During an assessment of a 20-year-old Asian patient, the nurse notices that he has dry, flaky cerumen in his canal. What is the significance of this finding? This finding:

Could be indicative of change in cilia; the nurse should assess for hearing loss.

Represents poor hygiene.

Is probably the result of lesions from eczema in his ear.

Is a normal finding and no further follow-up is necessary

Answer and Explanation

The Correct Answer is D

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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Correct Answer is D

Explanation

A. Make note of this finding: Delaying action by merely reporting the finding later may compromise patient care.

B. Prepare to remove cerumen: Sudden hearing loss is unlikely to be caused by cerumen buildup without further assessment.

C. Irrigate with rubbing alcohol: This is inappropriate and could harm the ear.

D. Notify the health care provider: Sudden sensorineural hearing loss can be a medical emergency and should be promptly evaluated by the healthcare provider.

A. Pupillary dilation when looking at a far object B. Pupillary constriction when looking at a near object C. Changes in peripheral vision in response to light D. Involuntary blinking in the presence of bright light

Correct Answer is B

Explanation

A. Pupillary dilation when looking at a far object: While dilation occurs with distance, the question specifically refers to near vision.

B. Pupillary constriction when looking at a near object: Accommodation is the process by which the eyes adjust to focus on near objects, which includes pupillary constriction and lens thickening.

C. Changes in peripheral vision: This describes visual field testing, not accommodation.

D. Involuntary blinking in bright light: This describes the corneal reflex, not accommodation.

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During an assessment of a 20-year-old Asian patient, the nurse notices that he has dry, flaky cerumen in his canal. What is the significance of this finding? This finding:

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A patient has been admitted after an accident at work. During the assessment, the patient is having trouble hearing and states, "I don't know what the matter is. All of a sudden, I can't hear you out of my left ear!" What should the nurse do next?

Correct Answer is D

Explanation

The nurse is testing a patient's visual accommodation, which refers to which action?

Correct Answer is B

Explanation

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