Deck 16: Ears

Question 1

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

A)Air conduction is the normal pathway for hearing.
B)Vibrations of the bones in the skull cause air conduction.
C)Amplitude of sound determines the pitch that is heard.
D)Loss of air conduction is called a conductive hearing loss.

Answer 1

Air conduction is the normal pathway for hearing.

Question 2

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

A)Speak loudly so the patient can hear the questions.
B)Assess for middle ear infection as a possible cause.
C)Ask the patient about current medications.
D)Look for the source of the obstruction in the external ear.

Answer 2

Ask the patient about current medications.

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?

A)"Do you ever notice ringing or crackling in your ears?"
B)"When was the last time you had your hearing checked?"
C)"Have you ever been told that you have any type of hearing loss?"
D)"Do you have any ear pain or discharge, and if so, when did they occur?"

Answer 3

"Do you have any ear pain or discharge, and if so, when did they occur?"

Question 4

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

A)Shield the lips so that the sound is muffled.
B)Whisper a set of random numbers and letters and then ask the patient to repeat them.
C)Ask the patient to place his finger in his ear to occlude outside noise.
D)Stand approximately 4 feet away to ensure that the patient can really hear at this distance.

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?

A)Rubella may affect the mother's hearing, but not the infant's.
B)Rubella can damage the infant's organ of Corti, which will impair hearing.
C)Rubella is only dangerous to the infant in the second trimester of pregnancy.
D)Rubella can impair the development of CN VIII and thus affect hearing.

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:

A)Maintain balance.
B)Interpret sounds as they enter the ear.
C)Conduct vibrations of sounds to the inner ear.
D)Increase amplitude of sound for the inner ear to function.

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?

A)I
B)III
C)VIII
D)XI

Question 8

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

A)Tilting the person's head forward during the examination
B)Once the speculum is in the ear, releasing the traction
C)Pulling the pinna up and back before inserting the speculum
D)Using the smallest speculum to decrease the amount of discomfort

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:

A)The production of cerumen.
B)Remaining open except when swallowing or yawning.
C)Allowing the passage of air between the middle and outer ear.
D)Helping equalize air pressure on both sides of the tympanic membrane.

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?

A)Atrophy of the apocrine glands
B)Cilia becoming coarse and stiff
C)Nerve degeneration in the inner ear
D)Scarring of the tympanic membrane

Question 11

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

A)As a sign of an ear infection.
B)As indicative of poor ear hygiene.
C)As protection and lubrication of the ear.
D)As necessary for transmitting sound through the auditory canal.

Question 12

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

A)Seek assistance from a colleague.
B)Document the finding as normal.
C)Refer the patient to a specialist.
D)Recommend irrigating the ear.

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?

A)If the drum has ruptured, then purulent drainage will result.
B)Bloody or clear watery drainage can indicate a basal skull fracture.
C)The auditory canal many be occluded from increased cerumen.
D)Foreign bodies from the accident may cause occlusion of the canal.

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:

A)Is normal for people of his age.
B)Is a characteristic of recruitment.
C)May indicate a middle ear infection.
D)Indicates that the patient has a cerumen impaction.

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?

A)"It is unusual for a small child to have frequent ear infections unless something else is wrong."
B)"We need to check the immune system of your son to determine why he is having so many ear infections."
C)"Ear infections are not uncommon in infants and toddlers because they tend to have more cerumen in the external ear."
D)"Your son's eustachian tube is shorter and wider than yours because of his age, which allows for infections to develop more easily."

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.

A)Auricle
B)Concha
C)Outer meatus
D)Mastoid process

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:

A)Cochlea
B)CN VIII
C)Organ of Corti
D)Labyrinth

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?

A)"Does your baby seem to startle with loud noises?"
B)"Has your baby had any surgeries on her ears?"
C)"Have you noticed any drainage from her ears?"
D)"How many ear infections has your baby had since birth?"

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:

A)Otosclerosis.
B)Presbycusis.
C)Trauma to the bones.
D)Frequent ear infections.

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:

A)The result of lesions from eczema in his ear.
B)Poor hygiene practices.
C)A normal finding and that no further follow-up is necessary.
D)Indicative of change in cilia and requires further assessment.

Question 21

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

A)Vertigo.
B)Pruritus.
C)Tinnitus.
D)Cholesteatoma.

Question 22

During an examination, the nurse notices that the patient stumbles a little while walking and that 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 documents that the patient is experiencing:

A)Objective vertigo.
B)Subjective vertigo.
C)Tinnitus.
D)Dizziness.

Question 23

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

A)Pulling the pinna down
B)Pulling the pinna up and back
C)Slightly tilting the child's head toward the examiner
D)Instructing the child to touch his chin to his chest

Question 24

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

A)Omit the otoscopic examination if the child has a fever.
B)Pull the ear up and back before inserting the speculum.
C)Ask the mother to leave the room while examining the child.
D)Perform the otoscopic examination at the end of the assessment.

Question 25

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

A)Turns his or her head to localize the sound.
B)Shows no obvious response to the noise.
C)Shows a startle and acoustic blink reflex.
D)Stops any movement, and appears to listen for the sound.

Question 26

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

A)Any change in the ability to hear
B)Any recent drainage from the ear
C)Recent history of trauma to the ear
D)Any prolonged exposure to extreme cold

Question 27

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:

A)Is most likely a benign sebaceous cyst.
B)Is most likely a keloid.
C)Could be a potential carcinoma, and the patient should be referred for a biopsy.
D)Is a tophus, which is common in the older adult and is a sign of gout.

Question 28

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.)

A)Hearing loss related to aging begins in the mid-40s.
B)Progression of hearing loss is slow.
C)The aging person has low-frequency tone loss.
D)The aging person may find it harder to hear consonants than vowels.
E)Sounds may be garbled and difficult to localize.
F)Hearing loss reflects nerve degeneration of the middle ear.

Question 29

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)Fungal infection.
B)Acute otitis media.
C)Perforation of the eardrum.
D)Cholesteatoma.

Question 30

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

A)Family history
B)Air conditioning
C)Excessive cerumen
D)Passive cigarette smoke

Question 31

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?

A)Malignancy
B)Viral infection
C)Blood in the middle ear
D)Yeast or fungal infection

Question 32

The mother of a 2-year-old toddler is questioning the need for tympanostomy tubes in her son's ears.The nurse will provide the following information in the teaching plan:

A)The tubes will be placed in the inner ear.
B)The tubes will correct sensorineural loss in children.
C)The tubes do not need surgery to be inserted.
D)The tubes will decrease the pressure and allow for drainage.

Question 33

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:

A)Use a cotton-tipped swab to dry the ear canals thoroughly after each swim.
B)Use rubbing alcohol or 2% acetic acid eardrops after every swim.
C)Irrigate the ears with warm water and a bulb syringe after each swim.
D)Rinse the ears with a warmed solution of mineral oil and hydrogen peroxide.

Question 34

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 colour 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:

A)Most likely has serous otitis media.
B)Has an acute purulent otitis media.
C)Has evidence of a resolving cholesteatoma.
D)Is experiencing the early stages of perforation.

Question 35

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

A)High-tone frequency loss
B)Increased elasticity of the pinna
C)Thin, translucent membrane
D)Shiny, pink tympanic membrane

Question 36

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

A)Red and bulging
B)Lack of mobility
C)Retraction with landmarks clearly visible
D)Flat, slightly pulled in at the centre, and moving with insufflation

Question 37

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 the 5 o'clock position and visible landmarks.The nurse should:

A)Refer the patient for the possibility of a fungal infection.
B)Know that these are scars caused from frequent ear infections.
C)Consider that these findings may represent the presence of blood in the middle ear.
D)Be concerned about the ability to hear because of this abnormality on the tympanic membrane.

Question 38

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?

A)Make note of this finding for the report to the next shift
B)Prepare to remove cerumen from the patient's ear
C)Notify the patient's health care provider
D)Irrigate the ear with rubbing alcohol

Question 39

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

A)Immobility of the drum is a normal finding.
B)An injected membrane would indicate an infection.
C)The normal membrane may appear thick and opaque.
D)The appearance of the membrane is identical to that of an adult.

Question 40

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

A)Rhinorrhea
B)Periorbital edema
C)Pain over the maxillary sinuses
D)Enlarged superficial cervical nodes

Question 41

The nurse is working with new parents to help decrease the incidence of childhood acute otitis media.The nurse provides recommendations which include: (Select all that apply.)

A)Propping the bottle for the baby in bed
B)Having a smoke-free home
C)Avoid letting the baby have a bottle lying flat in bed
D)Smoking in vehicle with the child, not in the home
E)Encouragement of breastfeeding from birth