Med-Surg Blueprint Unit Exam 5--Final (Sensory System)

Which test assesses a patient's ability to hear different sound frequencies and measures the degree of hearing loss? A. Rinne test B. Weber test C. Audiometry D. Tympanometry

Answer: C. Audiometry Rationale: Audiometry evaluates hearing at various sound frequencies and intensities. The Rinne and Weber tests are tuning fork tests, while tympanometry measures middle ear function.

What is the primary purpose of the Weber test in ear examination? a. Determine the severity of hearing loss b. Detect differences in bone conduction between ears c. Measure air conduction thresholds d. Evaluate middle ear pressure

Answer: b. Detect differences in bone conduction between ears Rationale: The Weber test uses a tuning fork to assess lateralization of sound, helping differentiate between conductive and sensorineural hearing loss.

Which medication is commonly prescribed as an otic solution for bacterial otitis externa? A. Ciprofloxacin B. Acetaminophen C. Amoxicillin D. Prednisone

Answer: A Rationale: Ciprofloxacin is a fluoroquinolone antibiotic effective for treating bacterial infections like otitis externa.

Which statement by a patient taking an anti-infective for an ear infection indicates they need further education? A. "I should use cotton swabs daily to keep my ear clean." B. "I will keep water out of my ear while using this medication." C. "I will finish the medication even if my symptoms go away." D. "I will contact my provider if I have severe ear pain or drainage."

Answer: A Rationale: Cotton swabs should not be used as they can push debris further into the ear or cause damage, worsening the condition.

Which fungal infection of the ear is most commonly treated with anti-infectives? A. Otomycosis B. Labyrinthitis C. Mastoiditis D. Cholesteatoma

Answer: A Rationale: Otomycosis is a fungal infection of the external ear and is treated with antifungal medications like clotrimazole or acetic acid drops.

What does the term "vertigo" signify? A) A sensation of spinning or dizziness B) Inflammation of the ear canal C) Sudden hearing loss D) Fluid buildup in the middle ear

Answer: A) A sensation of spinning or dizziness Rationale: Vertigo is a symptom of vestibular dysfunction, causing the individual to feel as though they or their surroundings are spinning.

What is "presbycusis"? A) Age-related hearing loss B) Ringing in the ears C) Fluid accumulation in the middle ear D) Dizziness caused by inner ear dysfunction

Answer: A) Age-related hearing loss Rationale: Presbycusis is a gradual loss of hearing due to aging, typically affecting higher frequencies.

The term "tympanoplasty" refers to: A) Reconstruction of the eardrum or ossicles B) Removal of excess earwax C) Testing the mobility of the eardrum D) Insertion of a hearing aid

Answer: A) Reconstruction of the eardrum or ossicles Rationale: Tympanoplasty is a surgical procedure to repair the eardrum and restore hearing function, often following perforations or damage.

During a pupillary light reflex test, what is a normal finding? A. Both pupils constrict equally when light is shone in one eye. B. Only the illuminated pupil constricts. C. Both pupils dilate in response to light. D. Pupils remain fixed regardless of light exposure.

Answer: A. Both pupils constrict equally when light is shone in one eye. Rationale: A normal pupillary light reflex demonstrates both a direct (illuminated eye) and consensual (non-illuminated eye) constriction.

During the Weber test, sound lateralizing to the right ear indicates which of the following? A. Conductive hearing loss in the right ear. B. Sensorineural hearing loss in the right ear. C. Normal hearing. D. Conductive hearing loss in the left ear.

Answer: A. Conductive hearing loss in the right ear. Rationale: In the Weber test, sound lateralizing to one side suggests conductive hearing loss on that side or sensorineural hearing loss on the opposite side

A patient with presbycusis is undergoing hearing tests. What result is most consistent with this condition? A. Difficulty hearing high-frequency sounds B. Normal results for all auditory tests C. Increased bone conduction compared to air conduction D. Asymmetrical hearing loss

Answer: A. Difficulty hearing high-frequency sounds Rationale: Presbycusis, age-related hearing loss, commonly affects the ability to hear high-frequency sounds. It typically presents symmetrically.

Which test evaluates the functional status of rods and cones in the retina? A. Electroretinography B. Visual field testing C. Fluorescein staining D. Snellen chart test

Answer: A. Electroretinography Rationale: Electroretinography measures electrical responses of rods and cones, diagnosing hereditary and acquired retinal conditions. Visual field testing (B) examines peripheral vision.

Which test is typically performed before cataract surgery to measure the curvature of the cornea? A. Keratometry B. Tonometry C. Fluorescein angiography D. Gonioscopy

Answer: A. Keratometry Rationale: Keratometry evaluates the curvature of the cornea to determine proper intraocular lens (IOL) measurements for cataract surgery. Tonometry (B) assesses intraocular pressure.

Which patient condition would most likely prompt a physician to order an Amsler grid test? A. Macular degeneration B. Cataracts C. Glaucoma D. Retinal detachment

Answer: A. Macular degeneration Rationale: The Amsler grid is used to detect distortions or blind spots in the central visual field, which are characteristic of macular degeneration.

Which diagnostic test involves a non-invasive scan to create detailed cross-sectional images of the retina? A. Optical coherence tomography (OCT) B. Visual field test C. Gonioscopy D. Electroretinography

Answer: A. Optical coherence tomography (OCT) Rationale: OCT is a high-resolution imaging technique used to evaluate retinal layers, often for conditions like macular degeneration or diabetic retinopathy. Visual field tests (B) assess peripheral vision, and gonioscopy (C) examines the anterior chamber angle.

What is the purpose of speech recognition threshold (SRT) testing? A. To determine the quietest level of speech a patient can detect. B. To evaluate the ability to discriminate between different tones. C. To assess balance and equilibrium. D. To identify conductive hearing loss.

Answer: A. To determine the quietest level of speech a patient can detect. Rationale: SRT testing measures the lowest decibel level at which a person can recognize and repeat spoken words, providing insight into speech perception.

Which diagnostic test measures intraocular pressure to assess for glaucoma? A. Tonometry B. Slit-lamp examination C. Fluorescein angiography D. Visual acuity test

Answer: A. Tonometry Rationale: Tonometry measures intraocular pressure (IOP), a key diagnostic tool for glaucoma. Elevated IOP can damage the optic nerve, leading to vision loss. Slit-lamp examination (B) is used to evaluate structures of the anterior eye, while fluorescein angiography (C) assesses retinal blood flow. Visual acuity tests (D) evaluate clarity of vision

What is the primary mechanism of action of most otic anti-infectives? A. Promotes fluid drainage from the middle ear B. Inhibits the growth of bacteria or fungi C. Reduces inflammation in the ear canal D. Increases the production of cerumen

Answer: B Rationale: Anti-infectives work by inhibiting the growth of or destroying pathogens causing the ear infection.

A child with otitis media is prescribed high-dose amoxicillin. The parent asks why the dose is so high. What is the best response? A. "Children require higher doses because their bodies process medication quickly." B. "High doses are needed to penetrate the fluid in the middle ear effectively." C. "The high dose prevents the infection from spreading to the throat." D. "It reduces the risk of side effects from the medication."

Answer: B Rationale: Higher doses of amoxicillin are required to achieve adequate concentrations in the middle ear fluid to treat the infection effectively.

When administering otic anti-infective drops, which step is crucial to ensure proper absorption? A. Administer the drops cold to reduce inflammation. B. Warm the drops to body temperature before use. C. Massage the outer ear vigorously after administration. D. Position the patient upright immediately after administration.

Answer: B Rationale: Warming the drops to body temperature reduces discomfort and promotes absorption by preventing vestibular reactions like dizziness.

What does "otorrhea" mean? A) Pain in the ear B) Drainage or discharge from the ear C) Hearing loss in one ear D) Fluid in the middle ear

Answer: B) Drainage or discharge from the ear Rationale: Otorrhea refers to ear discharge, which can result from infection, trauma, or a ruptured eardrum.

The term "otalgia" describes which of the following? A) Dizziness B) Ear pain C) Ear infection D) Inflammation of the ear canal

Answer: B) Ear pain Rationale: Otalgia specifically refers to pain in the ear, which can be caused by infections or other conditions.

What does the term "otosclerosis" refer to? A) Inflammation of the middle ear B) Hardening of the ear's ossicles C) Excessive earwax buildup D) Infection of the ear canal

Answer: B) Hardening of the ear's ossicles Rationale: Otosclerosis involves abnormal bone growth in the middle ear that causes hearing loss by impeding sound transmission.

"Mastoiditis" refers to which condition? A) Inflammation of the eardrum B) Infection of the mastoid bone C) Blockage of the Eustachian tube D) Abnormal bone growth in the middle ear

Answer: B) Infection of the mastoid bone Rationale: Mastoiditis is an infection of the mastoid process, located behind the ear, and is often secondary to middle ear infections.

What does "otoscopy" involve? A) Surgical repair of the ear canal B) Visual examination of the ear C) Hearing assessment using tuning forks D) Measurement of middle ear pressure

Answer: B) Visual examination of the ear Rationale: Otoscopy is a diagnostic procedure to visually inspect the ear canal and eardrum using an otoscope.

What is the normal intraocular pressure range measured during a tonometry test? A. 5-10 mmHg B. 10-21 mmHg C. 22-30 mmHg D. Over 30 mmHg

Answer: B. 10-21 mmHg Rationale: Normal intraocular pressure falls between 10 and 21 mmHg. Pressures outside this range may indicate glaucoma or other ocular issues.

What does the term "presbyopia" refer to? A. Loss of peripheral vision B. Age-related difficulty focusing on close objects C. Blurred vision due to cataracts D. Increased intraocular pressure

Answer: B. Age-related difficulty focusing on close objects Rationale: Presbyopia is a normal part of aging caused by reduced elasticity in the lens, making it hard to focus on near objects.

A nurse is performing the Rinne test. What does a normal result indicate? A. Bone conduction is greater than air conduction. B. Air conduction is greater than bone conduction. C. Both air and bone conduction are equal. D. There is no sound detected.

Answer: B. Air conduction is greater than bone conduction. Rationale: In a normal Rinne test, air conduction is better than bone conduction. A result where bone conduction is greater may indicate conductive hearing loss.

A patient reports seeing halos around lights and difficulty driving at night. This symptom is most indicative of: A. Macular degeneration B. Cataracts C. Glaucoma D. Retinal detachment

Answer: B. Cataracts Rationale: Halos around lights and night vision problems are classic symptoms of cataracts due to the clouding of the lens.

When performing a visual field test, the examiner is assessing: A. Depth perception B. Central and peripheral vision C. Color discrimination D. Eye muscle strength

Answer: B. Central and peripheral vision Rationale: A visual field test evaluates the entire scope of vision, including both central and peripheral fields.

Which of the following is a key nursing intervention before administering mydriatic eye drops for a diagnostic exam? A. Educating the patient about potential blurry vision B. Checking for a history of glaucoma C. Performing a tonometry test D. Performing a Snellen test

Answer: B. Checking for a history of glaucoma Rationale: Mydriatic drops dilate the pupils and can increase intraocular pressure, which is contraindicated in patients with glaucoma.

Which cranial nerve is assessed during an eye examination to evaluate pupillary reflexes? A. Cranial nerve II (Optic) B. Cranial nerve III (Oculomotor) C. Cranial nerve IV (Trochlear) D. Cranial nerve VI (Abducens)

Answer: B. Cranial nerve III (Oculomotor) Rationale: The oculomotor nerve controls pupil constriction and dilation as part of the pupillary reflex.

What is the primary purpose of a gonioscopy? A. Measuring intraocular pressure B. Examining the angle of the anterior chamber C. Evaluating the retina for tears D. Detecting optic nerve damage

Answer: B. Examining the angle of the anterior chamber Rationale: Gonioscopy assesses the drainage angle between the iris and cornea, often used to diagnose glaucoma. Optic nerve damage (D) is evaluated through ophthalmoscopy or visual field testing.

Which of the following tests uses fluorescein dye to detect corneal abrasions or ulcers? A. Visual field testing B. Fluorescein staining C. Electroretinography D. Amsler grid test

Answer: B. Fluorescein staining Rationale: Fluorescein staining highlights corneal defects under blue light. Electroretinography (C) measures retinal electrical activity, while the Amsler grid (D) screens for central vision distortion.

In auditory function testing, what is the significance of a flat tympanogram? A. Normal middle ear pressure B. Presence of fluid in the middle ear C. Hyper compliance of the tympanic membrane D. Eustachian tube dysfunction

Answer: B. Presence of fluid in the middle ear Rationale: A flat tympanogram typically indicates the presence of fluid in the middle ear, which can interfere with normal hearing.

What does a fluorescein angiography primarily assess? A. Tear production B. Retinal blood flow C. Optic nerve health D. Corneal abrasions

Answer: B. Retinal blood flow Rationale: Fluorescein angiography uses a dye to highlight blood vessels in the retina, diagnosing conditions like diabetic retinopathy or macular degeneration. Tear production (A) is evaluated by the Schirmer test, and corneal abrasions (D) are detected using fluorescein staining.

Which of the following diagnostic tests involves using fluorescein dye? A. Tonometry B. Slit-lamp examination C. Ophthalmoscopy D. Visual acuity test

Answer: B. Slit-lamp examination Rationale: Fluorescein dye is used during slit-lamp exams to highlight corneal abnormalities such as abrasions or ulcers.

What is a primary indication for performing otoacoustic emissions (OAE) testing? A. To evaluate sensorineural hearing loss in adults. B. To screen for hearing deficits in newborns. C. To assess conductive hearing loss in older adults. D. To test auditory nerve function.

Answer: B. To screen for hearing deficits in newborns. Rationale: OAE testing measures sound waves produced by the inner ear and is a key screening tool for newborn hearing assessment.

Which auditory test evaluates the compliance of the tympanic membrane and pressure in the middle ear? A. Audiometry B. Tympanometry C. Rinne test D. Weber test

Answer: B. Tympanometry Rationale: Tympanometry is used to assess the mobility of the tympanic membrane and detect issues like fluid in the middle ear or eustachian tube dysfunction.

Which finding during otoscopic examination may impact auditory testing results? A. Intact tympanic membrane B. Wax buildup (cerumen impaction) C. Transparent tympanic membrane D. Normal external auditory canal

Answer: B. Wax buildup (cerumen impaction) Rationale: Cerumen impaction can block sound transmission and affect hearing test results. Proper ear cleaning is essential before auditory tests.

Which of the following patients is at the greatest risk of developing ototoxicity from aminoglycosides? A. A 35-year-old with mild dehydration B. A 25-year-old with a history of diabetes C. A 60-year-old with chronic kidney disease D. A 50-year-old with hypertension

Answer: C Rationale: Aminoglycosides are nephrotoxic and ototoxic, especially in patients with impaired kidney function, which can increase drug levels in the body.

A patient with otitis media is prescribed amoxicillin. Which of the following instructions should the nurse provide? A. "Take the medication only when you have symptoms." B. "Stop the medication once you feel better." C. "Complete the entire course of antibiotics, even if symptoms improve." D. "Take the medication on an empty stomach for best absorption."

Answer: C Rationale: Completing the full course of antibiotics ensures the infection is fully eradicated and helps prevent the development of antibiotic resistance.

What is the most important nursing consideration when administering otic anti-infective medications to a pediatric patient? A. Administering drops at room temperature B. Ensuring the patient is upright during administration C. Pulling the auricle down and back during administration D. Flushing the ear with warm water before application

Answer: C Rationale: For pediatric patients, the auricle should be pulled down and back to straighten the ear canal for proper medication delivery.

What does "audiometry" measure? A) Ear pressure B) Balance and dizziness C) Hearing acuity D) Earwax levels

Answer: C) Hearing acuity Rationale: Audiometry is a test used to evaluate a person's hearing ability, often with varying tones and intensities.

Which condition is characterized by the sensation of ringing or buzzing in the ears? A) Vertigo B) Meniere's disease C) Tinnitus D) Otalgia

Answer: C) Tinnitus Rationale: Tinnitus is the perception of noise or ringing in the ears without an external sound source.

During which diagnostic eye test is a slit-lamp used? A. Retinal angiography B. Fundoscopy C. Anterior segment examination D. Keratometry

Answer: C. Anterior segment examination Rationale: A slit-lamp provides a magnified, three-dimensional view of the anterior eye, including the cornea, iris, and lens. Retinal angiography (A) focuses on retinal blood vessels.

Amsler grid testing is primarily used to detect changes in: A. Peripheral vision B. Depth perception C. Central vision D. Color vision

Answer: C. Central vision Rationale: The Amsler grid helps detect central vision abnormalities caused by conditions like macular degeneration. Peripheral vision (A) is tested with a visual field test.

A patient is undergoing a Snellen chart test. What does this test evaluate? A. Peripheral vision B. Color vision C. Central visual acuity D. Depth perception

Answer: C. Central visual acuity Rationale: The Snellen chart is used to determine central visual acuity by having patients read letters at a distance. Peripheral vision (A) is assessed with confrontation testing, and color vision (B) with the Ishihara test.

Which of the following is the primary purpose of a Snellen chart? A. Detecting color blindness B. Assessing peripheral vision C. Evaluating visual acuity D. Measuring intraocular pressure

Answer: C. Evaluating visual acuity Rationale: The Snellen chart is used to measure a person's ability to see at various distances, which is an assessment of visual acuity

A nurse is teaching a patient about using neomycin-polymyxin B ear drops. Which statement indicates a need for further teaching? A. "I should avoid using these drops if I have ear drainage." B. "I should continue using the drops until the prescription is finished." C. "I should stop using the drops if I experience severe itching or rash." D. "I can use these drops if I suspect I have a perforated eardrum."

Answer: D Rationale: Neomycin-polymyxin B ear drops are contraindicated in patients with a perforated eardrum due to the risk of ototoxicity.

A patient complains of dizziness when moving from sitting to standing. This is most likely caused by: a) Benign paroxysmal positional vertigo (BPPV) b) Otitis media c) Sensorineural hearing loss d) Tinnitus

Answer: a) Benign paroxysmal positional vertigo (BPPV) Rationale: BPPV is a common cause of dizziness, triggered by changes in head position due to displaced otoliths in the semicircular canals.

Which test evaluates the integrity of the vestibular system and semicircular canals? a) Caloric test b) Audiometry c) Tympanometry d) Rinne Test

Answer: a) Caloric test Rationale: The caloric test assesses the vestibular system by stimulating the semicircular canals with warm or cold water or air.

A patient complains of difficulty driving at night due to glare from headlights. What age-related eye condition might this indicate? a) Cataracts b) Retinal detachment c) Glaucoma d) Presbyopia

Answer: a) Cataracts Rationale: Cataracts cause clouding of the lens, which can increase glare sensitivity, particularly at night.

During a Rinne test, air conduction is found to last twice as long as bone conduction. What does this indicate? a) Normal hearing b) Conductive hearing loss c) Sensorineural hearing loss d) Mixed hearing loss

Answer: a) Normal hearing Rationale: In normal hearing, air conduction should last longer than bone conduction, typically by a ratio of 2:1

The Romberg test is considered positive if the patient: a) Sways or loses balance when standing with feet together and eyes closed b) Experiences dizziness when turning the head quickly c) Complains of ringing in the ears during testing d) Reports hearing loss in one ear during the test

Answer: a) Sways or loses balance when standing with feet together and eyes closed Rationale: A positive Romberg test indicates a loss of proprioception or vestibular dysfunction. It assesses the patient's ability to maintain balance without visual cues.

In a patient with suspected mastoiditis, which finding is most concerning? a. Tenderness over the mastoid process b. Dull tympanic membrane c. Clear fluid draining from the ear d. Bruising behind the ear

Answer: a. Tenderness over the mastoid process Rationale: Mastoiditis involves inflammation of the mastoid bone and typically presents with tenderness or swelling over the area, often requiring urgent treatment.

Which patient is most likely to benefit from a bone-anchored hearing aid (BAHA)? a) A patient with mild sensorineural hearing loss b) A patient with unilateral conductive hearing loss c) A patient with severe bilateral hearing loss d) A patient with age-related hearing loss

Answer: b) A patient with unilateral conductive hearing loss Rationale: BAHA devices are often used for conductive or mixed hearing loss, particularly when traditional hearing aids are unsuitable

Which diagnostic test measures hearing acuity and evaluates the ability to hear varying frequencies? a) Tympanometry b) Audiometry c) Rinne Test d) Weber Test

Answer: b) Audiometry Rationale: Audiometry evaluates hearing acuity for different sound frequencies and intensities, identifying degrees of hearing loss.

Which type of hearing aid is most suitable for patients with severe hearing loss? a) Completely-in-the-canal (CIC) b) Behind-the-ear (BTE) c) In-the-ear (ITE) d) Bone-anchored hearing aid (BAHA)

Answer: b) Behind-the-ear (BTE) Rationale: BTE hearing aids are more powerful and suitable for individuals with severe to profound hearing loss compared to CIC or ITE devices, which are typically for mild to moderate hearing loss.

During a Rinne test, what indicates conductive hearing loss? a) Air conduction is greater than bone conduction. b) Bone conduction is greater than air conduction. c) Both air and bone conduction are normal. d) The test result is inconclusive.

Answer: b) Bone conduction is greater than air conduction Rationale: In conductive hearing loss, sound travels more effectively through bone than through the impaired air conduction pathway.

Balance issues may result from a problem in which cranial nerve? a) Cranial nerve II (Optic) b) Cranial nerve VIII (Vestibulocochlear) c) Cranial nerve VII (Facial) d) Cranial nerve X (Vagus)

Answer: b) Cranial nerve VIII (Vestibulocochlear) Rationale: The vestibulocochlear nerve is responsible for transmitting auditory and balance information from the inner ear to the brain. Dysfunction can lead to vertigo or balance problems.

A patient with suspected otitis media undergoes tympanometry. What result is most consistent with this condition? a) High compliance of the eardrum b) Flat tracing on the tympanogram c) Increased pressure in the ear canal d) No abnormalities detected

Answer: b) Flat tracing on the tympanogram Rationale: Otitis media often causes a flat tympanogram, indicating fluid in the middle ear or lack of eardrum movement.

When assessing a patient with balance issues, which symptom is most indicative of vestibular dysfunction? a) Bilateral ear pain b) Frequent falls and unsteadiness c) Difficulty hearing high-pitched sounds d) Persistent sore throat

Answer: b) Frequent falls and unsteadiness Rationale: Vestibular dysfunction often manifests as balance issues, dizziness, and frequent falls due to impaired signals from the inner ear to the brain.

When fitting a new hearing aid, the patient should be advised to: a) Wear it continuously for 24 hours to adjust quickly. b) Gradually increase wearing time over several days. c) Keep the volume at the maximum setting initially. d) Test it only in quiet environments.

Answer: b) Gradually increase wearing time over several days. Rationale: Gradual adjustment helps the patient acclimate to amplified sounds and reduces discomfort.

Which of the following is NOT a typical change in the aging eye? a) Yellowing of the lens b) Increased production of tears c) Decreased peripheral vision d) Formation of floaters

Answer: b) Increased production of tears Rationale: Aging typically leads to decreased tear production, which can cause dry eyes, not increased tear production.

What condition involves the gradual loss of the eye's ability to focus on close objects, commonly occurring after age 40? a) Glaucoma b) Presbyopia c) Macular degeneration d) Astigmatism

Answer: b) Presbyopia Rationale: Presbyopia is the age-related stiffening of the lens, which affects near vision. It is corrected with reading glasses or bifocals.

What is the primary goal of nursing care for patients with balance disorders? a) Restore complete hearing ability b) Prevent injuries and falls c) Eliminate dizziness permanently d) Reduce ear infections

Answer: b) Prevent injuries and falls Rationale: Ensuring patient safety is the top priority when managing balance disorders, as these patients are at high risk for falls and associated injuries

What is a contraindication for hearing aid use? a) Sensorineural hearing loss b) Profound hearing loss that exceeds device limits c) Bilateral mild conductive hearing loss d) Age over 80 years

Answer: b) Profound hearing loss that exceeds device limits Rationale: Hearing aids are not effective for profound hearing loss that cannot be amplified adequately. Cochlear implants might be more suitable.

What does a tympanometry test assess? a) Hearing nerve functionality b) Sound conduction in the middle ear c) Eustachian tube dysfunction d) Cochlear damage

Answer: b) Sound conduction in the middle ear Rationale: Tympanometry evaluates the middle ear's ability to conduct sound by measuring eardrum movement in response to changes in air pressure.

Which finding is considered normal during a Weber test? a) Sound lateralizes to one ear. b) Sound is heard equally in both ears. c) Bone conduction lasts longer than air conduction. d) Air conduction is twice as long as bone conduction.

Answer: b) Sound is heard equally in both ears Rationale: Equal sound perception during the Weber test indicates normal auditory function or symmetrical hearing loss.

Which of the following indicates sensorineural hearing loss in a Weber test? a) Sound lateralizes to the affected ear. b) Sound lateralizes to the unaffected ear. c) No lateralization occurs. d) Both ears perceive the same sound.

Answer: b) Sound lateralizes to the unaffected ear Rationale: In sensorineural hearing loss, sound perception shifts to the ear with better cochlear function (unaffected ear).

A nurse is performing a Romberg test. Which safety measure is most appropriate? a) Perform the test in a quiet room b) Stand close to the patient to prevent a fall c) Ask the patient to sit down immediately after the test d) Instruct the patient to remove their shoes

Answer: b) Stand close to the patient to prevent a fall Rationale: The Romberg test can cause patients to lose balance and fall. Ensuring the nurse is close to support the patient is a critical safety measure

A patient complains that voices sound "tinny" through their hearing aid. What is the most likely cause? a) The hearing aid is not properly cleaned. b) The sound processor settings need adjustment. c) The battery is too old. d) The device is damaged beyond repair.

Answer: b) The sound processor settings need adjustment. Rationale: A "tinny" sound often indicates that the hearing aid's settings need fine-tuning by a professional to better match the patient's hearing needs.

What is the primary purpose of a hearing aid? a) To completely restore normal hearing b) To amplify environmental sounds c) To treat the underlying cause of hearing loss d) To prevent further hearing deterioration

Answer: b) To amplify environmental sounds Rationale: Hearing aids amplify sound to improve hearing in individuals with hearing loss. They do not restore normal hearing or address the underlying cause directly.

What is the primary purpose of annual eye exams for older adults? a) To reduce the risk of cataract formation b) To detect and manage conditions such as glaucoma and AMD early c) To monitor peripheral vision changes d) To improve tear production

Answer: b) To detect and manage conditions such as glaucoma and AMD early Rationale: Early detection of glaucoma, AMD, and other age-related conditions can prevent severe vision loss or blindness with timely intervention.

Which of the following is an example of a therapeutic intervention for balance problems caused by vestibular dysfunction? a) Cochlear implant b) Vestibular rehabilitation therapy c) Hearing aids d) Antibiotic therapy

Answer: b) Vestibular rehabilitation therapy Rationale: Vestibular rehabilitation therapy uses specific exercises to help patients improve balance and reduce dizziness by retraining the brain to compensate for inner ear issues.

Which patient complaint might indicate otitis externa (swimmer's ear)? a. "My ear feels full, and I hear ringing." b. "I feel sharp pain when I touch my ear." c. "Sounds seem muffled in one ear." d. "I feel dizzy and nauseous."

Answer: b. "I feel sharp pain when I touch my ear." Rationale: Otitis externa often causes pain with manipulation of the outer ear or tragus, along with redness and swelling of the ear canal.

What finding during an otoscopic exam of the tympanic membrane indicates a possible middle ear infection? a. Pearly gray and translucent membrane b. Bright red and bulging membrane c. Dull and retracted membrane d. Perforated membrane with drainage

Answer: b. Bright red and bulging membrane Rationale: A red, bulging tympanic membrane is a hallmark sign of otitis media (middle ear infection), caused by fluid accumulation and inflammation behind the membrane.

During a Rinne test, bone conduction is greater than air conduction in the patient's left ear. What does this suggest? a. Sensorineural hearing loss in the left ear b. Conductive hearing loss in the left ear c. Normal hearing d. Mixed hearing loss

Answer: b. Conductive hearing loss in the left ear Rationale: In conductive hearing loss, bone conduction (vibration transmission) exceeds air conduction due to impaired sound transmission in the outer or middle ear.

Which condition is characterized by noninfectious fluid accumulation in the middle ear? a. Otitis externa b. Otitis media with effusion c. Sensorineural hearing loss d. Perforated tympanic membrane

Answer: b. Otitis media with effusion Rationale: Otitis media with effusion involves sterile fluid trapped in the middle ear due to Eustachian tube dysfunction, causing a feeling of fullness and hearing changes.

Which tool is most commonly used during an ear examination to visualize the external auditory canal and tympanic membrane? a. Ophthalmoscope b. Otoscope c. Tuning fork . Audiometer

Answer: b. Otoscope Rationale: An otoscope is specifically designed to examine the external auditory canal and tympanic membrane for abnormalities such as infections or perforations.

When teaching a patient about preventing ear infections, what is the best advice? a. Clean ears daily with cotton swabs. b. Use earplugs while swimming. c. Avoid wearing hearing aids for extended periods. d. Rinse the ear canal with hydrogen peroxide weekly.

Answer: b. Use earplugs while swimming. Rationale: Using earplugs can prevent water entry into the ear canal, reducing the risk of external ear infections like otitis externa. Cotton swabs can push debris further into the ear and should be avoided.

Which of the following findings from an ear exam is normal? a. Clear drainage from the external auditory canal b. Yellowish, waxy cerumen c. Red, swollen external auditory canal d. Tympanic membrane with visible perforation

Answer: b. Yellowish, waxy cerumen Rationale: Yellowish cerumen (earwax) is a normal finding, as it protects the ear canal. Drainage or redness may indicate infection, and perforation suggests tympanic membrane damage.

Which intervention is most appropriate for an older adult with dry eyes? a) Encourage wearing sunglasses outdoors. b) Recommend frequent blinking exercises. c) Advise use of artificial tears or lubricating drops. d) Suggest reducing fluid intake before bedtime.

Answer: c) Advise use of artificial tears or lubricating drops. Rationale: Artificial tears or lubricating drops help manage the symptoms of dry eyes, which are common in older adults due to reduced tear production.

Which of the following changes in vision is commonly associated with aging? a) Increased peripheral vision b) Improved ability to see objects up close c) Decreased ability to adapt to low light conditions d) Reduced risk of cataracts

Answer: c) Decreased ability to adapt to low light conditions Rationale: As people age, the pupil size decreases and the lens becomes less flexible, reducing the ability to adjust to changes in lighting. This is a normal part of aging.

Which diagnostic test evaluates balance by observing eye movements in response to changes in position or head movement? a) Weber test b) Romberg test c) Electronystagmography (ENG) d) Rinne test

Answer: c) Electronystagmography (ENG) Rationale: ENG is used to assess the function of the inner ear and balance system by measuring involuntary eye movements (nystagmus), which can indicate balance or vestibular dysfunction.

How often should hearing aids be professionally cleaned? a) Weekly b) Monthly c) Every 6 months d) Annually

Answer: c) Every 6 months Rationale: Regular professional cleaning (typically every 6 months) ensures optimal function and prevents damage from wax or debris buildup.

What is the most common cause of blindness in older adults in the United States? a) Glaucoma b) Cataracts c) Macular degeneration d) Diabetic retinopathy

Answer: c) Macular degeneration Rationale: Age-related macular degeneration (AMD) is the leading cause of vision loss in older adults. It affects the central vision necessary for reading and recognizing faces.

A patient reports feedback (whistling) from their hearing aid. What is the most likely cause? a) A faulty microphone b) Incorrect battery size c) Poor fit or earwax blockage d) Volume set too low

Answer: c) Poor fit or earwax blockage Rationale: Feedback is commonly caused by an improper fit or obstructions like earwax that disrupt sound transmission.

A patient with age-related macular degeneration (AMD) would most likely report difficulty with which activity? a) Seeing objects in peripheral vision b) Identifying colors c) Reading and recognizing faces d) Adapting to bright light

Answer: c) Reading and recognizing faces Rationale: AMD affects the macula, which is responsible for sharp central vision, making it difficult to read and recognize faces.

Which of the following is an important step when teaching a patient to care for their hearing aid? a) Store the hearing aid in a damp location to avoid drying out. b) Use alcohol to clean the hearing aid. c) Remove the hearing aid and turn it off when not in use. d) Avoid replacing the battery until the device completely stops working.

Answer: c) Remove the hearing aid and turn it off when not in use. Rationale: Turning off the hearing aid when not in use preserves battery life and prevents unnecessary wear. Alcohol should not be used as it may damage the device.

What is the primary purpose of otoacoustic emissions (OAE) testing? a) Diagnose eustachian tube dysfunction b) Evaluate auditory nerve functionality c) Screen for hearing loss in newborns d) Assess middle ear pressure

Answer: c) Screen for hearing loss in newborns Rationale: OAE testing detects sound waves generated by the inner ear, often used in newborn hearing screenings to identify sensorineural deficits early.

Which part of the ear is primarily responsible for balance? a) Cochlea b) Tympanic membrane c) Semicircular canals d) Eustachian tube

Answer: c) Semicircular canals Rationale: The semicircular canals in the inner ear detect rotational movements and help maintain balance by sending signals to the brain about head position.

During balance testing, a patient reports dizziness and nausea. What is the nurse's immediate action? a) Encourage the patient to continue the test b) Provide the patient with headphones c) Stop the test and assist the patient to sit down d) Administer antiemetic medication

Answer: c) Stop the test and assist the patient to sit down Rationale: When a patient experiences dizziness and nausea during balance testing, the priority is patient safety. Stopping the test and assisting the patient to sit prevents potential falls or injury. Continuing the test (option a) may worsen symptoms and increase the risk of harm. Providing headphones (option b) is unrelated to managing dizziness or nausea. Administering antiemetic medication (option d) may be appropriate later but is not the immediate action. Ensuring the patient is safe and stable takes precedence.

Why do older adults often need more light to read as they age? a) Increased tear production reduces light absorption. b) The cornea becomes more opaque. c) The lens thickens and becomes less transparent. d) Peripheral vision deteriorates.

Answer: c) The lens thickens and becomes less transparent. Rationale: Lens thickening reduces the amount of light that reaches the retina, making it harder to see in dim lighting.

What diagnostic test uses a tuning fork placed on the forehead or the center of the head? a) Audiometry b) Tympanometry c) Weber Test d) Rinne Test

Answer: c) Weber Test Rationale: The Weber test helps localize sound perception to determine if hearing loss is conductive or sensorineural

Which nutritional supplement may help slow the progression of age-related macular degeneration? a) Vitamin C b) Vitamin B12 c) Omega-3 fatty acids d) Lutein

Answer: d) Lutein Rationale: Lutein and zeaxanthin are carotenoids found in the retina that may slow the progression of AMD when taken as supplements.

What is the primary reason older adults may be hesitant to use hearing aids? a) Lack of technology familiarity b) Fear of damaging the device c) Difficulty in purchasing batteries d) Stigma or perceived ineffectiveness

Answer: d) Stigma or perceived ineffectiveness Rationale: Many older adults associate hearing aids with aging or believe they won't improve their hearing significantly, leading to reluctance.

Which test assesses balance function by monitoring eye movements in response to positional changes? a. Rinne test b. Weber test c. Romberg test d. Electronystagmography

Answer: d. Electronystagmography Rationale: Electronystagmography evaluates balance by analyzing eye movements in response to specific stimuli, which is often used to assess inner ear or vestibular dysfunction.

A patient fails a pure-tone audiometry test. What condition might this result indicate? A. Otitis externa B. Tinnitus C. Hearing loss D. Ménière's disease

Answer: C. Hearing loss Rationale: Pure-tone audiometry measures the softest sounds a person can hear, and failing this test typically indicates hearing loss.