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Chapter 10 - Test Bank
Fundamental Concepts in Nursing (NUR 352)
Arizona State University
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Chapter 10: Assessing the Ears
Routine health assessment is dependent on a person’s ability to hear the health interview questions. During the first encounter the nurse should note whether ____________________ is intact while asking questions.
Conversational hearing
Conductive hearing
Sensorineural hearing
The cranial nerve
The nurse asks the patient if he or she has been exposed to loud noises. Why is this question important?
Hearing loss may be inherited or could be caused by ototoxic drugs.
Hearing loss can have an economic impact on everyday health.
Prolonged exposure to loud noise may cause wear and tear on the hairs or nerves.
Prolonged exposure to loud noise can cause tinnitus.
On assessment of a 56-year-old man the nurse discovers he is complaining of “ringing in the ears.” The nurse recalls that the medical term for this is:
Presbycusis.
Vertigo.
Tinnitus.
Tophi.
The nurse has finished her focused health history and is preparing to do an assessment of the ears. Which position should the patient be placed in?
Supine
Prone
Semi-Fowler’s
Comfortable sitting position
5.
What is the nurse assessing for in the photo?
Tenderness
Hearing loss
Visual deformities
Color
6.
You are assessing an ear and see this deviation. What is the name of the assessment finding shown in the photo?
Cyst
Darwin tubercle
Tophi
Tragus
This part of the ear is responsible for transmitting sound waves through the auditory nerve (cranial nerve VIII).
Inner
Middle
Auricle
Ear canal
After inspecting the ears of a 76-year-old male the nurse documents: “Patient presents with abnormally large ears.” The nurse recalls that the medical term for this is:
Vertigo.
Cauliflower ear.
Microtia.
Macrotia.
In performing the Weber test to assess for sensorineural hearing loss, where is the tuning fork placed on the patient?
Place the base of the tuning fork on the midline of the top of the patient’s head.
Place the tuning fork in front of the ear on the mastoid bone.
Place the tines of the tuning fork perpendicular to the patient’s ear canal.
Place the tines of the tuning fork on the midline of the top of the patient’s head.
The nurse has documented in the chart: “Patient exhibits a cauliflower ear.” What is a
Audiogram
You are performing a hearing assessment. You place the tuning fork on the mastoid bone and then place the tines perpendicular to the ears. What is the name of this hearing assessment?
Weber test
Rinne test
Whisper test
Audiogram
Which of the following findings would indicate a negative Rinne test?
Bone conduction is heard longer than air conduction.
Air conduction is heard longer than bone conduction.
Air and bone conduction are heard at the same length of time.
Only air conduction is heard.
The nurse has completed her inspection and palpation assessment of the ear. He is now going to use the otoscope. What is the purpose of assessing an ear using an otoscope?
To inspect the auricle for presence of water
To inspect the external auditory canal, middle ear, and eardrum
To assure you can see the light in the inferior quadrant at the 7 o’clock location in the left ear
To practice the use of the otoscope, as nurses do not regularly use an otoscope
The nurse is using an otoscope to assess the inner right ear and notes an excessive amount of a dark brown substance in the external ear canal. What would the nurse document in the electronic health record?
Right ear: excess cerumen present
Right ear: signs of otitis media present
Right ear: no abnormalities noted
Right ear: effusion present
Identify the ear condition: inflammation of the outer ear, yellow discharge in the external ear canal, and ear pain.
Cerumen
Otitis externa
Otitis media
Normal findings
One of the most common complaints for which individuals seek medical care for their ears is:
Hearing loss.
Tinnitus.
Vertigo.
Otalgia.
21.
You are performing an inner ear assessment. What is your assessment finding based on the photo above?
- Normal finding
- Otitis media
- Ruptured tympanic membrane
- Cerumen buildup
22.
The patient comes to urgent care complaining of ear pain. You assess the ear using an otoscope. What is your assessment finding?
Otitis media
Normal finding
Ruptured tympanic membrane
Cerumen
You note that while you are interviewing the patient he turns his right ear toward you. Which of the following questions are the BEST questions to ask about the patient’s ability to hear? Select all that apply.
“Do you have difficulty hearing words when an individual is talking?”
“Do you have hearing loss? When did it start?”
“Do you have presbycusis?”
“Do you have difficulty watching television?”
“Do you yell a lot?”
Answers
- Routine health assessment is dependent on a person’s ability to hear the health interview questions. During the first encounter the nurse should note whether ____________________ is intact while asking questions.
- Conversational hearing
- Conductive hearing
- Sensorineural hearing
- The cranial nerve
ANS: 1 Page: 169
Feedback
This is correct. During the first encounter the nurses notes whether the patient has hearing through conversational hearing. Conversational hearing is the ability to participate in a conversation without difficulty and comprehending and answering the question without asking for questions to be repeated.
This is incorrect. Conductive hearing is considered middle ear hearing loss and is when sound is not conducted through the outer ear canal to the eardrum. This is assessed by the Rinne test.
This is incorrect. Sensorineural hearing loss occurs when there is damage to the inner ear or to the nerve pathways from the inner ear to the brain. This is assessed by the Weber test.
This is incorrect. It is a vague answer. Specifically, cranial nerve VIII brings sound and information to the brain.
The nurse asks the patient if he or she has been exposed to loud noises. Why is this question important?
Hearing loss may be inherited or could be caused by ototoxic drugs.
Hearing loss can have an economic impact on everyday health.
Prolonged exposure to loud noise may cause wear and tear on the hairs or nerves.
Prolonged exposure to loud noise can cause tinnitus.
ANS: 3 Page: 172
Feedback
This is incorrect. This answer does not integrate with the question asking about exposure to loud noises.
This is incorrect. This question is not referring to economic impact on everyday health.
This is correct. Prolonged exposure to loud noise may cause wear and tear on the hairs and nerve cells in the cochlea that send sound signals to the brain. When these hairs or nerve cells are damaged or missing, electrical signals are not transmitted as efficiently and hearing loss occurs.
This is incorrect. Tinnitus is not known to be caused by prolonged exposure to loud noise. It could be a symptom of an inner ear disorder.
On assessment of a 56-year-old man the nurse discovers he is complaining of “ringing in the ears.” The nurse recalls that the medical term for this is:
Presbycusis.
Vertigo.
Tinnitus.
Tophi.
ANS: 3 Page: 172
Feedback
This is incorrect. Presbycusis is a natural process of hearing loss related to sensorineural hearing loss from death of cochlear hair cells.
This is incorrect. Vertigo is a feeling of lightheadedness, which may lead to feeling faint.
This is correct. Tinnitus is the perception of sound when no actual external noise is present. It is commonly referred to as “ringing in the ears” and can manifest many different perceptions of sound.
This is incorrect. Tophi are hard, whitish, or cream-colored nontender deposits of uric acid crystals indicative of gout.
The nurse has finished her focused health history and is preparing to do an assessment of the ears. Which position should the patient be placed in?
6.
You are assessing an ear and see this deviation. What is the name of the assessment finding shown in the photo?
- Cyst
- Darwin tubercle
- Tophi
- Tragus
ANS: 2 Page: 173
Feedback
This is incorrect. A cyst is a fluid-filled sac.
This is correct. Darwin tubercle is a congenital deviation that is a small cartilaginous protuberance of the helix of the ear.
This is incorrect. Tophi are hard, whitish, or cream-colored nontender deposits of uric acid crystals.
This is incorrect. Tragus is the protuberance anterior to the auditory canal. This is an anatomical feature of the ear.
This part of the ear is responsible for transmitting sound waves through the auditory nerve (cranial nerve VIII).
Inner
Middle
Auricle
Ear canal
ANS: 1 Page: 170
Feedback
This is correct. The inner ear or labyrinth is responsible for transmitting sound waves through the auditory nerve (cranial nerve VIII) to the brain.
This is incorrect. The middle ear transmits sound waves from the eardrum to the inner ear and the Eustachian tubes.
This is incorrect. The auricle is the outer visible portion of the ear.
This is incorrect. The ear canal is the outer ear that transmits sound waves to the eardrum.
After inspecting the ears of a 76-year-old male the nurse documents: “Patient presents with abnormally large ears.” The nurse recalls that the medical term for this is:
Vertigo.
Cauliflower ear.
Microtia.
Macrotia.
ANS: 4 Page: 174
Feedback
This is incorrect. Vertigo is dizziness or a feeling of lightheadedness. This may lead to fainting, a feeling that the environment is spinning.
This is incorrect. Cauliflower ear results from repeated trauma or hitting the ear.
This is incorrect. Microtia is a congenital deformity that involves an incompletely formed or small ear.
This is correct. Macrotia is abnormally large ears which are greater than 10 cm (approximately 4 inches) in vertical height in adults.
In performing the Weber test to assess for sensorineural hearing loss, where is the tuning fork placed on the patient?
Place the base of the tuning fork on the midline of the top of the patient’s head.
Place the tuning fork in front of the ear on the mastoid bone.
Place the tines of the tuning fork perpendicular to the patient’s ear canal.
Place the tines of the tuning fork on the midline of the top of the patient’s head.
ANS: 1 Page: 176
Feedback
is called:
- Conductive hearing loss.
- Sensorineural hearing loss.
- Mixed hearing loss.
- Complete hearing loss.
ANS: 1 Page: 175
Feedback
This is correct. Conductive hearing loss is considered middle ear hearing loss, when sound is not conducted through the outer ear canal to the eardrum and the tiny bones of the middle ear. Wax impaction is the most common cause of conductive hearing loss.
This is incorrect. Sensorineural hearing loss is considered inner ear hearing loss, where speech may sound unclear or muffled.
This is incorrect. Mixed hearing loss includes both sensorineural and conductive hearing loss.
This is incorrect. Complete hearing loss is absence of hearing.
An 88-year-old female has come in for her annual physical visit. During the review of systems she states that your voice sounds “muffled and unclear.” This type of hearing loss is called:
Conductive hearing loss.
Sensorineural hearing loss.
Hearing loss related to aging.
Complete hearing loss.
ANS: 2 Page: 175
Feedback
This is incorrect. Conductive hearing loss is when sound is not conducted through the outer ear to the eardrum. This involves a reduction in sound level or the ability to hear faint sounds. The nurse is not speaking quietly and the patient cannot hear the normal tone of her voice.
This is correct. Sensorineural hearing loss, which is also considered inner ear hearing loss, occurs when there is damage to the inner ear (cochlea) or to the nerve pathways from the inner ear to the brain. Speech may sound unclear or muffled. This is the most common type of permanent hearing loss.
This is incorrect. This is not the specific type of hearing loss. Presbycusis is the term related to hearing loss related to aging, which is caused by sensorineural hearing loss.
This is incorrect. Complete hearing loss is the absence of hearing.
Which of the following two tests should be performed to correctly assess sensorineural hearing loss?
Weber and Whisper tests
Weber and Rinne tests
Rinne and Whisper tests
Audiogram and Weber tests
ANS: 2 Page: 176
Feedback
- This is incorrect. These are not the two best tests to assess for sensorineural hearing loss. The Weber test assesses unilateral sensorineural hearing loss but the Whisper test assesses high frequency hearing loss.
- This is correct. The Weber test should always be accompanied by the Rinne test to assess for sensorineural hearing loss.
- This is incorrect. The Rinne and Whisper tests are not the best hearing tests to confirm sensorineural hearing loss. The Whisper test is for high frequency hearing loss.
- This is incorrect. The Audiometric testing (audiogram) is a hearing evaluation to assess the sensitivity of a person’s sense of hearing at different high and low frequencies.
14.
You are assessing for unilateral hearing loss and functioning of the cochlear nerve. Identify the assessment technique.
Weber test
This is incorrect. This is not an audiogram. An audiogram is a hearing evaluation to assess the sensitivity of a person’s sense of hearing at different high and low frequencies.
Which of the following findings would indicate a negative Rinne test?
Bone conduction is heard longer than air conduction.
Air conduction is heard longer than bone conduction.
Air and bone conduction are heard at the same length of time.
Only air conduction is heard.
ANS: 1 Page: 177
Feedback
This is correct. A negative Rinne test is when bone conduction is heard longer than air conduction.
This is incorrect. This is a positive Rinne test. Air conduction is heard longer than bone conduction.
This is incorrect. This is neither a positive or negative Rinne test.
This is incorrect. This is not a negative Rinne test. A Rinne test assesses both air and bone conduction.
The nurse has completed her inspection and palpation assessment of the ear. He is now going to use the otoscope. What is the purpose of assessing an ear using an otoscope?
To inspect the auricle for presence of water
To inspect the external auditory canal, middle ear, and eardrum
To assure you can see the light in the inferior quadrant at the 7 o’clock location in the left ear
To practice the use of the otoscope, as nurses do not regularly use an otoscope
ANS: 2 Page: 178
Feedback
This is incorrect. You do not need an otoscope to inspect the auricle.
This is correct. The purpose of assessing an ear using an otoscope is to inspect the external auditory canal, middle ear, and eardrum.
This is incorrect. This is an assessment of the ear, not a purpose.
This is incorrect. This is not the purpose of using an otoscope.
The nurse is using an otoscope to assess the inner right ear and notes an excessive amount of a dark brown substance in the external ear canal. What would the nurse document in the electronic health record?
Right ear: excess cerumen present
Right ear: signs of otitis media present
Right ear: no abnormalities noted
Right ear: effusion present
ANS: 1 Page: 179
Feedback
This is correct. Earwax (cerumen) is a moist or dry, waxy substance that acts to protect the skin of the external ear canal.
This is incorrect. Otitis media is an inflammation of the inner ear. On assessment the inner ear would be inflamed and have a buildup of fluid. The eardrum would appear red and bulging.
This is incorrect. Nurses should document that a dark brown substance was noted in the ear canal.
This is incorrect. There is no effusion to be noted on assessment of the inner ear, only the outer ear. Effusion is a collection of fluid.
Identify the ear condition: inflammation of the outer ear, yellow discharge in the external ear canal, and ear pain.
Cerumen
Otitis externa
Otitis media
Normal findings
ANS: 2 Page: 179
- Ruptured tympanic membrane
- Cerumen buildup
ANS: 2 Page: 179
Feedback
- This is incorrect. This is not a normal finding. The ear should appear without inflammation or discharge.
- This is correct. Otitis media is an inflammation of the inner ear, causing inflammation, a buildup of fluid, and a bright red bulging eardrum.
- This is incorrect. This is not a picture of a ruptured tympanic membrane. A ruptured tympanic membrane appears as a dark oval hole.
- This is incorrect. This is not a picture of earwax. Cerumen is a waxy colored substance.
22.
The patient comes to urgent care complaining of ear pain. You assess the ear using an otoscope. What is your assessment finding?
- Otitis media
- Normal finding
- Ruptured tympanic membrane
- Cerumen
ANS: 3 Page: 179
Feedback
This is incorrect. Otitis media is an inflammation of the inner ear. On assessment the inner ear would be inflamed, have a buildup of fluid, and the eardrum would appear red and bulging.
This is incorrect. This is not a normal finding. The tympanic membrane should appear intact.
This is correct. This is a ruptured tympanic membrane The membrane is a dark oval and a hole is present.
This is incorrect. Cerumen appears as a waxy substance.
You note that while you are interviewing the patient he turns his right ear toward you. Which of the following questions are the BEST questions to ask about the patient’s ability to hear? Select all that apply.
“Do you have difficulty hearing words when an individual is talking?”
“Do you have hearing loss? When did it start?”
“Do you have presbycusis?”
“Do you have difficulty watching television?”
“Do you yell a lot?”
ANS: 1, 2, 4 Page: 171
Feedback
This is correct. Difficulty hearing words when an individual is talking indicates that the spoken word may be mumbled and the individual may have difficulty hearing.
This is correct. These are direct questions. Patients should be able to tell the nurse if they have difficulty hearing and approximately how long they have had problems with their hearing.
This is incorrect. You should not ask a patient a question using medical terminology. Patients may not know what presbycusis means.
This is correct. Patients with hearing loss have difficulty watching television because they cannot hear the television.
This is incorrect. Patients with hearing loss may speak louder, but asking the patient if they “yell a lot” is not helpful.
During the palpation assessment of the ear, which structures are gently palpated in each ear? Select all that apply.
Tragus
Earlobes
Auricles
Mastoid process
Eardrum
Ossicles
ANS: 1, 2, 3, 4 Page: 174
Chapter 10 - Test Bank
Course: Fundamental Concepts in Nursing (NUR 352)
University: Arizona State University
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