Chapter 16: Ears Flashcards
The nurse needs to pull the portion of the ear that consists of movable cartilage and skin down and back when administering eardrops. This portion of the ear is called the:
a. Auricle.
b. Concha.
c. Outer meatus.
d. Mastoid process.
a. Auricle.
RATIONALE: The external ear is called the auricle or pinna and consists of movable cartilage and skin.
The nurse is examining a patients ears and notices cerumen in the external canal. Which of these statements about cerumen is correct?
a. Sticky honey-colored cerumen is a sign of infection.
b. The presence of cerumen is indicative of poor hygiene.
c. The purpose of cerumen is to protect and lubricate the ear.
d. Cerumen is necessary for transmitting sound through the auditory canal.
c. The purpose of cerumen is to protect and lubricate the ear.
RATIONALE: The ear is lined with glands that secrete cerumen, which is a yellow waxy material that lubricates and protects the ear.
When examining the ear with an otoscope, the nurse notes that the tympanic membrane should appear:
a. Light pink with a slight bulge.
b. Pearly gray and slightly concave.
c. Pulled in at the base of the cone of light.
d. Whitish with a small fleck of light in the superior portion.
b. Pearly gray and slightly concave.
RATIONALE: The tympanic membrane is a translucent membrane with a pearly gray color and a prominent cone of light in the anteroinferior quadrant, which is the reflection of the otoscope light. The tympanic membrane is oval and slightly concave, pulled in at its center by the malleus, which is one of the middle ear ossicles.
The nurse is reviewing the structures of the ear. Which of these statements concerning the eustachian tube is true?
a. The eustachian tube is responsible for the production of cerumen.
b. It remains open except when swallowing or yawning.
c. The eustachian tube allows passage of air between the middle and outer ear.
d. It helps equalize air pressure on both sides of the tympanic membrane.
d. It helps equalize air pressure on both sides of the tympanic membrane.
RATIONALE: The eustachian tube allows an equalization of air pressure on each side of the tympanic membrane so that the membrane does not rupture during, for example, altitude changes in an airplane. The tube is normally closed, but it opens with swallowing or yawning.
A patient with a middle ear infection asks the nurse, What does the middle ear do? The nurse responds by telling the patient that the middle ear functions to:
a. Maintain balance.
b. Interpret sounds as they enter the ear.
c. Conduct vibrations of sounds to the inner ear.
d. Increase amplitude of sound for the inner ear to function.
c. Conduct vibrations of sounds to the inner ear.
RATIONALE: Among its other functions, the middle ear conducts sound vibrations from the outer ear to the central hearing apparatus in the inner ear. The other responses are not functions of the middle ear.
The nurse is reviewing the function of the cranial nerves (CNs). Which CN is responsible for conducting nerve impulses to the brain from the organ of Corti?
a. I
b. III
c. VIII
d. XI
c. VIII
RATIONALE: The nerve impulses are conducted by the auditory portion of CN VIII to the brain.
The nurse is assessing a patient who may have hearing loss. Which of these statements istrue concerning air conduction?
a. Air conduction is the normal pathway for hearing.
b. Vibrations of the bones in the skull cause air conduction.
c. Amplitude of sound determines the pitch that is heard.
d. Loss of air conduction is called a conductive hearing loss.
a. Air conduction is the normal pathway for hearing.
RATIONALE: The normal pathway of hearing is air conduction, which starts when sound waves produce vibrations on the tympanic membrane. Conductive hearing loss results from a mechanical dysfunction of the external or middle ear. The other statements are not true concerning air conduction.
A patient has been shown to have a sensorineural hearing loss. During the assessment, it would be important for the nurse to:
a. Speak loudly so the patient can hear the questions.
b. Assess for middle ear infection as a possible cause.
c. Ask the patient what medications he is currently taking.
d. Look for the source of the obstruction in the external ear.
c. Ask the patient what medications he is currently taking.
RATIONALE: A simple increase in amplitude may not enable the person to understand spoken words. Sensorineural hearing loss may be caused by presbycusis, which is a gradual nerve degeneration that occurs with aging and by ototoxic drugs, which affect the hair cells in the cochlea.
During an interview, the patient states he has the sensation that everything around him is spinning. The nurse recognizes that the portion of the ear responsible for this sensation is the:
a. Cochlea.
b. CN VIII.
c. Organ of Corti.
d. Labyrinth.
d. Labyrinth.
RATIONALE: If the labyrinth ever becomes inflamed, then it feeds the wrong information to the brain, creating a staggering
gait and a strong, spinning, whirling sensation called vertigo.
A patient in her first trimester of pregnancy is diagnosed with rubella. Which of these statements iscorrect regarding the significance of this in relation to the infants hearing?
a. Rubella may affect the mothers hearing but not the infants.
b. Rubella can damage the infants organ of Corti, which will impair hearing.
c. Rubella is only dangerous to the infant in the second trimester of pregnancy.
d. Rubella can impair the development of CN VIII and thus affect hearing.
b. Rubella can damage the infants organ of Corti, which will impair hearing.
RATIONALE: If maternal rubella infection occurs during the first trimester, then it can damage the organ of Corti and impair hearing.
The mother of a 2-year-old is concerned because her son has had three ear infections in the past year. What would be an appropriate response by the nurse?
a. It is unusual for a small child to have frequent ear infections unless something else is wrong.
b. We need to check the immune system of your son to determine why he is having so many ear infections.
c. Ear infections are not uncommon in infants and toddlers because they tend to have more cerumen in the external ear.
d. Your sons eustachian tube is shorter and wider than yours because of his age, which allows for infections to develop more easily.
d. Your sons eustachian tube is shorter and wider than yours because of his age, which allows for infections to develop more easily.
RATIONALE: The infants eustachian tube is relatively shorter and wider than the adults eustachian tube, and its position is more horizontal; consequently, pathogens from the nasopharynx can more easily migrate through to the middle ear. The other responses are not appropriate.
A 31-year-old patient tells the nurse that he has noticed a progressive loss in his hearing. He says that it does seem to help when people speak louder or if he turns up the volume of a television or radio. The most likely cause of his hearing loss is:
a. Otosclerosis.
b. Presbycusis.
c. Trauma to the bones.
d. Frequent ear infections.
a. Otosclerosis.
RATIONALE: Otosclerosis is a common cause of conductive hearing loss in young adults between the ages of 20 and 40 years. Presbycusis is a type of hearing loss that occurs with aging. Trauma and frequent ear infections are not a likely cause of his hearing loss.
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 cant 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?
a. Atrophy of the apocrine glands
b. Cilia becoming coarse and stiff
c. Nerve degeneration in the inner ear
d. Scarring of the tympanic membrane
c. Nerve degeneration in the inner ear
RATIONALE: Presbycusis is a type of hearing loss that occurs in 60% of those older than 65 years of age, even in those living in a quiet environment. This sensorineural loss is gradual and caused by nerve degeneration in the inner ear. Words sound garbled, and the ability to localize sound is also impaired. This communication dysfunction is accentuated when background noise is present.
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:
a. Is probably the result of lesions from eczema in his ear.
b. Represents poor hygiene.
c. Is a normal finding, and no further follow-up is necessary.
d. Could be indicative of change in cilia; the nurse should assess for hearing loss.
c. Is a normal finding, and no further follow-up is necessary.
RATIONALE: Asians and Native Americans are more likely to have dry cerumen, whereas Blacks and Whites usually have wet cerumen.
The nurse is taking the history of a patient who may have a perforated eardrum. What would be an important question in this situation?
a. Do you ever notice ringing or crackling in your ears?
b. When was the last time you had your hearing checked?
c. Have you ever been told that you have any type of hearing loss?
d. Is there any relationship between the ear pain and the discharge you mentioned?
d. Is there any relationship between the ear pain and the discharge you mentioned?
RATIONALE: Typically with perforation, ear pain occurs first, stopping with a popping sensation, and then drainage occurs.
A 31-year-old patient tells the nurse that he has noticed pain in his left ear when people speak loudly to him. The nurse knows that this finding:
a. Is normal for people of his age.
b. Is a characteristic of recruitment.
c. May indicate a middle ear infection.
d. Indicates that the patient has a cerumen impaction.
b. Is a characteristic of recruitment.
RATIONALE: Recruitment is significant hearing loss occurring when speech is at low intensity, but sound actually becomes painful when the speaker repeats at a louder volume. The other responses are not correct.
