Question 1

An older nursing home resident reports that her hearing loss is getting worse. What is the first action of the nurse?&#10;A) Refer the resident for an evaluation for a hearing aid&#10;B) Raise her voice when speaking to the resident&#10;C) Examine the resident's ears for cerumen impaction&#10;D) Teach the resident to read lips

Accepted Answer

When hearing loss is suspected or a person with existing hearing loss experiences increasing difficulty, it is important to first check for cerumen impaction. Hearing aids are not the first intervention since the cause of the hearing loss has not been determined. Hearing aids do not help all type of hearing losses. Raising one's voice is not effective; it often makes hearing more difficult. Lip reading may be a useful skill for an individual with hearing loss, but it is critical to first ascertain what the cause of the hearing loss is.

Question 2

An older patient asks a nurse, &#34;My doctor referred me to a hearing specialist who thinks that surgery for a cochlear implant may be beneficial for me. Can you tell me how one of those things works?&#34; The nurse formulates a response based on the knowledge that:&#10;A) a cochlear implant is permanent, surgically-implanted hearing aid.&#10;B) a cochlear implant speeds up the conduction of sound to the auditory nerve.&#10;C) a cochlear implant functions as an artificial auditory nerve.&#10;D) a cochlear implant directly stimulates the auditory nerve.

Accepted Answer

A cochlear implant bypasses damaged portions of the ear and directly stimulates the auditory nerve.

Question 3

An older client reports to a nurse, &#34;My daughter says there is something wrong with my hearing. I am not so sure. Yes, I have some problems hearing, but I am 78 years old. What does she expect? I noticed that at Christmas dinner, with all the racket around, I had some trouble. I think it is that my granddaughters mumble a lot, just like all young people. I guess it has been getting steadily worse; it seems to be both ears as well.&#34; Based on the client's description, the nurse suspects which of the following?&#10;A) Presbycusis&#10;B) Otosclerosis&#10;C) Tinnitus&#10;D) A perforated eardrum

Accepted Answer

Presbycusis is a type of sensorineural hearing loss. It is slow and progressive and often ignored by older adults and considered normal aging. Symptoms include difficulty filtering background noise and understanding women and children's voices. Individuals often accuse people of mumbling. Often, it is recognized by others first, before the affected person notices it. Otosclerosis is a cause of conductive hearing loss, as is a perforated eardrum. Tinnitus is a perception of sound in one or both ears where no external sound is present.

Question 4

A nurse in an assisted living community notes that one of the residents who has hearing impairment and new bilateral hearing aids frequently does not wear the hearing aids. The nurse knows that which of the following factors contribute to low hearing aid use after purchase? (Select all that apply.)

A) Difficulty placing hearing aid properly in the ear
B) Stigma associated with wearing a hearing aid
C) Difficulty changing the batteries in the hearing aid
D) Ineffectiveness of hearing aids for individuals with age-related hearing loss
E) Hearing annoying loud noises

Accepted Answer

Options A, B, C, and E are all factors associated with low use after purchase. Option D is incorrect; most individuals with age-related hearing loss do experience some hearing enhancement with hearing aid use.

Question 5

An older person reports hearing whistling in both ears when no external sounds are present and is diagnosed with tinnitus. Which of the following are causes of tinnitus? (Select all that apply.)&#10;A) Exposure to loud noises&#10;B) Use of a hearing aid&#10;C) Cerumen buildup&#10;D) Side effects of medications&#10;E) Age-related changes in the middle and inner ear

Accepted Answer

Hearing aids are not known as a cause or a trigger to worsen tinnitus and are at times used to amplify environmental noise to mask tinnitus. Tinnitus is not an age-related change, although it occurs in about 11% of individuals who have presbycusis. Exposure to loud noise and cerumen buildup are known to exacerbate or cause tinnitus. Over 200 prescription and nonprescription medications have tinnitus as a side effect. There are also many ototoxic medications.

Question 6

A 74-year-old client who has experienced a progressive loss of hearing acuity in recent years obtains a new hearing aid. Which of the following should be included in the nurse's teaching plan?&#10;A) &#34;Many people find that hearing aids only help with certain types of hearing loss that are caused by previous noise exposure.&#34;&#10;B) &#34;With the right hearing aid, you can expect your hearing to be back to normal.&#34;&#10;C) &#34;Hearing aids are covered by Medicare Part B.&#34;&#10;D) &#34;Even though hearing aids will help you, they also bring challenges like distorted speech and amplified background noise.&#34;

Accepted Answer

Hearing aids do bring challenges, such as distorted speech and amplified background noise. Although hearing aids are not indicated for all individuals with hearing loss, they are not restricted to those with hearing loss due to excessive noise exposure. Hearing aids do not restore hearing to normal. Medicare does not cover the cost of hearing aids.

Question 7

An older patient is diagnosed with sensorineural hearing loss. The nurse knows that causes of sensorineural hearing loss include: (Select all that apply.)&#10;A) tumors of the middle ear.&#10;B) cerumen impaction.&#10;C) infections of the external and middle ear.&#10;D) age-related hearing impairment.&#10;E) excessive and loud noise.

Accepted Answer

A, B, and C are all associated with conductive hearing loss. Age-related hearing impairment, or presbycusis, is a form of sensorineural hearing loss. Excessive and loud noise can cause noise-induced hearing loss, which is also a common type of sensorineural hearing loss.

Deck 12: Hearing