NSG 474-Week 3 Material: HEENT (Chapters 18-24)

The nurse needs to pull the portion of the ear that consists of moveable cartilage and skin down and back when administering ear drops. This portion of the ear is called the: A. Auricle B. Concha C. Outer meatus D. Mastoid process

A. Auricle The external ear is called the auricle or pinna and consists of movable cartilage and skin.

While discussing the history of a 6-month-old infant, the mother tells the nurse that she took a significant amount of aspirin while she was pregnant. What question would the nurse want to include in the history? A. "Does your baby seem to startle with loud noises?" B. "Has your baby had any surgeries on her ears?" C. "Have you noticed any drainage from her ears?" D. "How many ear infections has your baby had since birth?

A. "Does your baby seem to startle with loud noises?" Children at risk for hearing deficit include those exposed in utero to a variety of conditions, such as maternal rubella or maternal ototoxic drugs

A client has been diagnosed as being legally blind. The nurses realizes this clients vision is: A. 20/200 or less in the better eye with correction B. 20/200 or less in the worse eye without correction C. 20/100 or less in the better eye without correction D. 20/100 or less in the worse eye with correction

A. 20/200 of less in the better eye with correction Legal blindness is defined as vision of 20/200 or less on a Snellen eye chart in the better eye with correction. The eye needs to have correction in order to be diagnosed as legally blind, therefore, the choice of 20/200 in the worse eye without correction would be incorrect. The vision measurements of the other choices can be corrected with lenses and would not be categorized as legal blindness

A client complains of a slight itching, slight pain, and a scratching sound in the ear. The nurse suspects that an insect may have entered the ear. Which of the following should not be done? A. Add water to flush out the insect B. Add mineral oil to kill the insect C. Add lidocaine to kill the insect D. Call an otologist for a referral

A. Add water to flush out the insect Avoid placing water in the ear canal, which will only make the insect swell, thereby making it more difficult to remove. An otologist should be called for the removal. The audiologist may prescribe mineral oil or lidocaine to be applied to the ear canal.

The nurse is assessing a patient who may have hearing loss. Which of these statements is true 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 determine 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 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

The nurse is caring for a client diagnosed with acute sinusitis. Which of the following symptoms is the client most likely experiencing? A. Anosomia B. Fever C. Halitosis D. Metallic taste

A. Anosomia Clients often complain of unilateral face pain, purulent nasal discharge, pain during mastication, anosomia (absence of smell), and headache. Less common symptoms include fever, nasal congestion, halitosis, toothache, metallic taste, and cough

Fluctuations and reductions in estrogen may be a contributing factor in which type of rhinitis? A. Vasomotor rhinitis B. Rhinitis medicamentosum C. Atrophic rhinitis D. Viral rhinitis

A. Vasomotor rhinitis

After surgery to remove a cataract, which of the following should the nurse instruct the client? A. Be sure to follow the schedule for prescribed eyedrop medication B. Sleep on the right side to promote drainage C. It is okay to rub the eye because the surgery was on the inside D. This is an outpatient procedure, and there are no instructions for the patient

A. Be sure to follow the schedule for prescribed eyedrop medication Client education is extremely important in the aftercare of cataract surgery. There is a need to emphasize the postoperative care of eyedrop instillation. The client should not put any pressure near or on the eye Postoperative instructions are highly important for the client having an outpatient surgical procedure

The nurse is teaching a client how to use a nasal spray. Which of the following should be included in these instructions? A. Blow the nose before instilling the spray B. Tilt the head back and angle the tip of the bottle to the side of the nostril C. Use a finger to occlude the nostril that is not receiving the spray D. Inhale gently and evenly while discharging the spray into the nostril E. If a second spray is recommended, immediately repeat the procedure F. Blow the nose after administration of the spray

A. Blow the nose before instilling the spray C. Use a finger to occlude the nostril that is not receiving the spray D. Inhale gently and evenly while discharging the spray into the nostril For the steps to be correct, the head should be slightly forward, the second spray should be given 15-20 seconds after the spray, and the client should not blow the nose after the administration of the spray. The client should be instructed to blow the nose before instilling the spray, to use a finger to occlude the nostril that is not receiving the spray, and to gently inhale while the spray is being discharged into the nostril

A client is diagnosed with an inability to recognize visual information. The nurse realizes that which of the following cranial nerves is involved in the transmitting of visual stimuli to the brain for interpretation? A. CN II B. CN III C. CN IV D. CN VI

A. CN II The optic nerve is the second cranial nerve and is responsible for the transmitting of visual stimuli Cranial nerves III, IV, and VI control extraocular movements

A 2-week-old infant can fixate on an object but cannot follow a light or bright toy. The nurse would: A. Consider this a normal finding B. Assess the pupillary light reflex for possible blindness C. Continue with the examination, and assess visual fields D. Expect that a 2-week-old infant should be able to fixate and follow an object

A. Consider this a normal finding By 2-4 weeks an infant can fixate on an object. By the age of 1 month, the infant should fixate and follow a bright light or toy

When performing the corneal light reflex assessment, the nurse notes that the light is reflected at 2 o'clock in each eye. The nurse should: A. Consider this a normal finding B. Refer the individual for further evaluation C. Document this finding as an asymmetric light reflex D. Perform the confrontation test to validate the findings

A. Consider this a normal finding Reflection of the light on the corneas should be in exactly the same spot on each eye, or symmetric. If asymmetry is noted, then the nurse should administer the cover test.

Which of the following should the nurse assess in a client diagnosed with open-angle glaucoma? A. Degree of lost vision B. Severity of headaches C. Amount of blurred vision D. Date of onset

A. Degree of lost vision Open-angle glaucoma is characterized by a gradual increase in pressure and a gradual loss of vision. Closed-angle glaucoma presents with a sudden onset causing headache, blurred vision, and eye pain

Which type of stomatitis results in necrotic ulceration of the oral mucous membranes? A. Vincent's stomatitis B. Allergic stomatitis C. Apthous stomatitis D. Herpetic stomatitis

A. Vincent's stomatitis

The nurse is planning instruction for a client experiencing dry eyes. Which of the following should be included in these instructions. Select all that apply: A. Drink 8-10 glasses of water a day B. Apply petroleum jelly to the eyelids C. Blink more frequently D. Avoid sun exposure E. Avoid rubbing the eyes F. Avoid dry air

A. Drink 8-10 glasses of water a day C. Blink more frequently E. Avoid rubbing the eyes F. Avoid dry air Interventions to improve dry eyes include drinking 8-10 glasses of water a day, blink more frequently, avoid rubbing eyes, and know that dry air makes the condition worse Petroleum jelly is not a treatment for dry eyes. Avoiding the sun is good advice; however, it is not proven to help with dry eyes

A client is diagnosed with ocular cancer. The nurse realizes this client could be treated with: Select all that apply A. Enucleation B. Laser surgery C. Plaque brachytherapy D. Block incision E. Trabeculoplasty F. Trabeculectomy

A. Enucleation C. Plaque brachytherapy D. Block incision Surgical options for a client diagnosed with ocular cancer include enucleation, plaque brachytherapy, or block incision. Laser surgery, trabeculoplasty, and trabeculectomy would be used to treat glaucoma

A client is demonstrating signs of chronic sinusitis. Which of the following will the nurse most likely assess in this client? Select all that apply. A. Facial pain B. Fever C. Headache D. Toothache E. Fatigue F. Swollen neck glands

A. Facial pain C. Headache D. Toothache E. Fatigue Manifestations of chronic sinusitis include facial pain, headache, toothache, and fatigue. Fever and swollen neck glands would indicate the disorder has spread beyond the sinuses

When caring for a client with total hearing loss, the nurse is instructing the client about the many options that are available to function in hearing world. Which of the following should the nurse include? Select all that apply. A. Flashing lights for alarms B. TV with closed captions C. Talking computer D. Lip reading and sign language E. Cell phones with headsets F. Loud ringers on telephones

A. Flashing lights for alarms B. TV with closed captions D. Lip reading and sign language Patients who have no hearing have access to various mechanisms to alert them to various sounds. Flashing lights for alarms to phones and doorbells, TV with closed captions for the hearing impaired, and classes in lip reading and sign language are some options. Talking computers and cell phones with headsets are advancements for the hearing, not for the hearing impaired. Loud ringers on telephones would also be helpful to the client with some hearing and not a total hearing loss.

With which of the following can the nurse instruct a client who is experiencing pain from a sore throat? Select all that apply. A. Gargle with warm salty water B. Eat salty foods C. Suck on hard candy D. Drink fluids E. Avoid citrus fruits F. Suck on popsicles

A. Gargle with warm salty water C. Suck on hard candy D. Drink fluids F. Suck on popsicles Interventions to reduce the pain from a sore throat include gargling with warm salt water, sucking on throat lozenges or hard candy, sucking on flavored frozen desserts or popsicles, using a humidifier in the bedroom, and drinking fluids. The client should not be instructed to eat salty foods or avoid citrus fruits

A client is diagnosed with a congenital hearing loss. Which causes does the nurses realize are reasons for this type of hearing loss? Select all that apply. A. Genetics B. Natal infections C. Physical deformities D. Noise level E. Maternal ototoxic drugs F. Maternal TORCH infections

A. Genetics B. Natal infections C. Physical deformities E. Maternal ototoxic drugs F. Maternal TORCH infections Congenital hearing loss can be derived from genetics, natal infections, or physical deformities of the ear in addition to maternal ototoxic drug use and maternal TORCH infections that include toxoplasmosis, rubella, cytomegalovirus, and herpes virus type 2. Noise levels do not cause a congenital hearing loss.

A patient's vision is recorded as 20/80 in each eye. The nurse interprets this finding to mean that the patient: A. Has poor vision B. Has acute vision C. Has normal vision D. Is presbyopic

A. Has poor vision Normal visual acuity is 20/20 in each eye; the larger the denominator, the poorer the vision

The nurse is performing an ear examination of an 80-year-old patient. Which of these findings would be considered normal? A. High-tone frequency loss B. Increased elasticity of the pinna C. Thin, translucent membrane D. Shiny, pink tympanic membrane

A. High-tone frequency loss A high-tone frequency loss is apparent for those affected by presbycusis, the hearing loss that occurs with aging. The pinna loses elasticity, causing earlobes to be pendulus The eardrum may be whiter in color and more opaque and duller in the older person than in the younger adult

Otitis media is considered chronic when: A. Inflammation persists more than 3 months with intermittent or persistent otic discharge B. There are more than six occurrences of otitis media in a 1-year period C. Otitis media does not resolve after 2 courses of antibiotics D. All of the above

A. Inflammation persists more than 3 months with intermittent or persistent otic discharge

When examining the eye, the nurse notices that the patient's eyelid margins approximate completely. The nurse recognizes that this assessment finding: A. Is expected B. May indicate a problem with extraocular muscles C. May result in problems with tearing D. Indicates increased intraocular pressure

A. Is expected The palpebral fissure is the elliptical open space between the eyelids, and when closed, the lid margins approximate completely, which is a normal finding

Which of the following should the nurse instruct a client with type 2 DM regarding vision care? Select all that apply: A. Maintain good glucose control B. Stop smoking C. Limit exercise D. Reduce reading E. Frequently rest the eyes F. Rub eyes daily

A. Maintain good glucose control B. Stop smoking To preserve vision and reduce the onset of diabetic retinopathy, the nurse should instruct the patient to control blood glucose level, manage other complications, and stop smoking. The client should not be instructed to limit exercise, reduce reading, rest the eyes, or rub the eyes to prevent the onset of diabetic retinopathy

A client is complaining of dizziness, unilateral ringing in the ear, feeling of pressure or fullness in the ear, and unilateral hearing loss. The nurse would suspect the client is experiencing A. Meniere's disease B. Osteosclerosis C. Otitis media D. Mastoiditis

A. Meniere's disease All of the clients complaints are signs and symptoms of Meniere's disease. Although hearing disorders may have similar signs and symptoms, they do not include all of them

When performing an otoscopic examination of a 5-year-old child with a history of chronic ear infections, the nurse sees that the right tympanic membrane is amber-yellow in color and that air bubbles are visible behind the tympanic membrane. The child reports occasional hearing loss and a popping sound with swallowing. The preliminary analysis based on this information is that the child: A. Most likely has serous otitis media B. Has an acute purulent otitis media C. Has evidence of a resolving cholesteatoma D. Is experiencing the elderly stages of perforation

A. Most likely has serous otitis media An amber-yellow color to the tympanic membrane suggests serum or pus in the middle ear. Air or fluid or bubbles behind the tympanic membrane are often visible. The patient may have feelings of fullness, transient hearing loss, and a popping sound with swallowing. These findings most likely suggest that the child has serous otitis media. The other responses are not correct

As diabetic retinopathy progresses, the presence of cotton wool spots can be detected. Cotton wool spots refer to: A. Nerve fiber layer infarctions B. Blood vessel proliferation C. Venous beading D. Retinal hemorrhage

A. Nerve fiber layer infarctions

Which subtype of cataracts is characterized by significant nearsightedness and a slow indolent course? A. Nuclear cataracts B. Cortical cataracts C. Posterior cataracts D. Immature cataracts

A. Nuclear cataracts

During an examination, the nurse notices that the patient stumbles a little while walking, and when she sits down, she holds on to the sides of the chair. The patient states, "It feels like the room is spinning"! The nurse notices that the patient is experiencing: A. Objective vertigo B. Subjective vertigo C. Tinnitus D. Dizziness

A. Objective vertigo With objective vertigo, the patient feels like the room spins & with subjective vertigo, the person feels like he or she is spinning. Tinnitus is a sound that comes from within a person. It can be a ringing, crackling, or buzzing sound. It accompanies some hearing or ear disorders Dizziness it not the same as true vertigo. The person who is dizzy may feel unsteady and lightheaded

When instructing a client on cleaning the ear, the nurse should instruct the client to clean: A. Only the outer ear B. All the way to the middle ear C. All parts of the outer ear, middle, and inner ear D. Just the tympanic membrane

A. Only the outer ear Only the outer portion of the ear should be cleaned. Inserting different objects into the ear canal may result in injury and damage

The nurse is examining a patient's retina with an ophthalmoscope. Which finding is considered normal? A. Optic disc that is a yellow-orange color B. Optic disc margins that are blurred around the edges C. Presence of pigmented crescents in the macular area D. Presence of the macula located on the nasal side of the retina

A. Optic disc that is a yellow-orange color The optic disc is located on the nasal side of the retina. The color is a creamy yellow-orange to a pink, and the edges are distinct and sharply demarcated, not blurred. A pigmented crescent is black and is due to the accumulation of pigment in the choroid

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 the 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 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

Which of the following medications used in the treatment of glaucoma works by constricting the pupils to open the angle and allow aqueous fluid to escape? A. Pilocarpine B. Timolol C. Brinzolamide D. Acetalzolamide

A. Pilocarpine

The nurse is planning care for the client diagnosed with viral rhinitis. Which of the following would be the best goal of care for this client? A. Prevent secondary bacterial infection B. Prevent rhinitis medicamentosa C. Refrain from use of analgesics D. Encourage complete participation in activities

A. Prevent secondary bacterial infection Treatment of acute rhinitis, or the common cold, is aimed at decreasing the impact of the symptoms and preventing secondary bacterial infection Rhinitis medicamentosa occurs from misuse of nasal decongestants Acetaminophen or an NSAID agent is useful for fever, aches, and pain Rest is encouraged

The nurse is preparing to do an otoscopic examination on a 2-year-old child. Which one of these reflects the correct procedure? A. Pulling the pinna down B. Pulling the pinna up and back C. Slightly tilting the child's head toward the examiner D. Instructing the child to touch his chin to his chest

A. Pulling the pinna down For an otoscopic examination on an infant or on a child under 3 years of age, the pinna is pulled down. The other responses are not part of the correct procedure

Which of the following are indications that a client has been exposed to excessive noise? Select all that apply. A. Raising the voice to talk in normal conversation B. Clear drainage from the ears C. Inability to hear a conversation 2 feet away D. Sounds are muffled E. Ringing of the ears F. Short periods of pain in the ears

A. Raising the voice to talk in normal conversation C. Inability to hear a conversation 2 feet away D. Sounds are muffled E. Ringing of the ears F. Short periods of pain in the ears Warning signs of excessive noise exposure include raising the voice to talk in normal conversation, inability to hear a conversation 2 feet away, muffled sounds, ear ringing, and short periods of ear pain. Clear drainage from the ears does not occur with excessive noise exposure

A client has been diagnosed with allergic rhinitis. Which of the following should the nurse instruct the client regarding strategies to avoid this disorder? Select all that apply: A. Remove home carpeting B. Reduce the use of an air conditioner C. Remove pets from the home D. Open windows in the spring and summer E. Use feather pillows F. Wash bed linens in cold water

A. Remove home carpeting conditioner C. Remove pets from the home Strategies to reduce symptoms of allergic rhinitis include removing home carpeting and removing pets from the home. The client should be instructed to use an air conditioner, keep windows closed during allergy season, avoid feather pillows, and wash bed linens in hot water

The nurse is instructing a client diagnosed with otitis media on management during the acute phase. Which of the following should the nurse include in the teaching? Select all that apply. A. Take the antibiotics as ordered B. Take the over-the-counter analgesics for mild pain as recommended C. It is okay to go swimming D. It is okay to go on vacation and trips the require flying E. If excruciating pain develops, seek medical care F. Limit fluids

A. Take the antibiotics as ordered B. Take the over-the-counter analgesics for mild pain as recommended E. If excruciating pain develops, seek medical care Clients must complete the medication as ordered to kill the infection. Mild analgesics for pain are often needed. If excruciating ear pain develops, the client should seek medical care to rule out perforation of the eardrum. It is important to keep the ear dry, so the client should not swim at this time. Flying is not recommended at this time. Limiting fluids is not necessary with otitis media

The nurse is performing an external eye examination. Which statement regarding the outer layer of the eye is true? A. The outer layer of the eye is very sensitive to touch B. The outer layer of the eye is darkly pigmented to prevent light from reflecting internally C. The trigeminal nerve (CN V) and the trochlear nerve (CN IV) are stimulated when the outer surface of the eye is stimulated. D. The visual receptive layer of the eye in which light waves are changed into nerve impulses is located in the outer layer of the eye

A. The outer layer of the eye is very sensitive to touch The cornea and sclera make up the outer layer of the eye. The cornea is very sensitive to touch. The middle layer, the choroid, has dark pigmentation to prevent light from reflecting internally. The trigeminal nerve (CN V) and facial nerve (CN VII) are stimulated when the outer surface of the eye is stimulated The retina, in the inner layer of the eye, is where light waves are changed into nerve impulses

The nurse is planning to assess a client diagnosed with conductive hearing loss. When performing the Weber test, the nurse would expect which of the following findings? A. The sound will be louder in the affected ear B. The sound will be louder in the good ear C. Air conduction is shorter than bone conduction D. No sounds will be heard

A. The sound will be louder in the affected ear During a Weber test, which tests bone conduction, a client with conductive hearing loss hears louder sounds on the affected side Hearing louder sounds on the unaffected side is sensorineural loss. The Rinne test compares bone with air conduction

A client tells the nurse that he does not want to develop macular degeneration like his mother. Which of the following should the nurse instruct the client as being risk factors for the development of this disorder? Select all that apply. A. There is greater risk as people age B. Women are at greater risk than men C. African Americans are at greater risk than Caucasians D. Family history of macular degeneration increases risk E. Smoking does not increase risk F. Alcohol prevents onset of this disorder

A. There is greater risk as people age B. Women are at greater risk than men D. Family history of macular degeneration increases risk Recent statistics show that macular degeneration is age related and that women are at greater risk than men. Family history and smoking are also significant risk factors. Caucasians are at greater risk than African Americans. Alcohol does not prevent the onset of this disorder

A client with a family history of hearing loss asks the nurse when he can do to prevent this disorder as he ages. Which of the following should the nurse instruct this client? Select all that apply: A. Turn down radio and television volume B. Avoid noisy areas such as rock concerts C. Wear protective devices D. Use plain cotton balls in the ears E. Avoid sun exposure F. Flush the ears daily with mineral oil

A. Turn down radio and television volume B. Avoid noisy areas such as rock concerts C. Wear protective devices Measures to prevent hearing loss include turning down the volume on the radio and television, avoiding noisy areas such as rock concerts, and wearing protective devices. Using cotton balls in the ears does not decrease noise from reaching the middle ear. Sun exposure does not impact hearing. Flushing the ears daily with mineral oil might decrease the buildup of cerumen; however, it will not improve hearing

The nurse assesses the hearing of a 7-month-old by clapping hands. What is the expected response? The infant: A. Turns his or her head to localize the sound B. Shows no obvious response to the noise C. Shows a startle and acoustic blink reflex D. Stops any movement, and appears to listen for the sound

A. Turns his or her head to localize the sound With a loud sudden noise, the nurse should notice the infant turning his or her head to localize the sound and to respond to his/her own name. A startle reflex and acoustic blink reflex is expected in newborns; at age 3-4 months, the infant stops any movement and appears to listen

A client is receiving tests to diagnose glaucoma. Which of the following diagnostic tests will be used to identify this disorder in the client? Select all that apply. A. Visual acuity B. Visual field test C. Tonometry D. Weber test E. Rinne test F. Electroencephalpgram

A. Visual acuity B. Visual field test C. Tonometry Glaucoma is determined through a comprehensive eye exam including a visual acuity test, visual fields tests, and tonometry. The Weber and Rinne tests are used in an ear assessment An electroencephalogram is not used to diagnose glaucoma

Severe pain associated with acute otitis media signifies perforation of the tympanic membrane. True or False?

Answer = False

Acute angle-closure glaucoma involves a sudden severe rise in intraocular pressure. Which of the following ranges represents normal intraocular pressure? A. 0-7mmHg B. 8-21mmHg C. 22-40mmHg D. 40-80mmHg

B. 8-21mmHg

A client was assessed as having normal intraocular pressure. The nurse would document this clients pressure as being: A. 1.5mmHg to 3mmHg B. 15mmHg to 3mmHg C. 30mmHg to 3mmHg D. 50mmHg to 3mmHg

B. 15mmHg to 3mmHg Normal intraocular pressure is about 15mmHg 3mmHg. An intraocular pressure of 5mmHg would be too low. A pressure of 30 to 50mmHg would be considered critical

While performing the otoscopic examination of a 3-year-old boy who has been pulling on his left ear, the nurse finds that his left tympanic membrane is bright red and that the light reflex is not visible. The nurse interprets these findings to indicate a(n): A. Fungal infection B. Acute otitis media C. Perforation of the eardrum D. Cholesteatoma

B. Acute otitis media Absent or distorted light reflex and a bright red color of the eardrum are indicative of acute otitis media (see table 15-5 for descriptions of the other conditions)

A client is not able to successfully pass the whisper test. Which of the following would be indicated for this client? A. Head CT scan B. Audiometry C. MRI of the brain D. Electroencephalogram

B. Audiometry Failure to pass the whisper test would indicate the need for formal audiometry testing. The client would not need a heead CT and MRI at this time. An electroencephalogram is not necessary

The nurse is assessing a 16-year-old patient who has suffered head injuries from a recent motor vehicle accident. Which of these statements indicates the most important reason for assessing for any drainage from the ear canal? A. If the drum has ruptured, then purulent drainage will result B. Bloody or clear watery drainage can indicate a basal skull fracture C. The auditory canal may be occluded from the increased cerumen D. Foreign bodies from the accident may cause occlusion of the canal

B. Bloody or clear watery drainage can indicate a basal skull fracture Frank blood or clear watery drainage (cerebrospinal leak) after a trauma suggests basal skull fracture and warrants immediate referral. Purulent drainage indicates otitis externa or otitis media

A client is diagnosed with a conductive hearing loss. The nurse realizes this type of hearing loss in not associated with: A. Cerumen B. Brain damage C. Otitis media D. Otosclerosis

B. Brain damage Conductive hearing loss results in a blockage of sound waves in the external or middle portions of the ear. Wax (cerumen) buildup and infections are a large part of conductive hearing loss Otosclerosis is associated with conductive hearing loss.

The hearing of an unresponsive client needs to be assessed. Which of the following will be used to assess the hearing of this client? A. Audiometer B. Brainstem auditory evoked responses (BAER) test C. Rinne test D. Weber test

B. Brainstem auditory evoked responses (BAER) test The BAER test calculates the ability to hear in a client who is unresponsive. The BAER measures the sound impulse needed to evoke a brain response, which will indicate the clients ability to hear The other tests need the cooperation of the client and cannot be done at this time

A client is experiencing a gradual blurring of vision in both eyes not associated with any pain. The nurse suspects the client is experiencing: A. Glaucoma B. Cataracts C. Macular degeneration D. Retinal detachment

B. Cataracts Cataracts occur as the opacity of the lens becomes cloudy, blurring vision. It occurs in both eyes, but is usually worse in one eye. Gradual eye blurring is not associated with glaucoma, macular degeneration, or retinal detachment

A client is having difficulty perceiving different colors. The nurse realizes the client may have a disorder that affects the photosensitive receptor cells of the retina, which makes the perception of color possible, or a disorder that affects the: A. Rods B. Cones C. Optic discs D. Irises

B. Cones Other neurosensory elements located in the retina are cones, which mediate color vision. Rods mediate black and white vision. The optic disc and iris are not responsible for color vision

A client is experiencing redness, burning, itching, and pain of the eyes. The nurse suspects the client is experiencing: A. Blepharitis B. Conjunctivitis C. Keratitis D. Iritis

B. Conjunctivitis Clinical manifestations of conjunctivitis (pink eye) include watery eyes, redness, itching, and burning pain Blepharitis is associated with a sticky exudate Keratitis is associated with photophobia Iritis is associated with blurred vision and photophobia

Which of these assessment findings would the nurse expect to see when examining the eyes of a black patient? A. Increased night vision B. Dark retinal background C. Increased photosensitivity D. Narrowed palpebral fissures

B. Dark retinal background An ethnically based variability in the color of the iris and in retinal pigmentation exists, with darker irides having darker retina behind them

A client is diagnosed with strabismus. Which of the following will the client most likely experience with this disorder? A. Nystagmus B. Diplopia C. Aphakic vision D. Ptosis

B. Diplopia Diplopia, or double vision, is the primary symptom of strabismus. Nystagmus is a disorder that causes involuntary rhythmic movements in the eye. Aphakic vision occurs when the lens of the eye is removed Ptosis is drooping of the eyelid

The presence of hairy leukoplakia in a person with no other symptoms of immune suppression is strongly suggestive of which type of infection? A. HSV type 2 B. HIV C. Pneumonia D. Syphillis

B. HIV

An acutely presenting, erythematous, tender lump within the eyelid is called: A. Blepharitis B. Hordeolum C. Chalazion D. Iritis

B. Hordeolum

A patient comes into the clinic complaining of pain in her right eye. On examination, the nurse sees a pustule at the lid margin that is painful to touch, red, and swollen. The nurse recognizes that this is a: A. Chalazion B. Hordeolum (stye) C. Dacryocystitis D. Blepharitis

B. Hordeolum (stye) A hordeolum, or stye, is a painful, red, and swollen pustule at the lid margin. A chlazion is a nodule protruding on the lid, toward the inside and is nontender, firm, with discrete swelling. Dacryocystitis is an inflammation of the lacrimal sac. Blepharitis is inflammation of the eyelids

The nurse suspects that a patient has otitis media. Early signs of otitis media include which of these findings of the tympanic membrane: A. Red and bulging B. Hypomobility C. Retraction and landmarks clearly visible D. Flat, slightly pulled in at the center, and moves with insufflation

B. Hypomobility An early sign of otitis media is hypomobility of the tympanic membrane. As pressure increases, the tympanic membrane will begin to bulge

Which immunoglobulin mediates type 1 hypersensitivity reaction involved in allergic rhinitis? A. IgA B. IgE C. IgG D. IgM

B. IgE

A woman who is in the second trimester of pregnancy mentions that she has had more nosebleeds than ever since she became pregnant. The nurse recognizes this is a result of: A. A problem with the coagulation system B. Increased vascularity in the upper respiratory tract as a result of the pregnancy C. Increased susceptibility to colds and nasal irritation D. Inappropriate use of nasal sprays

B. Increased vascularity in the upper respiratory tract as a result of the pregnancy Nasal stuffiness and epistaxis may occur during pregnancy as a result of increased vascularity in the upper respiratory tract

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 Recruitment is a 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

The nurse is performing a middle ear assessment on a 15-year-old patient who has had a history of chronic ear infections. When examining the right tympanic membrane, the nurse sees the presence of dense white patches. The tympanic membrane is otherwise unremarkable. It is pearly, with the light reflex at 5 o'clock and landmarks visible. The nurse should: A. Refer the patient for the possibility of a fungal infection B. Know that these are scars caused from frequent ear infections C. Consider that these findings may represent the presence of blood in the middle ear D. Be concerned about the ability to hear because of this abnormality on the tympanic membrane

B. Know that these are scars caused from frequent ear infections Dense white patches on the tympanic membrane are the sequelae of repeated ear infections. They do not necessarily affect hearing

The nurse is reviewing age-related changes in the eye for a class. Which of these physiologic changes is responsible for presbyopia? A. Degeneration of the cornea B. Loss of lens elasticity C. Decrease adaptation to darkness D. Decreased distance vision abilities

B. Loss of lens elasticity the lens loses elasticity and decreases its ability to change shape to accommodate for near vision. This condition is called presbyopia

The nurse should instruct the client, diagnosed with glaucoma, that the purpose of medication is to: A. Help dry up excess secretions B. Lower the intraocular pressure C. Strengthen the muscles of the eye D. Improve the vision in the eye

B. Lower the intraocular pressure Glaucoma is a disease that relates to the increase of intraocular pressure. The medication given will decrease this intraocular pressure. Medication for glaucoma is not used to help dry up excess secretions, strengthen the eye muscles, or improve vision

A patient presents with the following signs and symptoms: gradual onset of low-grade fever, marked fatigue, severe sore throat, and posterior cervical lymphadenopathy. Based on the signs and symptoms alone, which of the following conditions is most likely the cause? A. Gonorrhea B. Mononucleosis C. Influenza D. Herpes zoster

B. Mononucleosis

A client, diagnosed with keratoconus, asks the nurse what caused the disorder to develop. The nurse should instruct the client on which of the following as risk factors for the development of this disorder. Select all that apply: A. Sun exposure B. Ocular allergies C. Wearing rigid contact lenses D. Vigorous eye rubbing E. Herpes simplex virus F. Dry eyes

B. Ocular allergies C. Wearing rigid contact lenses D. Vigorous eye rubbing Risk factors for the development of keratoconus include ocular allergies, rigid contact lens wear, and vigorous eye rubbing Sun exposure, herpes simplex, and dry eyes are not risk factors for this disorder

The nurse is performing the diagnostic positions test. Normal findings would be which of these results? A. Convergence of the eyes B. Parallel movement of both eyes C. Nystagmus in extreme superior gaze D. Slight amount of lid lag when moving the eyes from a superior to an inferior position

B. Parallel movement of both eyes A normal response for the diagnostic positions test is parallel tracking of the object with both eyes. Eye movement that is not parallel indicates a weakness of extraocular muscle or dysfunction of the CN that innervates it

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 The tympanic membrane is a translucent membrane with a pearly gray color and prominent cone light in the anteriorinferior 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

A client is prescribed a medication that is ototoxic. The nurse realizes that this medication may cause: A. Permanent or temporary vision loss B. Permanent or temporary hearing loss C. Nausea and vomiting D. Central nervous system depression

B. Permanent or temporary hearing loss Although many drugs cause nausea and vomiting and central nervous system (CNS) depression, ototoxic drugs cause hearing loss and the risks must be considered prior to suggesting these types of medications

The nurse realizes that a client, diagnosed with chronic dry eyes, may have a disorder of the lacrimal gland because it: A. Covers the eye for protection B. Produces tears to lubricate the eye C. Helps the eye keep its shape D. Provides blood to the eye

B. Produces tears to lubricate the eye The lacrimal gland moistens the eye by producing and distributing tears to lubricate the eye.

The nurse is testing the hearing of a 78-year-old man and is reminded of the changes in hearing that occur with aging that include which of the following? Select all that apply. A. Hearing loss related to aging begins in the mid 40's B. Progression of hearing loss is slow C. The aging person has low-frequency tone loss D. The aging person may find it harder to hear consonants than vowels E. Sound may be garbled and difficult to localize F. Hearing loss reflects nerve degeneration of the middle ear

B. Progression of hearing loss is slow D. The aging person may find it harder to hear consonants than vowels F. Hearing loss reflects nerve degeneration of the middle ear Presbycusis is a type of hearing loss that occurs with aging and is found in 60% of those older than 65 years. It is a gradual sensorineural loss caused by nerve degeneration in the inner ear or auditory nerve, and it slowly progresses after the age of 50 years. The person first notices high-frequency tone loss; it is harder to hear consonants (high-pitched components of speech) than vowels, which makes words sound garbled. The ability to localize sound is also impaired

A patient in her first trimester of pregnancy is diagnosed with rubella. Which of these statements is correct 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 If maternal rubella infection occurs during the first trimester, then it can damage the organ of Corti and impair hearing

A patient comes to the emergency department after a boxing match, and his left eye is swollen almost shut. He has bruises on his face and neck. He says he is worried because he can't see well from his left eye. The physician suspects retinal damage. The nurse recognizes that signs of retinal detachment include: A. Loss of central vision B. Shadow or diminished vision in one quadrant or one half of the visual field C. Loss of peripheral vision D. Sudden loss of pupillary constriction and accommodation

B. Shadow or diminished vision in one quadrant or one half of the visual field With retinal detachment, the person has shadows or diminished vision in one quadrant or one half of the visual field. The other responses are not signs of retinal detachment

You are in the park playing with your children when you see that your friend is screaming for help. Her toddler has fallen and there is a stick lodged in his eye. The child is kicking and screaming and grabbing for the stick. You: A. Instruct his mother to hold him securely and not allow him to touch the stick, then carefully remove the stick from the eye B. Stabilize the foreign object and accompany the mother and child to the local ER C. Find a water fountain, hold the child to the water, and flush the eye D. Call 911

B. Stabilize the foreign object and accompany the mother and child to the local ER

A client has been diagnosed with cataracts. The nurse realizes that the only treatment for this disorder is: A. Medical management with eyedrops B. Surgical removal of the lens C. Cryopexy D. Phototherapy

B. Surgical removal of the lens Surgical treatment for cataracts begins when vision in sufficiently impaired. The lens is removed and the replacement artificial ocular lens is put in place. Cataracts cannot be treated with medication alone. Cryopexy and phototherapy are not used to treat cataracts

The nurse is conducting a visual examination. Which of these statements regarding visual pathways and visual fields is true? A. The right side of the brain interprets the vision for the right eye B. The image formed on the retina is upside down and reversed from its actual appearance in the outside world C. Light rays are refracted through the transparent media of the eye before striking the pupil D. Light impulses are conducted through the optic nerve to the temporal lobes of the brain

B. The image formed on the retina is upside down and reversed from its actual appearance in the outside world The image formed on the retina is upside down and reversed from its actual appearance in the outside world. The light rays are refracted through transparent media of the eye before striking the retina, and the nerve impulses are conducted through the optic nerve tract to the visual cortex of the occipital lobe of the brain The left side of the brain interprets vision for the right eye

A patients vision is recorded as 20/30 when the Snellen eye chart is used. The nurse interprets these results to indicate that: A. At 30 feet the patient can read the entire chart B. The patient can read at 20 feet what a person with normal vision can read at 30 feet C. The patient can read the chart from 20 feet in the left eye and 30 feet in the right eye D. The patient can read from 30 feet what a person with normal vision can read from 20 feet

B. The patient can read at 20 feet what a person with normal vision can read at 30 feet The top number indicates the distance the person is standing from the chart; the denominator gives the distance at which a normal eye can see

The nurse is performing an eye assessment on an 80-year-old patient. Which of these findings is considered abnormal? A. Decrease in tear production B. Unequal pupillary constriction in response to light C. Presence of arcus senilis observed around the cornea D. Loss of the outer hair on the eyebrows attributable to a decrease in hair follicles

B. Unequal pupillary constriction in response to light Pupils are small in older adults, and pupillary light reflex may be slowed, but pupillary constriction should be symmetric. The assessment findings in the other responses are considered normal in older persons

A 17-year-old student is a swimmer on her high school swim team. She has had three bouts of otitis externa this season and wants to know what to do to prevent it. The nurse instructs her to: A. Use a cotton-tipped swab to dry the ear canals thoroughly after each swim B. Use rubbing alcohol or 2% acetic acid eardrops after each swim C. Irrigate the ears with warm water and a bulb syringe after each swim D. Rinse the ears with a warmed solution of mineral oil and hydrogen peroxide

B. Use rubbing alcohol or 2% acetic acid eardrops after each swim With otitis externa (swimmer's ear), swimming causes the external canal to become waterlogged and swell; skinfolds are set up for infection. Otitis externa can be prevented by using rubbing alcohol or 2% acetic acid eardrops after every swim

In performing a voice test to assess hearing, which of these actions would the nurse perform? A. Shield the lips so that the sound is muffled B. Whisper a set of random numbers and letters, and then ask the patient to repeat them C. Ask the patient to place his finger in his ear to occlude outside noise D. Perform the otoscopic examination at the end of the assessment

B. Whisper a set of random numbers and letters, and then ask the patient to repeat them With the head 30-60cm (1-2 feet) from the patients ear, the examiner exhales and slowly whispers a set of random numbers and letters (5, B, 6). Normally the patient is asked to repeat each number and letter correctly after hearing the examiner say them

Sinusitis is considered chronic when there are episodes of prolonged inflammation with repeated or inadequately treated acute infection lasting greater than: A. 4 weeks B. 8 weeks C. 12 weeks D. 16 weeks

C. 12 weeks

A client is diagnosed with a vision disorder. The nurse realizes that the client will experience an alteration in sensory information because the eyes transmit what percentage of all sensory information to the brain? A. 30% B. 50% C. 70% D. 90%

C. 70% Approximately 70% of all sensory information reaches the brain through the eyes. The other percentages are incorrect

A patient presents to the clinician with a sore throat, fever of 100.7F, and tender anterior cervical lymphadenopathy. The clinician suspects strep throat and performs a rapid strep test that is negative. What would the next step be? A. The patient should be instructed to rest and increase fluid intake as the infection is most likely viral and will resolve without antibiotic treatment B. Because the patient does not have strep throat, the clinician should start broad spectrum antibiotics in order to cover the offending pathogen C. A throat culture should be performed to confirm the results of the rapid strep test. D. The patient should be treated with antibiotics for strep throat as the rapid strep test is not very sensitive

C. A throat culture should be performed to confirm the results of the rapid strep test.

The nurse notices the presence of periorbital edema when performing an eye assessment on a 70-year-old patient. The nurse should: A. Check for the presence of exophthalmos B. Suspect that the patient has hyperthyroidism C. Ask the patient if he/she has a history of heart failure D. Assess for blepharitis, which is often associated with periorbital edema

C. Ask the patient if he/she has a history of heart failure The presence of shadows in the anterior chamber may be a sign of acute angle-closure glaucoma. The normal iris is flat and creates no shadows. This method is not correct for assessment of dacryocystitis, conjunctivitis, or cataracts

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 medication he is currently taking D. Look for the source of the obstruction in the external ear

C. Ask the patient what medication he is currently taking 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

The clinician is seeing a patient complaining of red eye. The clinician suspects conjunctivitis. The presence of mucopurulent discharge suggests which type of conjunctivitis? A. Viral conjunctivitis B. Keratoconjunctivitis C. Bacterial conjunctivitis D. Allergic conjunctivitis

C. Bacterial conjunctivitis

Which of the following statements is true concerning the use of bilberry as a complementary therapy for cataracts? A. The body coverts bilberry to Vitamin A, which helps to maintain a healthy lens B. Bilberry blocks an enzyme that leads to sorbitol accumulation that contributes to cataract formation in diabetes C. Bilberry boosts oxygen and blood delivery to the eye D. Bilberry is a good choice for patients with diabetes as it does not interact with antidiabetic drugs

C. Bilberry boosts oxygen and blood delivery to the eye

A mother asks when her newborn infants eyesight will be developed. The nurse should reply: A. Vision is not totally developed until 2 years of age B. Infants develop the ability to focus on an object approximately 8 months of age C. By approximately 3 months of age, infants develop more coordinated eye movements and can fixate on an object D. Most infants have uncoordinated eye movements for the first year of life

C. By approximately 3 months of age, infants develop more coordinated eye movements and can fixate on an object Eye movements may be poorly coordinated at birth, but by 3-4 months of age the infant should establish binocularity and should be able to fixate simultaneously on a single image with both eyes.

A 16-year-old client is being prescribed a medication to treat acute sinusitis. The nurse realizes that this client should not be prescribed: A. Amoxicillin B. Cefuroxime C. Ciprofloxacin D. Erythromycin

C. Ciprofloxacin Quinolones such as ciprofloxacin (Cipro) and levofloxacin (Levaquin) are contraindicated in children younger than 17 years of age

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 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.

In using the ophthalmoscope to assess a patients eyes, the nurse notices a red glow in the patient's pupils. On the basis of this finding, the nurse would: A. Suspect than an opacity is present in the lens or cornea B. Check the light sources of the ophthalmoscope light off the inner retina C. Consider the red glow a normal reflection of the ophthalmoscope light off the inner retina D. Continue with the ophthalmoscopic examination, and refer the patient for further evaluation

C. Consider the red glow a normal reflection of the ophthalmoscope light off the inner retina The red glow filling the persons pupil is the red reflex and is a normal finding caused by the reflection of the ophthalmoscope light off the inner retina. The other responses are not correct

The nurse is performing an assessment on a 65-year-old man. He reports a crusty nodule behind the pinna. It intermittently bleeds and has not healed over the past 6 months. On physical assessment, the nurse finds an ulcerated crusted nodule with an indurated base. The preliminary analysis in this situation is that: A. It is most likely a benign sebaceous cyst B. It is most likely keloid C. Could be a potential carcinoma, and the patient should be referred for a biopsy D. It is a tophus, which is common in the older adult and is a sign of gout

C. Could be a potential carcinoma, and the patient should be referred for a biopsy The ulcerated crusted nodule with an indurated base that fails to heal is characteristic of a carcinoma. These lesions fail to heal and intermittently bleed. Individuals with such symptoms should be referred for a biopsy.

When examining a patient's eyes, the nurse recalls that stimulation of the sympathetic branch of the autonomic nervous system: A. Causes pupillary constriction B. Adjusts the eye for near vision C. Elevates the eyelid and dilates the pupil D. Causes contraction of the ciliary body

C. Elevates the eyelid and dilates the pupil Stimulation of the sympathetic branch of the autonomic nervous system dilates the pupil and elevates the eyelid Parasympathetic stimulation causes the pupil to constrict The muscle fibers of the iris contract the pupil in bright light to accommodate for near vision The ciliary body controls the thickness of the lens

The nurse is instructing the mother of a client recovering from a tonsillectomy. Which of the following should the nurse instruct the mother to report? A. Difficulty swallowing B. Difficulty talking C. Excessive swallowing D. Pain

C. Excessive swallowing Excessive swallowing is usually a sign of bleeding and should be reported. Pain and difficulty talking/swallowing are expected

Which of the following would prohibit an elderly client from wanting to obtain and use a hearing aid? A. Fear sounds will be too loud B. Thinks not necessary for a temporary problem C. Fears the cost D. Prefers the silence

C. Fears the cost Some of the problems encountered by clients obtaining hearing aids include appearance, cost, education, unrealistic expectations, and difficulty with the care and maintenance of the hearing aids. The other choices are not problems encountered by clients obtaining hearing aids

After a mastoidectomy, the most important complication for the nurse to assess for is: A. Vomiting B. Headache C. Fever D. Stiff neck

C. Fever All are complications that can occur following this type of surgery. Fever is of extra importance because of its possible link to infection. The mastoid bone is in direct contact with the brain, and therefore any infection can travel to the brain

A client is demonstrating signs of peritonsillar abscess. Which of the following will the nurse most likely assess in this client? Select all that apply. A. Bradynpnea B. Drop in blood pressure C. Hot potato voice D. Trismus E. Dysphagia F. Sore throat

C. Hot potato voice D. Trismus E. Dysphagia F. Sore throat Assessment findings consistent with peritonsillar abscess include: hot potato voice, trismus (difficulty opening the mouth), dysphagia (painful swallowing), sore throat. Bradypnea and drop in blood pressure are not assessment findings consistent with peritonsillar abscess

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 Asians and Native Americans are more likely to have dry cerumen, whereas Blacks and Whites usually have wet cerumen

Which of the following antibiotics provides the best coverage in acute or chronic sinusitis when gram-negative organisms are suspected? A. Penicillin V B. Amoxicillin C. Levofloxacin D. Clindamycin

C. Levofloxacin

A client is experiencing a loss of central vision but not a loss of peripheral vision. The nurse realizes the client should be evaluated for: A. Detached retina syndrome B. Nystagmus C. Macular degeneration D. Conjunctivitis

C. Macular degeneration Macular degeneration is a deterioration of part of the retina, causing loss of central vision but not affecting peripheral vision. The loss of central vision is not typically seen in a detached retina, nystagmus, or conjunctivitis

Which of the following should the nurse instruct a client recovering from a tonsillectomy? A. Drink milk to promote healing B. Gargle with salt water C. Maintain good hydration D. Use a straw to drink

C. Maintain good hydration Drinking milk does not promote healing and may encourage production of mucous Gargling and drinking with a straw may disrupt the clot at the operative site and cause bleeding Maintaining good hydration and eating soft foods are encouraged

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? 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 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

A client tells the nurse that she sees a shadow that is slowly getting worse in her left eye. Which of the following should the nurse do? A. Instruct the client to return home to rest in bed B. Encourage the client to continue with normal daily activities C. Notify the ophthalmologist D. Encourage fluids and saline drops

C. Notify the ophthalmologist The nurse should notify the ophthalmologist with the clients symptoms. The onset of a shadow in the field of vision that will not dissipate is an indication of a detached retina. Retinal detachments rarely self-repair, and the client will need surgery. The nurse should not instruct the client to return home to rest in bed. The client should not be encouraged to continue with normal daily activities. Fluids and saline eyedrops will not help a detached retina

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 out of my left ear"! What should the nurse do next? A. Make note of this finding and report to the next shift B. Prepare to remove cerumen from the patient's ear C. Notify the patient's health care provider D. Irrigate the ear with rubbing alcohol

C. Notify the patient's health care provider Any sudden loss of hearing in one or both ears that is not associated with an upper respiratory infection needs to be reported at once to the patient's healthcare provider. Hearing loss associated with trauma is often sudden. Irrigating the ear or removing cerumen is not appropriate at this time

A 60-year-old man is at the clinic for an eye examination. The nurse suspects that he has ptosis of one eye. How should the nurse check for this? A. Perform the confrontation test B. Assess the individuals near vision C. Observe the distance between the palpebral fissures D. Perform the corneal light test, and look for symmetry of the light reflex

C. Observe the distance between the palpebral fissures Ptosis is a drooping of the upper eyelid that would be apparent by observing the distance between the upper and lower eyelids. The confrontation test measures peripheral vision Measuring near vision or the corneal light test does not check for ptosis

A client tells the nurse that she experiences a stuffy nose, nasal pain, and postnasal drip every time she works in her company office. Which of the following types of allergic rhinitis is this client most likely experiencing? A. Infectious B. Perennial C. Occupational D. Seasonal

C. Occupational Occupational allergic rhinitis occurs from airborne substances in the workplace. Seasonal allergic rhinitis occurs during a specific time of the year Perrenial allergic rhinitis occurs in response to exposure to environmental allergens that can occur throughout the year Infectious rhinitis is a nonallergic type of rhinitis

A 65-year-old presents to the clinician with complaints of increasing bilateral peripheral vision loss, poor night vision, and frequent prescription changes that started 6 months previously. Recently, he has also been seeing halos around lights. The clinician suspects chronic open-angle glaucoma. Which of the following statements is true concerning the diagnosis of chronic open-angle glaucoma? A. The presence of increased intraocular pressure measure by tonometry is definitive for the diagnosis of open-angle glaucoma B. The clinician can definitively diagnose open-angle glaucoma based on the subjective complaints of the patient C. Physical diagnosis relies on gonioscopic evaluation of the angle by an ophthalmologist D. Early diagnosis is essential in order to reverse any damage that has occurred to the optic nerve

C. Physical diagnosis relies on gonioscopic evaluation of the angle by an ophthalmologist

A client diagnosed with hypertension is experiencing allergic rhinitis. The nurse realizes that the medication that would not be indicated for this client would be: A. Loratadine B. Montelukast C. Pseudoephedrine D. Zafirlukast

C. Pseudoephedrine Pseudoephedrine is contraindicated for patients with hypertension. Loratadine, montelukast, and zafirlukast should be used cautiously for patients with hepatic impairment

The nurse is performing an otoscopic examination on an adult. Which of these actions is correct? A. Tilting the persons head forward during the examination B. Once the speculum is in the ear, releasing the traction C. Pulling the pinna up and back before inserting the speculum D. Using the smallest speculum to decrease the amount of discomfort

C. Pulling the pinna up and back before inserting the speculum The pinna is pulled up and back on an adult or older child, which helps straighten the S-shape of the canal. Traction should not be released on the ear until the examination is completed and the otoscope is removed

In a patient who has anisocoria, the nurse would expect to observe: A. Dilated pupils B. Excessive tearing C. Pupils of unequal size D. Uneven curvature of the lens

C. Pupils of unequal size Unequal pupil size is termed anisocoria. It normally exists in 5% of the population but may also be indicative of central nervous system disease

A client diagnosed with viral rhinitis tells the nurse that she has been using a decongestant nasal spray for several weeks and symptoms are getting worse. Which of the following does the nurse suspect is occurring with this client? A. Developing pneumonia B. Subacute rhinitis C. Rhinitis medicamentosa D. Chronic otitis media

C. Rhinitis medicamentosa Rhinitis medicamentosa can occur with overuse of decongestant nasal sprays, and it leads to rebound nasal congestion that is often worse than the original nasal congestion The use of nasal sprays does not cause pneumonia, subacute rhinitis, or chronic otitis media

The clinician is assessing a patient complaining of hearing loss. The clinician places a tuning fork over the patient's mastoid process, and when the sound fades away, the fork is placed without restriking it over the external auditory meatus. The patient is asked to let the clinician know when the sound fades away. This is an example of which type of test? A. Weber Test B. Schwabach test C. Rinne test D. Auditory brainstem response (ABR) test

C. Rinne test

When assessing the pupillary light reflex, the nurse should use which technique? A. Shine a penlight from directly in front of the patient, and inspect for pupillary constriction B. Ask the patient to follow the penlight in eight directions, and observe for bilateral pupil constriction C. Shine a light across the pupil from the side, and observe for direct and consensual pupillary constriction D. Ask the patient to focus a distant object. Then ask the patient to follow the penlight to approximately 7cm from the nose

C. Shine a light across the pupil from the side, and observe for direct and consensual pupillary constriction To test the pupillary light reflex, the nurse should advance a light in from the side and note the direct and consensual pupillary constriction

The nurse is trying to communicate with a hearing-impaired client. The best way to do this is to: A. Write down all of the message B. Shout in the impaired ear C. Speak slowly and clearly while facing the client D. Talk in a regular voice in the good ear

C. Speak slowly and clearly while facing the client When trying to communicate with the hearing-impaired client, the nurse should speak slowly and clearly while facing the client to give her the opportunity to see and hear the words being spoken.

The nurse is assessing color vision of a male child. Which statement is correct? The nurse should: A. Check color vision annually until the age of 18 years B. Ask the child to identify the color of his/her clothing C. Test for color vision once between ages 4 and 8 years D. Begin color vision screening at the child's 2-year checkup

C. Test for color vision once between ages 4 and 8 years Test boys only once for color vision between the ages of 4-8 years. Color vision is not tested in girls because it is rare in girls. Testing is performed with the Ishihara test, which is a series of polychromatic cards

The nurse is preparing to perform an otoscopic examination of a newborn infant. Which statement is true regarding this examination? A. Immobility of the drum is a normal finding B. An injected membrane would indicate an infection C. The normal membrane may appear thick and opaque D. The appearance of the membrane is identical to that of an adult

C. The normal membrane may appear thick and opaque During the first few days after birth, the tympanic membrane of a newborn often appears thickened and opaque. It may look injected and have mild redness from increased vascularity. The other statements are not correct

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 The ear is lined with glands that secrete cerumen, which is a yellow waxy material that lubricates and protects the ear

A tonometry test has been performed with a client and the results are 25 mmHg. The nurse knows that: A. The reading is low and there is not problem B. The reading is normal and nothing needs to be done at this time C. The results are high and follow-up readings and tests are needed D. The results are high and there is no cure to bring the pressure down

C. The results are high and follow-up readings and tests are needed Several readings need to be taken throughout the day to establish the highest reading to be the treated pressure. Normal intraocular pressure ranges from 12-16 mmHg. The reading of 25 mmHg is not low or normal. Medication can be prescribed to reduce the pressure

The nurse realizes that the best medication treatment for open-angle glaucoma would be: A. Timolol (Timoptic) eyedrops B. Latanoprost (Xalatan) eyedrops C. Timolol (Timoptic) and Latanoprost (Xalatan) eyedrops D. Metoprolol oral medication

C. Timolol (Timoptic) and Latanoprost (Xalatan) eyedrops For the best effect in the treatment of open-angle glaucoma, timolol (Timoptic) and latanoprost (Xalatan) should be prescribed together. Metoprolol is not prescribed for open-angle glaucoma

During an examination, the patient states he is hearing a buzzing sound and says that it is, "driving me crazy"! The nurse recognizes that this symptom indicates A. Vertigo B. Pruritus C. Tinnitus D. Cholesteatoma

C. Tinnitus Tinnitus is a sound that comes from within a person; it can be a ringing, crackling, or buzzing sound. It accompanies some hearing or ear disorders

The nurse is preparing to assess the visual acuity of a 16-year-old patient. How should the nurse proceed? A. Perform the confrontation test B. Ask the patient to read the print on a handheld Jaeger card C. Use the Snellen chart positioned 20 feet away from the patient D. Determine the patients ability to read newsprint at a distance of 12-14 feet

C. Use the Snellen chart positioned 20 feet away from the patient The Snellen alphabet chart is the most commonly used and most accurate measure of visual acuity The confrontation test is a gross measure of peripheral vision. The Jaeger card or newspaper tests are used to test near vision

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 The nerve impulses are conducted by the auditory portion of CN VIII to the brain

The most significant precipitating event leading to otitis media with effusion is: A. Pharyngitis B. Allergies C. Viral upper respiratory infection (URI) D. Perforation of the eardrum

C. Viral upper respiratory infection (URI)

During an examination of the eye, the nurse would expect what normal finding when assessing the lacrimal apparatus? A. Presence of tears along the inner canthus B. Blocked nasolacrimal duct in a newborn infant C. Slight swelling over the upper lid and along the bony orbit if the individual has a cold D. Absence of drainage from the puncta when pressing against the inner orbital rim

D. Absence of drainage from the puncta when pressing against the inner orbital rim No swelling, redness, or drainage from the puncta should be observed when it is pressed. Regurgitation of fluid from the puncta, when pressed, indicates blockage. The lacrimal glands are not functional at birth

In which of the following situations would referral to a specialist be needed for sinusitis? A. Recurrent sinusitis B. Allergic sinusitis C. Sinusitis that is refractory to antibiotic therapy D. All of the above

D. All of the above

Patients with acute otitis media should be referred to a specialist in which of the following situations? A. Concurrent vertigo or ataxia B. Failed closure of a ruptured tympanic membrane C. If symptoms worsen after 3-4 days of treatment D. All of the above

D. All of the above

The nurse is reviewing causes of increased intraocular pressure. Which of these factors determines intraocular pressure? A. Thickness of bulging of the lens B. Posterior chamber as it accommodates increased fluid C. Contraction of the ciliary body in response to the aqueous within the eye D. Amount of aqueous produced and resistance to its outflow at the angle of the anterior chamber

D. Amount of aqueous produced and resistance to its outflow at the angle of the anterior chamber Intraocular pressure is determined by a balance between the amount of aqueous produced and the resistance to its outflow at the angle of the anterior chamber. The other responses are incorrect

The nurse is performing an assessment on a client. To test the optic nerves function, what should the nurse do? A. Check for extraocular movement B. Check the pupils reaction to light C. Check to see if the patient can blink D. Use a Snellen chart

D. Use a Snellen chart A Snellen chart is used to assess visual acuity of the optic nerve. Extraocular movements assess cranial nerves III, IV, and VI. Pupil reaction to light and eye blinking are not functions of the optic nerve

An assessment of a 23-year-old patient reveals the following: an auricle that is tender and reddish-blue in color with small vesicles. The nurse would need to know additional information that includes which of these? A. Any change in the ability to hear B. Any recent drainage from the ear C. Recent history of trauma to the ear D. Any prolonged exposure to extreme cold

D. Any prolonged exposure to extreme cold Frostbite causes reddish-blue discoloration and swelling of the auricle after exposure to extreme cold. Vesicles or bullae may develop, and the person feels pain and tenderness

When assessing the corneal reflex, the nurse realizes this reflex is a function of which cranial nerve? A. CN II B. CN III C. CN IV D. CN V

D. CN V The stimulation of the trigeminal nerve (CN V) causes the corneal reflex, a protective blink. Cranial nerves II, III, or IV do not control the corneal reflex

Which of the following should the nurse instruct a client who is being fitted for a hearing aid? A. Keep the appliance turned on at all times B. Store the hearing aid in a warm, moist place C. Batteries last for at least 1 month D. Clean ear molds at lease once a week

D. Clean ear molds at lease once a week The nurse should instruct the patient to turn off the appliance when not in use; store in a cool, dry, place; change the batteries at least once per week; and clean ear molds at least once per week

The nurse is testing a patients visual accommodation, which refers to what action? A. Pupillary constriction when looking at a near object B. Pupillary dilation when looking at a far object C. The eye focuses the image in the center of the pupil D. Constriction of both pupils occurs in response to bright light

D. Constriction of both pupils occurs in response to bright light The pupillary light reflex is the normal constriction of the pupils when bright light shines on the retina. The other responses are not correct

The nurse is assessing a patients eyes for the accommodation response and would expect to see which normal finding? A. Dilation of the pupils B. Consensual light reflex C. Conjugate movement of the eyes D. Convergence of the axes of the eyes

D. Convergence of the axes of the eyes The accommodation reaction includes pupillary constriction and convergence of the axes of the eyes. The other responses are not correct

In an individual with otitis externa, which of these signs would the nurse expect to find on assessment? A. Rhinorrhea B. Periorbital edema C. Pain over the maxillary sinuses D. Enlarged superficial cervical nodes

D. Enlarged superficial cervical nodes The lymphatic drainage of the external ear flows to the parotid, mastoid, and superficial cervical nodes. The signs are severe swelling of the canal, inflammation, and tenderness. Rhinorrhea, periorbital edema, and pain over the maxillary sinuses do not occur with otitis externa

A client asks the nurse if there is an antihistamine that does not cause drowsiness. Which of the following medications would this client most likely prefer to treat allergic rhinitis? A. Diphenhydramine B. Chlorpheniramine maleate C. Clemastine D. Fexofenadine

D. Fexofenadine Fexofenadine (Allegra) is a second-generation antihistamine, and second-generation antihistamines exhibit less sedation than first-generation medications such as diphenhydramine, chlorpheniramine maleate, and clemastine

A child is diagnosed with severe allergic rhinitis. Which of the following manifestations would the nurse most likely assess in this client? A. Edematous neck glands B. Reduced hearing C. Pruritus D. Frequent wiping of the nose with the palm of the hand

D. Frequent wiping of the nose with the palm of the hand Frequent wiping of the nose with the palm of the hand is one symptom seen in the client diagnosed with severe allergic rhinitis.

Heart valve damage resulting from acute rheumatic fever is a long-term sequelae resulting from infection with which of the following pathogens? A. Coxsackievirus B. Cytomegalovirus C. Francisella tularensis D. Group A streptococcus

D. Group A streptococcus

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? Typically with perforation, ear pain occurs first, stopping with a popping sensation, and then drainage occurs

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 The eustachian tube allows an equalization of 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

The nurse is performing postoperative teaching with a client recovering from a stapedectomy. Which of the following instructions would the nurse want to include in the teaching? A. It is okay to resume exercise the next day B. It is ok to resume work the same day C. It is ok to shower and shampoo the next day D. It is ok to blow the nose gently one side at a time

D. It is ok to blow the nose gently one side at a time Care must be taken not to disturb the ossicles fro their position, so exercise and work should not be resumed until healing is complete. it is also important to keep the ear dry. The client should be taught to blow the nose gently on one side at a time so as not to increase the pressure in the ear

A 52-year-old patient describes the presence of occasional floaters or spots moving in front of his eyes. The nurse should: A. Examine the retina to determine the number of floaters B. Presume the patient has glaucoma and refer him for further testing C. Consider these to be abnormal findings, and refer him to an ophthalmologist D. Know that floaters are usually insignificant and are caused by condensed vitreous fibers

D. Know that floaters are usually insignificant and are caused by condensed vitreous fibers Floaters are a common sensation with myopia or after middle age and are attributable to condensed vitreous fibers. Floaters or spots are not usually significant, but the acute onset of floaters may occur with retinal detachment.

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 or Corti D. Labyrinth

D. Labyrinth If the labyrinth ever becomes inflamed, then it feeds the wrong information to the brain, creating a staggering gait and strong, spinning, whirling sensation called vertigo

A patient presents to the clinician complaining of ear pain. On examination, the clinician finds that the patient has tenderness on traction of the pinna as well as when applying pressure over the tragus. These findings are classic signs of which condition? A. Otitis media B. Meniere's disease C. Tinnitus D. Otitis externa

D. Otitis externa

The nurse is conducting a child safety class for new mothers. Which factor places young children at risk for ear infections? A. Family history B. Air conditioning C. Excessive cerumen D. Passive cigarette smoke

D. Passive cigarette smoke Exposure to passive and gestational smoke is a risk factor for ear infections in infants and children.

In performing an examination of a 3-year-old child with a suspected ear infection, the nurse would: A. Omit the otoscopic examination if the child has a fever B. Pull the ear up and back before inserting the speculum C. Ask the mother to leave the room while examining the child D. Perform the otoscopic examination at the end of the assessment

D. Perform the otoscopic examination at the end of the assessment In addition to its place in the complete examination, eardrum assessment is mandatory for any infant or child requiring care for an illness or fever. For the infant or young child, otoscopic examination is best toward the end of the complete examination

Which of the following is an example of sensorineural hearing loss? A. Perforation of the tympanic membrane B. Otosclerosis C. Cholestetoma D. Presbycusis

D. Presbycusis

During an assessment of the sclera of a black patient, the nurse would consider which of these an expected finding? A. Yellow fatty deposits over the cornea B. Pallor near the outer canthus of the lower lid C. Yellow color of the sclera that extends up to the iris D. Presence of small brown macules on the sclera

D. Presence of small brown macules on the sclera Normally in dark-skinned people, small brown macules may be observed in the sclera.

A client is experiencing little flashes of lights and things floating in the visual field. The nurse suspects: A. Cataracts B. Glaucoma C. Conjunctivitis D. Retinal detachment

D. Retinal detachment Retinal detachment is clinically manifested by flashes and floaters in the visual field. Flashes of light and floaters are not associated with cataracts, glaucoma, or conjunctivitis

A patient is unable to read even the largest letters on the Snellen chart. The nurse should take which action next? A. Refer the patient to an ophthalmologist or optometrist for further evaluation B. Assess whether the patient can count the nurses fingers when they are placed in front of his/her eyes C. Ask the patient to put on his or her reading glasses and attempt to read the Snellen chart D. Shorten the distance between the patient and the chart until the letters are seen, and record the distance

D. Shorten the distance between the patient and the chart until the letters are seen, and record the distance If the person is unable to see even the largest letters while standing 20 feet from the chart, then the nurse should shorten the distance to the chart until the letters are seen, and record that distance (e.g. 10/200). If visual acuity is even lower, then the nurse should assess whether the person can count fingers when they are spread in front of the eyes or can distinguish light perception from a penlight. If vision is poorer than 20/30, then a referral to an ophthalmologist or optometrist is necessary, but the nurse must first assess the visual acuity

A client is experiencing epistaxis. Which of the following interventions would the nurse complete? A. Call the doctor B. Check laboratory results C. Obtain an emesis bin D. Show the patient how to pinch the nose

D. Show the patient how to pinch the nose The initial intervention for a client with epistaxis is to show the client how to lean forward and pinch the nose against the nasal septum for about 5-15 minutes continuously. The other interventions are not necessary at this time

During ocular examinations, the nurse keeps in mind that movement of the extraocular muscles is: A. Decreased in the older adult B. Impaired in a patient with cataracts C. Stimulated by cranial nerves I and II D. Stimulated by cranial nerves III, IV, and VI

D. Stimulated by cranial nerves III, IV, and VI Movement of the extraocular muscles is stimulated by CN III, IV, and VI

The nurse is performing an eye screening clinic at a daycare center. When examining a 2-year-old child, the nurse suspects that the child has a lazy eye and should: A. Examine the external surfaces of the eye B. Assess visual acuity with the Snellen eye chart C. Assess the child's visual fields with the confrontation test D. Test for strabismus by performing the corneal light reflex test

D. Test for strabismus by performing the corneal light reflex test Testing for strabismus is done by performing the corneal light reflex test and the cover test. The Snellen eye chart and confrontation and confrontation test are not used to test for strabismus

You have a patient who is positive for Strep on rapid antigen testing (rapid strep test). You order amoxicillin after checking for drug allergies (patient is negative) but he returns 3 days later, reporting that his temperature has gone up, not down (101.5F in office). You also note significant adenopathy, most notably in the posterior and anterior cervical chains, some hepatomegaly, and a diffuse rash. You decide: A. To refer the patient B. That he is having an allergic response and needs to be changed to a macrolide antibiotic C. That his antibiotic dosage is not sufficient and should be changed D. That he possibly has mononucleosis concurrent with his strep infection

D. That he possibly has mononucleosis concurrent with his strep infection

A client is recovering from a total laryngectomy with the placement of a tracheostomy. The nurse should include which of the following instructions to this client? A. Clean the tracheostomy tube with soap and water daily B. Limit protein in the diet C. Restrict fluids D. The nasogastric tube will be in for 2 weeks

D. The nasogastric tube will be in for 2 weeks Patients recovering from a laryngectomy are unable to take nutrition orally for about 10-14 days. During this time the patient will receive nutrition via IV fluids, enteral feedings through an NG tube, or parenteral nutrition. Protein and fluids are not limited. The tracheostomy tube is not cleaned with soap and water

The mother of a 2-year-old toddler is concerned about the upcoming placement of tympanostomy tubes in her son's ears. The nurse would include which of these statements in the teaching plan? A. The tubes are placed in the inner ear. B. The tubes are used in children with sensorineural loss. C. The tubes are permanently inserted during a surgical procedure. D. The purpose of the tubes is to decrease the pressure and allow for drainage.

D. The purpose of the tubes is to decrease the pressure and allow for drainage. Polyethylene tubes are surgically inserted into the eardrum to relieve middle ear pressure and to promote drainage of chronic or recurrent middle ear infections. Tubes spontaneously extrude in 6 months to 1 year

A client has been diagnosed with stage IV cancer of the larynx. The nurse realizes that which of the following surgeries is recommended for this type of cancer? A. Hemilaryngectomy B. Partial laryngectomy C. Supraglottic laryngectomy D. Total laryngectomy

D. Total laryngectomy In clients diagnosed with invasive or infiltrating tumors such as those of stage III or stage IV, the entire larynx is removed. The other surgeries only remove portions of the larynx and would be appropriate for lesser stages of the disease

During an otoscopic examination, the nurse notices an area of black and white dots on the tympanic membrane and the ear canal wall. What does this finding suggest? A. Malignancy B. Viral infection C. Blood in the middle ear D. Yeast or fungal infection

D. Yeast or fungal infection A colony or black or white dots on the drum or canal wall suggests a yeast or fungal infection (otomycosis)

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 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 correct