Question 1

The nurse is performing an ear examination of an 80-year-old patient.Which of these findings would be considered normal?

Accepted Answer

A high-tone frequency hearing loss is apparent for those affected with presbycusis,the hearing loss that occurs with aging.The pinna loses elasticity,causing earlobes to be pendulous.The eardrum may be whiter in color and more opaque and duller in the older person than in the younger adult.

Question 2

A patient has been admitted after an accident at work.During the assessment,the patient is having trouble hearing and states,"I don't know what the matter is.All of a sudden,I can't hear you out of my left ear!" What should the nurse do next?

Accepted Answer

Any sudden loss of hearing in one or both ears that is not associated with an upper respiratory infection needs to be reported at once to the patient's health care provider.Hearing loss associated with trauma is often sudden.Irrigating the ear or removing cerumen is not appropriate at this time.

Question 3

The nurse is performing an assessment on a 65-year-old man.He reports a crusty nodule behind the pinna.It intermittently bleeds and has not healed over the past 6 months.On physical assessment,the nurse finds an ulcerated crusted nodule with an indurated base.The preliminary analysis in this situation is that this:

Accepted Answer

An ulcerated crusted nodule with an indurated base that fails to heal is characteristic of a carcinoma.These lesions fail to heal and intermittently bleed.Individuals with such symptoms should be referred for a biopsy (see Table 15-2).The other responses are not correct.

Question 4

The nurse is preparing to do an otoscopic examination on a 2-year-old child.Which one of these reflects the correct procedure?

Accepted Answer

For an otoscopic examination on an infant or on a child under 3 years of age,the pinna is pulled down.The other responses are not part of the correct procedure.

Question 5

The nurse is testing the hearing of a 78-year-old man and is reminded of the changes in hearing that occur with aging that include which of the following? Select all that apply.

Accepted Answer

Presbycusis is a type of hearing loss that occurs with aging and is found in 60% of those older than 65 years.It is a gradual sensorineural loss caused by nerve degeneration in the inner ear or auditory nerve,and it slowly progresses after the age of 50 years.The person first notices a high-frequency tone loss; it is harder to hear consonants (high-pitched components of speech)than vowels,which makes words sound garbled.The ability to localize sound is also impaired.

Question 6

The nurse suspects that a patient has otitis media.Early signs of otitis media include which of these findings of the tympanic membrane?

Accepted Answer

An early sign of otitis media is hypomobility of the tympanic membrane.As pressure increases,the tympanic membrane begins to bulge.

Question 7

The nurse is conducting a child safety class for new mothers.Which factor places young children at risk for ear infections?

Accepted Answer

Exposure to passive and gestational smoke is a risk factor for ear infections in infants and children.

Question 8

The nurse is preparing to perform an otoscopic examination of a newborn infant.Which statement is true regarding this examination?

Accepted Answer

During the first few days after the birth,the tympanic membrane of a newborn often appears thickened and opaque.It may look injected and have a mild redness from increased vascularity.The other statements are not correct.

Question 9

The mother of a 2-year-old toddler is concerned about the upcoming placement of tympanostomy tubes in her son's ears.The nurse would include which of these statements in the teaching plan?

Accepted Answer

Polyethylene tubes are surgically inserted into the eardrum to relieve middle ear pressure and to promote drainage of chronic or recurrent middle ear infections.Tubes spontaneously extrude in 6 months to 1 year.

Question 10

A 17-year-old student is a swimmer on her high school's swim team.She has had three bouts of otitis externa this season and wants to know what to do to prevent it.The nurse instructs her to:

Accepted Answer

With otitis externa (swimmer's ear),swimming causes the external canal to become waterlogged and swell; skinfolds are set up for infection.Otitis externa can be prevented by using rubbing alcohol or 2% acetic acid eardrops after every swim.

Question 11

During an examination,the nurse notices that the patient stumbles a little while walking,and,when she sits down,she holds on to the sides of the chair.The patient states,"It feels like the room is spinning!" The nurse notices that the patient is experiencing:

Accepted Answer

With objective vertigo,the patient feels like the room spins; with subjective vertigo,the person feels like he or she is spinning.Tinnitus is a sound that comes from within a person; it can be a ringing,crackling,or buzzing sound.It accompanies some hearing or ear disorders.Dizziness is not the same as true vertigo; the person who is dizzy may feel unsteady and lightheaded.

Question 12

In an individual with otitis externa,which of these signs would the nurse expect to find on assessment?

Accepted Answer

The lymphatic drainage of the external ear flows to the parotid,mastoid,and superficial cervical nodes.The signs are severe swelling of the canal,inflammation,and tenderness.Rhinorrhea,periorbital edema,and pain over the maxillary sinuses do not occur with otitis externa.

Question 13

In performing an examination of a 3-year-old child with a suspected ear infection,the nurse would:

Accepted Answer

In addition to its place in the complete examination,eardrum assessment is mandatory for any infant or child requiring care for an illness or fever.For the infant or young child,the timing of the otoscopic examination is best toward the end of the complete examination.

Question 14

The nurse is performing a middle ear assessment on a 15-year-old patient who has had a history of chronic ear infections.When examining the right tympanic membrane,the nurse sees the presence of dense white patches.The tympanic membrane is otherwise unremarkable.It is pearly,with the light reflex at 5 o'clock and landmarks visible.The nurse should:

Accepted Answer

Dense white patches on the tympanic membrane are sequelae of repeated ear infections.They do not necessarily affect hearing.

Question 15

When performing an otoscopic examination of a 5-year-old child with a history of chronic ear infections,the nurse sees that his right tympanic membrane is amber-yellow in color and that air bubbles are visible behind the tympanic membrane.The child reports occasional hearing loss and a popping sound with swallowing.The preliminary analysis based on this information is that the child:

Accepted Answer

An amber-yellow color to the tympanic membrane suggests serum or pus in the middle ear.Air or fluid or bubbles behind the tympanic membrane are often visible.The patient may have feelings of fullness,transient hearing loss,and a popping sound with swallowing.These findings most likely suggest that the child has serous otitis media.The other responses are not correct.

Question 16

The nurse assesses the hearing of a 7-month-old by clapping hands.What is the expected response? The infant:

Accepted Answer

With a loud sudden noise,the nurse should notice the infant turning his or her head to localize the sound and to respond to his or her own name.A startle reflex and acoustic blink reflex is expected in newborns; at age 3 to 4 months,the infant stops any movement and appears to listen.

Question 17

While performing the otoscopic examination of a 3-year-old boy who has been pulling on his left ear,the nurse finds that his left tympanic membrane is bright red and that the light reflex is not visible.The nurse interprets these findings to indicate a(n):

Accepted Answer

Absent or distorted light reflex and a bright red color of the eardrum are indicative of acute otitis media.(See Table 15-5 for descriptions of the other conditions.)

Question 18

During an examination,the patient states he is hearing a buzzing sound and says that it is "driving me crazy!" The nurse recognizes that this symptom indicates:

Accepted Answer

Tinnitus is a sound that comes from within a person; it can be a ringing,crackling,or buzzing sound.It accompanies some hearing or ear disorders.

Question 19

An assessment of a 23-year-old patient reveals the following: an auricle that is tender and reddish-blue in color with small vesicles.The nurse would need to know additional information that includes which of these?

Accepted Answer

Frostbite causes reddish-blue discoloration and swelling of the auricle after exposure to extreme cold.Vesicles or bullae may develop,and the person feels pain and tenderness.

Question 20

During an otoscopic examination,the nurse notices an area of black and white dots on the tympanic membrane and the ear canal wall.What does this finding suggest?

Accepted Answer

A colony of black or white dots on the drum or canal wall suggests a yeast or fungal infection (otomycosis).

Quiz 15: Ears