Question 1

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

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 2

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?

Accepted Answer

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 3

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

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 4

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

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 5

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?

Accepted Answer

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 6

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

Accepted Answer

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 7

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:

Accepted Answer

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

Question 8

The nurse is preparing to perform 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 his chin to his chest

Question 9

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) 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 10

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:

Accepted Answer

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

Question 11

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.)

Accepted Answer

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

Question 12

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

Accepted Answer

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.

Question 13

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

Accepted Answer

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 14

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

Question 15

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?

Accepted Answer

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 16

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:

Accepted Answer

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

Question 17

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 18

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:

Accepted Answer

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

Question 19

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.

Accepted Answer

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

Question 20

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?

Accepted Answer

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

Exam 16: Ears