AD1 HESI: Eyes, Ears, and Sensory questions
with verified answers
A client presents with hearing loss in the right ear. When the nurse
performs a Weber test with a tuning fork, the client hears the sound
better with the right ear. Which condition would the nurse suspect from
these results? Ans✓✓✓Conduction hearing loss
Rationale: During a Weber test, conduction hearing loss often causes the
tuning fork to be heard better and more clearly in the impaired ear
A client receiving intravenous vancomycin reports ringing in both ears.
Which initial action would the nurse take? Ans✓✓✓Stop the infusion.
Rationale: Vancomycin can cause temporary or permanent hearing loss.
A client says, 'I hear a man speaking from the corner of the room. Do
you hear him, too?' Which response is best? Ans✓✓✓No, I don't hear
him, but that must be upsetting for you.
Rationale: The nurse states reality and then acknowledges the client's
feelings.
A client who sustained a head injury from a fall off a ladder has clear
fluid leaking from the left ear. Which action would the nurse take?
Ans✓✓✓Test the ear drainage with a glucose reagent strip.
,Rationale: If a basilar skull fracture has occurred, the CSF may drain
through the client's ears or nose. This clear fluid may be tested with a
glucose strip.
A client who sustained a head injury reports to the nurse that food
always tastes unappealingly bland even though the food has been
prepared to be flavorful. Which area of the brain would the nurse suspect
to be affected in the client? Ans✓✓✓Parietal lobe
Rationale: Functions of the parietal lobe of brain include interpretation
of taste impulses and spatial perception and understanding of sensory
inputs.
A client with diabetes mellitus complains of difficulty seeing. Which
factor would the nurse suspect as being the cause? Ans✓✓✓The growth
of new retina blood vessels or 'neovascularization'
Rationale: Proliferative diabetic retinopathy is growth of new retinal
blood vessels, also known as 'neovascularization.' When retinal blood
flow is poor and hypoxia develops, retinal cells secrete growth factors
that stimulate the formation of new blood vessels in the eye. These new
vessels are thin, fragile, and bleed easily, leading to eye hemorrhage and
vision loss. Hemorrhage in the eyes precipitate retinal detachment,
resulting in blindness.
A client with pulmonary tuberculosis develops tinnitus and vertigo.
Which antitubercular medication would the nurse suspect is causing
these symptoms? Ans✓✓✓Streptomycin
, Rationale: Streptomycin is ototoxic and can cause damage to the eighth
cranial nerve, resulting in deafness.
After many episodes of otitis media a 3 year old is to undergo
myringotomy and have tubes implanted surgically. Which should the
nurse include in the discharge preparation for this family?
Ans✓✓✓Insert earplugs during the child's bath.
Rationale: Water in the ears after myringotomy may be a source of
infection.
An auditory screening reveals that a child has mild hearing loss. Which
statement would the nurse use to explain this degree of hearing loss?
A severe hearing deficit may develop
It will not interfere with progress in school
An immediate follow-up visit is not necessary
Speech therapy and hearing aids may be required Ans✓✓✓Speech
therapy and hearing aids may be required
with verified answers
A client presents with hearing loss in the right ear. When the nurse
performs a Weber test with a tuning fork, the client hears the sound
better with the right ear. Which condition would the nurse suspect from
these results? Ans✓✓✓Conduction hearing loss
Rationale: During a Weber test, conduction hearing loss often causes the
tuning fork to be heard better and more clearly in the impaired ear
A client receiving intravenous vancomycin reports ringing in both ears.
Which initial action would the nurse take? Ans✓✓✓Stop the infusion.
Rationale: Vancomycin can cause temporary or permanent hearing loss.
A client says, 'I hear a man speaking from the corner of the room. Do
you hear him, too?' Which response is best? Ans✓✓✓No, I don't hear
him, but that must be upsetting for you.
Rationale: The nurse states reality and then acknowledges the client's
feelings.
A client who sustained a head injury from a fall off a ladder has clear
fluid leaking from the left ear. Which action would the nurse take?
Ans✓✓✓Test the ear drainage with a glucose reagent strip.
,Rationale: If a basilar skull fracture has occurred, the CSF may drain
through the client's ears or nose. This clear fluid may be tested with a
glucose strip.
A client who sustained a head injury reports to the nurse that food
always tastes unappealingly bland even though the food has been
prepared to be flavorful. Which area of the brain would the nurse suspect
to be affected in the client? Ans✓✓✓Parietal lobe
Rationale: Functions of the parietal lobe of brain include interpretation
of taste impulses and spatial perception and understanding of sensory
inputs.
A client with diabetes mellitus complains of difficulty seeing. Which
factor would the nurse suspect as being the cause? Ans✓✓✓The growth
of new retina blood vessels or 'neovascularization'
Rationale: Proliferative diabetic retinopathy is growth of new retinal
blood vessels, also known as 'neovascularization.' When retinal blood
flow is poor and hypoxia develops, retinal cells secrete growth factors
that stimulate the formation of new blood vessels in the eye. These new
vessels are thin, fragile, and bleed easily, leading to eye hemorrhage and
vision loss. Hemorrhage in the eyes precipitate retinal detachment,
resulting in blindness.
A client with pulmonary tuberculosis develops tinnitus and vertigo.
Which antitubercular medication would the nurse suspect is causing
these symptoms? Ans✓✓✓Streptomycin
, Rationale: Streptomycin is ototoxic and can cause damage to the eighth
cranial nerve, resulting in deafness.
After many episodes of otitis media a 3 year old is to undergo
myringotomy and have tubes implanted surgically. Which should the
nurse include in the discharge preparation for this family?
Ans✓✓✓Insert earplugs during the child's bath.
Rationale: Water in the ears after myringotomy may be a source of
infection.
An auditory screening reveals that a child has mild hearing loss. Which
statement would the nurse use to explain this degree of hearing loss?
A severe hearing deficit may develop
It will not interfere with progress in school
An immediate follow-up visit is not necessary
Speech therapy and hearing aids may be required Ans✓✓✓Speech
therapy and hearing aids may be required
