event. Medications that are commonly used
for this purpose include dimenhydrinate (Dramamine),
scopolamine (Transderm-Scop), promethazine
(Phenergan), and prochlorperazine (Compazine). Options
A, C, and D are incorrect.
39. An adult client makes an appointment with an ear
specialist because of the frequent recurrence of middle
ear infections. In performing an intake assessment of the
client, the nurse would ask about which of the following
as a risk factor related to infection of the ears?
a) exposure to loud noise
b) use of drilling and other power tools
c) congenital abnormalities
d) occupational noise
Otitis media (middle ear infection) is associated with
colds, allergies, sore throats, and blockage of the
eustachian tube. Risk factors include a young age
(usually a childhood disease), congenital abnormalities,
immune deficiencies, exposure to cigarette smoke, family
history of otitis media, recent upper respiratory
infections, and allergies. Options A, B, and D can cause
hearing loss. Hearing loss can occur as a result of an
acute loud noise (acoustic trauma) or by the chronic
exposure to loud noise (noise-induced hearing loss).
40. A nurse is planning to instruct a client with chronic
vertigo about safety measures to prevent exacerbation of
symptoms or injury. Teaching for this client will include
which of the following statements?
a) drive only when feelings of dizziness have not been
experienced for several hours
b) go to the bedroom and lie down when vertigo is
experienced
c) remove throw rugs and clutter in the home
d) turn the head slowly when spoken to
The client with chronic vertigo should avoid driving
and using public transportation. The sudden movements
involved in each could precipitate an attack. To further
prevent vertigo attacks, the client should change
positions slowly and should turn the entire body, not just
the head, when spoken to. If vertigo does occur, the
client should immediately sit down or grasp the nearest
piece of furniture. The client should maintain the home
without throw rugs and in a state that is free of clutter,
because the effort of trying to regain balance after
slipping could trigger the onset of vertigo.