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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Free Nursing Study Resources

Correct Answer is {"A":{"answers":"A"},"B":{"answers":"A"},"C":{"answers":"A"},"D":{"answers":"B"}}

Explanation

New Nurse Statement	Met	Not Met
I will confirm the patient's pupil size with the scale on the side of the penlight.	✅
When putting the penlight at the bridge of the nose, the eyes converge and constrict	✅
I will check the patient's pupillary reflex by shining a light into their eyes.	✅
When shining the penlight into the patient's eyes, their pupils should dilate		✅

Rationale:

"I will confirm the patient's pupil size with the scale on the side of the penlight" (Met):

This is a correct use of the penlight to assess pupil size and document findings accurately.

"When putting the penlight at the bridge of the nose, the eyes converge and constrict" (Met):

This statement describes the normal accommodation reflex, where the eyes converge and pupils constrict when focusing on a near object.

"I will check the patient's pupillary reflex by shining a light into their eyes" (Met):

This correctly describes testing for the pupillary light reflex, where the pupil constricts in response to light.

"When shining the penlight into the patient's eyes, their pupils should dilate" (Not Met):

This is incorrect. The pupils should constrict in response to light, not dilate. Dilation occurs in response to low light or sympathetic stimulation.

A. Using the smallest speculum to decrease the amount of discomfort B. Once the speculum is in the ear, releasing the traction C. Tilting the person's head forward during the examination D. Pulling the pinna up and back before inserting the speculum

Correct Answer is D

Explanation

A. Smallest speculum: The smallest speculum may not provide the best view of the ear canal and tympanic membrane, especially in adults. The correct size should be chosen for adequate visualization.

B. Releasing the traction: Traction should be maintained to stabilize the ear and allow a better view of the ear canal.

C. Tilting the person's head forward: This is not the ideal positioning for the ear examination. The head should be tilted slightly away to straighten the ear canal.

D. Pulling the pinna up and back: This helps straighten the ear canal, especially in adults, providing better visualization during the otoscopic examination.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is {"A":{"answers":"A"},"B":{"answers":"A"},"C":{"answers":"A"},"D":{"answers":"B"}}

Explanation

The nurse is performing an otoscopic examination on an adult. Which of these actions is correct?

Correct Answer is D

Explanation

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