ATI LPN
Timby's Introductory Medical-Surgical Nursing Thirteenth, North American Edition
Chapter 43 : Caring for Clients With Ear Disorders Questions
Question 1 of 5
Which symptom reported by a client would the nurse relate to a tentative diagnosis of objective vertigo?
Correct Answer: D
Rationale: Objective vertigo includes the sensation that the environment is moving or a sense that things are moving around oneself. The symptoms do not include a headache, pain in the outer ear, or difficulty hearing.
Question 2 of 5
Which nursing goal is a priority when caring for a client newly diagnosed with vertigo?
Correct Answer: B
Rationale: Safety is always a concern when a client is experiencing vertigo. The goal of the nurse's instruction and care is for the client to remain safe. Maintaining a therapeutic medication schedule and caretaker and establishing strategies to reduce symptoms are important but not of highest priority.
Question 3 of 5
The nurse on a cruise ship is assessing clients for motion sickness. Which is a common misconception regarding motion sickness?
Correct Answer: B
Rationale: When the client experiences motion sickness, the client will use that data to avoid further symptoms in the future. The client can use medication, change location or position, and recognize symptoms earlier for symptom management. The other options are correct and teachable statements.
Question 4 of 5
The nurse is caring for a client in the triage section of a walk-in clinic. Which triad of common symptoms suggests a diagnosis of M?©ni?¨re disease?
Correct Answer: D
Rationale: Hearing loss, vertigo, and tinnitus are common symptoms of many disease processes but, when placed together, indicate M?©ni?¨re disease. The other options do not include the accurate triad of symptoms.
Question 5 of 5
The nurse is instructing a client's family members on the most incapacitating symptom of M?©ni?¨re disease. Which nursing instruction associated with the symptom is most helpful?
Correct Answer: A
Rationale: The most incapacitating symptom of M?©ni?¨re disease is vertigo. When the client is experiencing vertigo or dizziness, gait becomes unsteady. Having a person assist the client when ambulating is most helpful in preventing falls. Keeping a bucket at the bedside is helpful if the client is experiencing nausea. Photophobia is not a main symptom of M?©ni?¨re disease. If the client experiences hearing loss, being able to see the nurse's lips may be helpful.