An older client reports to a nurse. "My daughter says there is something wrong with my hearing. I am not so sure. Yes, I have some problems hearing, but I am 78 years old. What does she expect? I noticed that at Christmas dinner, with all the racket around, I had some trouble. I think it is that my granddaughters mumble a lot, just like all young people. I guess it has been getting steadily worse; it seems to be both ears as well." Based on the client's description, the nurse suspects which of the following?
A perforated eardrum
Otosclerosis
Tinnitus
Presbycusis
The Correct Answer is D
A. A perforated eardrum typically causes sudden hearing loss, pain, or drainage from the ear, and usually affects one ear—not both.
B. Otosclerosis is a hereditary condition involving abnormal bone growth in the middle ear that leads to conductive hearing loss, usually starting in one ear and affecting younger adults.
C. Tinnitus is characterized by ringing or buzzing in the ears, not by gradual, bilateral hearing loss or difficulty hearing in noisy environments.
D. Presbycusis is age-related sensorineural hearing loss that occurs gradually in both ears. It commonly involves difficulty hearing high-pitched sounds and distinguishing speech in noisy environments—exactly as described by the client.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Delirium typically has a sudden onset, often over hours or days, while dementia has a gradual, progressive onsetover months to years.
B. Delirium is usually acute and reversible, often triggered by underlying medical conditions like infections, while dementia is chronic, progressive, and irreversible.
C. Hallucinations are more common in deliriumthan in early stages of dementia. Dementia may involve hallucinations in later stages, but they are not a distinguishing feature.
D. Dementia does not always result in complete memory loss, and delirium can also affect attention, memory, and cognition, especially in older adults.
Correct Answer is B
Explanation
Benzodiazepines are generally not recommended for treating insomnia in older adultsdue to their side effects, including increased risk of falls, cognitive impairment, and dependence. Non-pharmacologic approaches (like sleep hygiene and cognitive-behavioral therapy) are preferred first-line treatments. If medication is necessary, safer alternatives with fewer risks should be considered.
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