Question 1

The nurse is assessing a patient who may have hearing loss.Which of these statements concerning air conduction is true?

Accepted Answer

The normal pathway of hearing is air conduction, which starts when sound waves produce vibrations on the tympanic membrane.Conductive hearing loss results from a mechanical dysfunction of the external or middle ear.The other statements are not true concerning air conduction.

Question 2

A patient has been shown to have a sensorineural hearing loss.During the assessment, it would be important for the nurse to:

Accepted Answer

A simple increase in amplitude may not enable the person to understand spoken words.Sensorineural hearing loss may be caused by presbycusis, which is a gradual nerve degeneration that occurs with aging and by ototoxic drugs, which affect the hair cells in the cochlea.

Question 3

The nurse is taking the history of a patient who may have a perforated eardrum.What would be an important question in this situation?

Accepted Answer

Typically with perforation, ear pain occurs first, stopping with a popping sensation, and then drainage occurs.

Question 4

In performing a voice test to assess hearing, which of these actions would the nurse perform?

Accepted Answer

With the head half a metre (2 feet) from the patient's ear, the examiner exhales and slowly whispers a set of random numbers and letters, such as "5, B, 6." Normally, the patient is asked to repeat each number and letter correctly after hearing the examiner say them.

Question 5

A patient in her first trimester of pregnancy is diagnosed with rubella.Which of these statements is correct regarding the significance of this in relation to the infant's hearing?

Accepted Answer

If maternal rubella infection occurs during the first trimester, then it can damage the organ of Corti and impair hearing in the child.

Question 6

A patient with a middle ear infection asks the nurse, "What does the middle ear do?" The nurse responds by telling the patient that the middle ear functions to:

Accepted Answer

Among its other functions, the middle ear conducts sound vibrations from the outer ear to the central hearing apparatus in the inner ear.The other responses are not functions of the middle ear.

Question 7

The nurse is reviewing the function of the cranial nerves (CNs).Which CN is responsible for conducting nerve impulses to the brain from the organ of Corti?

Accepted Answer

The nerve impulses are conducted by the auditory portion of CN VIII to the brain.

Question 8

The nurse is performing an otoscopic examination on an adult.Which of these actions is correct?

Accepted Answer

The pinna is pulled up and back on an adult or older child, which helps straighten the "S" shape of the canal.Traction should not be released on the ear until the examination is completed and the otoscope is removed.

Question 9

When reviewing the structures of the ear with a class of nursing students, the nurse discusses the importance of the function of the eustachian tube in:

Accepted Answer

The eustachian tube allows an equalization of air pressure on each side of the tympanic membrane so that the membrane does not rupture during, for example, altitude changes in an airplane.The tube is normally closed, but it opens with swallowing or yawning.

Question 10

A 70-year-old patient tells the nurse that he has noticed that he is having trouble hearing, especially in large groups.He says that he "can't always tell where the sound is coming from" and the words often sound "mixed up." What might the nurse suspect as the cause for this change?

Accepted Answer

Presbycusis is a type of hearing loss that occurs in 60% of those older than 65 years of age, even in those living in a quiet environment.This sensorineural loss is gradual and caused by nerve degeneration in the inner ear.Words sound garbled, and the ability to localize sound is also impaired.This communication dysfunction is accentuated when background noise is present.

Question 11

The nurse is examining a patient's ears and notices a yellow waxy substance in the external canal.The nurse recognizes this:

Accepted Answer

The ear is lined with glands that secrete cerumen, which is a yellow waxy material that lubricates and protects the ear.

Question 12

When examining the ear with an otoscope, the nurse notes that the tympanic membrane is translucent and pearly.The nurse will:

Accepted Answer

The tympanic membrane is a translucent membrane with a pearly grey colour and a prominent cone of light in the anteroinferior quadrant, which is the reflection of the otoscope light.The tympanic membrane is oval and slightly concave, pulled in at its centre by the malleus, which is one of the middle ear ossicles.

Question 13

The nurse is assessing a 16-year-old patient who has suffered head injuries from a recent motor vehicle accident.Which of these statements indicates the most important reason for assessing for any drainage from the ear canal?

Accepted Answer

Frank blood or clear watery drainage (cerebrospinal fluid leak) after a trauma suggests a basal skull fracture and warrants immediate referral.Purulent drainage indicates otitis externa or otitis media.

Question 14

A 31-year-old patient tells the nurse that he has noticed pain in his left ear when people speak loudly to him.The nurse knows that this finding:

Accepted Answer

Recruitment is significant hearing loss occurring when speech is at low intensity, but sound actually becomes painful when the speaker repeats at a louder volume.The other responses are not correct.

Question 15

The mother of a 2-year-old is concerned because her son has had three ear infections in the past year.What would be an appropriate response by the nurse?

Accepted Answer

The infant's eustachian tube is relatively shorter and wider than the adult's eustachian tube, and its position is more horizontal; consequently, pathogens from the nasopharynx can more easily migrate through to the middle ear.The other responses are not appropriate.

Question 16

The nurse is administering ear drops to a 68-year-old patient.The nurse will pull the area of the ear consisting of movable cartilage and skin, known as the ___________, upward and backward to open the ear canal.

Accepted Answer

The external ear is called the auricle or pinna and consists of movable cartilage and skin.

Question 17

During an interview, the patient states he has the sensation that "everything around him is spinning." The nurse recognizes that the portion of the ear responsible for this sensation is the:

Accepted Answer

If the labyrinth ever becomes inflamed, it feeds the wrong information to the brain, creating a staggering gait and a strong spinning and whirling sensation called vertigo.

Question 18

While discussing the history of a 6-month-old infant, the mother tells the nurse that she took a significant amount of aspirin while she was pregnant.What question would the nurse want to include during history taking?

Accepted Answer

Children at risk for a hearing deficit include those exposed in utero to a variety of conditions, such as maternal rubella or to maternal ototoxic drugs.

Question 19

A 31-year-old patient tells the nurse that he has noticed a progressive loss in his hearing.He says that it does seem to help when people speak louder or if he turns up the volume of the television or radio.The most likely cause of his hearing loss is:

Accepted Answer

Otosclerosis is a common cause of conductive hearing loss in young adults between ages 20 and 40 years.Presbycusis is a type of hearing loss that occurs with aging.Trauma and frequent ear infections are not a likely cause of his hearing loss.

Question 20

During an assessment of a 20-year-old Asian patient, the nurse notices that he has dry, flaky cerumen in his canal.The nurse recognizes this as:

Accepted Answer

Individuals of Asian or Indigenous descent are more likely to have dry cerumen, whereas those of African or European descent usually have wet cerumen.

Quiz 16: Ears