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 {"A":{"answers":"A"},"B":{"answers":"B"}}

Explanation

Each category must have at least 1 response option selected

Finding	Normal	Abnormal
Tympany to percussion over the intestines	✅
Loose, watery stool		✅
Suprapubic tenderness		✅
A non-palpable spleen	✅
Aortic pulsation in the epigastric area	✅
Decreased bowel sounds		✅

Rationale:

Tympany to percussion over the intestines (Normal):

Tympany is expected due to the presence of gas in the intestines.

Loose, watery stool (Abnormal):

This is indicative of diarrhea, which may point to gastrointestinal upset or infection.

Suprapubic tenderness (Abnormal):

Tenderness in this area may indicate bladder infection, inflammation, or pelvic issues.

A non-palpable spleen (Normal):

The spleen is generally not palpable in healthy individuals unless it is enlarged (splenomegaly).

Aortic pulsation in the epigastric area (Normal):

Mild pulsations may be felt in thin or normal-weight individuals. However, a widened or strong pulsation could suggest an abdominal aortic aneurysm.

Decreased bowel sounds (Abnormal):

Hypoactive or absent bowel sounds may indicate decreased intestinal motility, such as in ileus or peritonitis.

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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Naxlex Comprehensive Predictor Exams

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

Explanation

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Correct Answer is B

Explanation

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