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?
Nerve degeneration in the inner ear
Cilia becoming coarse and stiff
Scarring of the tympanic membrane
Atrophy of the apocrine glands
The Correct Answer is A
A. Nerve degeneration in the inner ear: This describes presbycusis, a common age-related hearing loss due to degeneration of the cochlea or auditory nerve, often affecting the ability to hear high-frequency sounds and distinguish sounds in noisy environments.
B. Cilia becoming coarse and stiff: This contributes to conductive hearing loss but does not typically cause difficulty localizing sounds.
C. Scarring of the tympanic membrane: This may result from repeated infections but usually causes conductive hearing loss.
D. Atrophy of the apocrine glands: This affects sweat production, not hearing.
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Related Questions
Correct Answer is C
Explanation
A. Determine areas of tenderness: While identifying tenderness is important, it is not the reason for auscultating first.
B. Allows the patient to relax: Relaxation is helpful but not the primary reason for the sequence.
C. Prevents distortion of bowel sounds: Percussion and palpation can stimulate or suppress bowel sounds, leading to inaccurate findings if performed before auscultation.
D. Prevents distortion of vascular sounds: Vascular sounds (bruits) are less likely to be affected by percussion or palpation.
Correct Answer is D
Explanation
A. Make note of this finding: Delaying action by merely reporting the finding later may compromise patient care.
B. Prepare to remove cerumen: Sudden hearing loss is unlikely to be caused by cerumen buildup without further assessment.
C. Irrigate with rubbing alcohol: This is inappropriate and could harm the ear.
D. Notify the health care provider: Sudden sensorineural hearing loss can be a medical emergency and should be promptly evaluated by the healthcare provider.
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