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. Liver enlargement: Pain from liver enlargement is typically felt in the right upper quadrant, not along the costovertebral angle.

B. Spleen enlargement: Splenic pain is usually located in the left upper quadrant, not in the costovertebral area.

C. Ovarian infection: Pain from ovarian infection is typically felt in the lower abdomen or pelvis, not the back.

D. Kidney inflammation: Pain along the costovertebral angles often indicates kidney inflammation or infection, such as pyelonephritis.

A. 3,1,2,5,4 B. 2,1,4,5,3 C. 2,1,3,4,5 D. 3,2,1,5,4

Correct Answer is C

Explanation

A. Begin with inspection to visually assess the abdomen for abnormalities. Auscultate before palpation and percussion to avoid altering bowel sounds. Determine areas of pain to avoid causing discomfort during palpation and percussion. Lightly palpate to assess for tenderness or masses. Percuss last to evaluate organ size and detect abnormal fluid or gas.
B. Begin with inspection to visually assess the abdomen for abnormalities. Auscultate before palpation and percussion to avoid altering bowel sounds. Determine areas of pain to avoid causing discomfort during palpation and percussion. Lightly palpate to assess for tenderness or masses. Percuss last to evaluate organ size and detect abnormal fluid or gas.
C. Begin with inspection to visually assess the abdomen for abnormalities. Auscultate before palpation and percussion to avoid altering bowel sounds. Determine areas of pain to avoid causing discomfort during palpation and percussion. Lightly palpate to assess for tenderness or masses. Percuss last to evaluate organ size and detect abnormal fluid or gas.
D. Begin with inspection to visually assess the abdomen for abnormalities. Auscultate before palpation and percussion to avoid altering bowel sounds. Determine areas of pain to avoid causing discomfort during palpation and percussion. Lightly palpate to assess for tenderness or masses. Percuss last to evaluate organ size and detect abnormal fluid or gas.

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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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Naxlex Comprehensive Predictor Exams

A patient is reporting sharp pain along the costovertebral angles. What does this symptom most often indicate?

Correct Answer is D

Explanation

Correct Answer is C

Explanation

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