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

Answer and Explanation

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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Correct Answer is D

Explanation

A. Warming the stethoscope: Improves comfort but is not the first step.

B. Bending the knees: Helps relax abdominal muscles but is done after bladder emptying.

C. Exposing only the abdomen: Ensures privacy but does not affect comfort as much as an empty bladder.

D. Emptying the bladder relieves pressure and discomfort, allowing for a thorough and accurate examination.

A. Decrease in tear production B. Unequal pupillary constriction in response to light C. Loss of the outer hair on the eyebrows attributable to a decrease in hair follicles D. Presence of arcus senilis observed around the cornea

Correct Answer is B

Explanation

A. Decrease in tear production: This is a common age-related change and is not considered abnormal.

B. Unequal pupillary constriction: Correct. Unequal pupillary constriction (anisocoria) is not normal and may indicate neurological issues.

C. Loss of outer eyebrow hair: This is a normal age-related change due to decreased hair follicles.

D. Arcus senilis: This is a common finding in older adults and is typically benign, caused by lipid deposits around the cornea.

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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?

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Which of the following is the first important step in helping the patient to relax for the complete abdominal examination?

Correct Answer is D

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Correct Answer is B

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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?

During an assessment of an older adult, the nurse should expect to notice which finding as a normal physiologic change associated with the aging process?