Question 1

During an examination, the patient states he is hearing a buzzing sound and says that it is "driving me crazy!" What does this indicate?

Accepted Answer

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

Question 2

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

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

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

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)  "Is there any relationship between the ear pain and the discharge you mentioned?"

Question 4

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

Accepted Answer

A)  Wet, honey-colored cerumen is a sign of infection. 
B)  The presence of cerumen is indicative of poor hygiene. 
C)  The purpose of cerumen is to protect and lubricate the ear. 
D)  Cerumen is necessary for transmitting sound through the auditory canal.

Question 5

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

Accepted Answer

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

Question 6

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

Accepted Answer

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

Question 7

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

Accepted Answer

A)  It represents poor hygiene. 
B)  It is probably the result of lesions from eczema in his ear. 
C)  It is a normal finding, and no further follow-up is necessary. 
D)  It could be indicative of change in cilia; the nurse should assess for hearing loss.

Question 8

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 in the history?

Accepted Answer

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 9

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. What should the nurse do?

Accepted Answer

A)  Refer the patient for the possibility of a fungal infection. 
B)  Recognize 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 10

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!" What do this signs and symptoms indicate?

Accepted Answer

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

Question 11

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

Accepted Answer

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

Question 12

A patient with a middle ear infection asks the nurse, "What does the middle ear do?" Which is the best response by the nurse?

Accepted Answer

A)  It helps maintain balance. 
B)  It interprets sounds as they enter the ear. 
C)  It conducts vibrations of sounds to the inner ear. 
D)  It increases the amplitude of sound for the inner ear to function.

Question 13

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

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 their chin to their chest

Question 14

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 is the matter. All of a sudden I can't hear you out of my left ear!" What should the nurse do next?

Accepted Answer

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

Question 15

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

Accepted Answer

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 or her finger in their ear to occlude outside noise. 
D)  Stand approximately 4 feet away to ensure that the patient can really hear at this distance.

Question 16

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. Based on these findings, what does the nurse suspect?

Accepted Answer

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

Question 17

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

Question 18

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 loss 
B)  Thin, translucent membrane 
C)  Shiny, pink tympanic membrane 
D)  Increased elasticity of the pinna

Exam 16: Ears