Question 1

A colleague is assessing an 80-year-old patient who has ear pain and asks him to hold his nose and swallow.Which of the following about this technique is true?

Accepted Answer

The eardrum is flat and slightly pulled in at the centre;it flutters when the person performs the Valsalva manoeuvre or holds the nose and swallows (insufflation).One can elicit this reaction to assess drum mobility but should avoid doing it in an older adult because these actions may disrupt equilibrium.

Question 2

The nurse is taking history from 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,which stops with a popping sensation,and then drainage occurs.

Question 3

When examining the ear with an otoscope,the nurse would expect to find that the tympanic membrane is:

Accepted Answer

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

Question 4

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

Accepted Answer

The child's eustachian tube is relatively shorter and wider,and its position is more horizontal than the adult's.It is,therefore,easier for pathogens from the nasopharynx to migrate through to the middle ear.

Question 5

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

Accepted Answer

If maternal rubella infection occurs during the first trimester,it can damage the organ of Corti in the fetus and lead to impaired hearing.

Question 6

The nurse is examining a patient's ears and notices cerumen in the external canal.Which of the following statements about cerumen is correct?

Accepted Answer

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

Question 7

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

Accepted Answer

Frank blood or clear watery drainage (cerebrospinal leak)after trauma suggests a basal skull fracture and warrants immediate medical attention.

Question 8

Which of the following statements about air conduction is true?

Accepted Answer

The normal pathway of hearing is air conduction,and it is the most efficient.

Question 9

The nurse is performing an otoscopic examination on an adult.Which of the following is true?

Accepted Answer

Pull the pinna up and back on an adult or older child.This helps straighten the S-shape of the canal.

Question 10

A 70-year-old patient reports to the nurse that he is having trouble hearing,especially when he is in large groups.He says 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?

Accepted Answer

Presbycusis is a type of hearing loss that occurs with aging,even in people living in quiet environments.It is a gradual sensorineural loss caused by degeneration of the nerve in the inner ear,or the auditory nerve.This makes words sound garbled.The ability to localize sound is also impaired.This communication dysfunction is accentuated when background noise is present.

Question 11

Which of the following statements about the eustachian tube is true?

Accepted Answer

The eustachian tube allows equalization of air pressure on both sides of the tympanic membrane so that the membrane does not rupture (e.g. ,during altitude changes).The tube is normally closed,but it opens during swallowing or yawning.

Question 12

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

Accepted Answer

Children at risk for hearing deficit include those exposed in utero to a variety of conditions,such as maternal rubella,syphilis,cytomegalovirus,toxoplasmosis,or to maternal ototoxic medications.The important assessment question to ask is to assess whether or not their baby startles at loud noises.

Question 13

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 a marked hearing loss occurring when sound is at low intensity;sound actually may become painful when repeated at a louder volume.

Question 14

Tests have shown that a patient has 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 what he or she hears.Sensorineural hearing loss may be caused by presbycusis,a gradual nerve degeneration that occurs with aging and through use of ototoxic medications,both of which affect the hair cells in the cochlea.

Question 15

During an assessment of a 20-year-old Aboriginal patient,the nurse notices that he has dry,flaky cerumen in his ear canal.What is the significance of this finding?

Accepted Answer

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

Question 16

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

Accepted Answer

Otosclerosis is a common cause of conductive hearing loss in young adults between the ages of 20 and 40 years.

Question 17

A patient with a middle ear infection asks the nurse,"What does the middle ear do?" The nurse says that the function of the middle ear is 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.

Question 18

During an interview,the patient says that he experiences a sensation as if "everything around him is spinning." The nurse recognizes that the portion of the ear responsible for this sensation is:

Accepted Answer

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

Question 19

The portion of the ear that consists of movable cartilage and skin is called the:

Accepted Answer

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

Question 20

Which of the following cranial nerves (CNs)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.

Quiz 16: Ears