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 B
Explanation
A. Ptosis: Drooping of the upper eyelid, often caused by nerve or muscle dysfunction.
B. Ectropion: This condition results from age-related weakening of eyelid muscles or facial nerve palsy, causing the lower eyelid to turn outward, exposing the conjunctiva.
C. Exophthalmos: Protrusion of the eyeball, commonly seen in conditions like Graves' disease.
D. Entropion: Inward rolling of the eyelid, leading to eyelashes rubbing against the eye.
Correct Answer is D
Explanation
A. Change in cilia: This is not the cause of dry, flaky cerumen. It would not be typical to assess hearing loss based on this observation alone.
B. Poor hygiene: Dry, flaky cerumen is not indicative of poor hygiene. Hygiene-related cerumen would more likely be wet and impacted.
C. Lesions from eczema: While eczema can affect the ear canal, the dry cerumen itself is more likely to be a normal characteristic for some individuals, particularly in people of Asian descent.
D. Normal finding: The presence of dry, flaky cerumen is normal in certain ethnic groups, including East Asians, and usually requires no follow-up.
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