Health Assessment

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cindyblalack
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147285
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Health Assessment
Updated:
2012-04-12 15:07:06
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Ear Assessment Evolve questions
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Ear Assessment - Evolve questions
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  1. Mr. Jones is a 43-year-old patient with a complaint of right ear pain. During assessment, the external structure of the ear is identified as the:
    A) auricle.
    B) ossicle
    C) cochlea
    D) presbycusis
    • Correct Answer(s): A
    • The external structure of the ear is identified as the auricle.
  2. Which of the following is not a function of the middle ear?
    A) Sound conduction
    B) Reduction of sound amplitude
    C) Amplification of sound
    D) Pressure equalization
    C) Amplification of sound Feedback: CORRECT Amplification of sound is not a function of the middle ear.
    (this multiple choice question has been scrambled)
  3. At the peripheral level of hearing, which of the following functions takes place?
    A) Conversion of vibrations into electrical impulses
    B) Interpretation of sound variations
    C) Differentiation of pitch and frequency
    D) Conversion of air conduction to bone conduction
    • A) Conversion of vibrations into electrical impulses Feedback: CORRECT
    • Conversion of vibrations into electrical impulses takes place at the peripheral level of hearing.
  4. Mr. Rucker is a 57-year-old patient who presents with a complaint of hearing difficulties. As the health care provider, you know that a conductive hearing loss occurs when:
    A) air conduction is converted to bone conduction.
    B) a mechanical dysfunction of the external or the middle ear occurs.
    C) sound is dampened by excessive amplitude reduction.
    D) electrical impulses are trapped in the brain stem.
    • B) a mechanical dysfunction of the external or the middle ear occurs. Feedback: CORRECT
    • A conductive hearing loss occurs when a mechanical dysfunction of the external or the middle ear occurs.
  5. The labyrinth of the inner ear is responsible for maintaining the body's:
    A) binaural interaction.
    B) air conduction.
    C) equilibrium.
    D) pressure equalization.
    • C) equilibrium. Feedback: CORRECT
    • The labyrinth of the inner ear is responsible for maintaining the body's equilibrium.
  6. Mrs. Kitts is a 29-year-old patient who is in her first trimester of pregnancy. During her examination, she brings up concerns about exposure to rubella. As the health care provider, you explain that, if she contracts rubella, her developing fetus is at risk for damage to which of the following? (Note: This damage could lead to hearing impairment.)
    A) Eustachian tube
    B) Ossicles
    C) Tympanic membrane
    D) Organ of Corti
    • B) otosclerosis. Feedback: CORRECT
    • A condition in which conductive hearing loss occurs as a result of gradual hardening of the footplate of the stapes is identified as otosclerosis.
  7. A condition in which conductive hearing loss occurs as a result of gradual hardening of the footplate of the stapes is identified as: A) ossicular petrifaction.
    B) otosclerosis.
    C) presbycusis.
    D) otitis externa.
    • B) otosclerosis. Feedback: CORRECT
    • A condition in which conductive hearing loss occurs as a result of gradual hardening of the footplate of the stapes is identified as otosclerosis.
  8. An individual who may act irritable or show a startle reflex when hearing a raised voice is demonstrating:
    A) a conductive hearing loss.
    B) presbycusis.
    C) recruitment.
    D) otorrhea.
    • C) recruitment. Feedback: CORRECT
    • An individual who may act irritable or show a startle reflex when hearing a raised voice is demonstrating recruitment.
  9. Mrs. Saturen is a 53-year-old patient who comes to the clinic for a routine follow-up examination. During your assessment, you notice the patient behaves in a manner that is a clue to the possibility of hearing loss. Which of the following behaviors did you observe?
    A) The patient spoke in an inappropriately soft voice.
    B) The patient’s voice had a flat, monotonous tone.
    C) The patient’s speech was well articulated and clear.
    D) The patient looked directly at you when you spoke to her and maintained appropriate eye contact.
    • B) The patient’s voice had a flat, monotonous tone. Feedback: CORRECT
    • A behavior that is a clue to the possibility of hearing loss is that the patient’s voice has a flat, monotonous tone.
  10. The eardrum is connected to which of the middle ear ossicles?
    A) Malleus
    B) Incus
    C) Stapes
    D) Cochlea
    A) Malleus Feedback: CORRECT The eardrum is connected to the malleus of the middle ear ossicles.
    (this multiple choice question has been scrambled)
  11. Mrs. Carney is a 48-year-old patient who comes to the office with complaints of ear pain. While taking the patient history, which of the following responses indicate that she is experiencing vertigo?
    A) "The room is spinning around me.”
    B) "I feel like I am about to faint."
    C) "I have a ringing in my ears."
    D) "I have difficulty hearing certain sounds.”
    • A) "The room is spinning around me.” Feedback: CORRECT
    • The following response indicates that the patient is experiencing vertigo: "The room is spinning around me.”
  12. Which of the following individuals is at risk of being an otitis-prone child?
    A) An 18-month-old infant who lives with an individual who smokes cigarettes
    B) A 2-year-old child who has had two ear infections in the past 6 months
    C) A 6-month-old infant with a sibling who had tubes inserted at 3 years of age
    D) An 18-month-old infant who has had three episodes of ear infections in a 5-month period
    • A) An 18-month-old infant who lives with an individual who smokes cigarettes Feedback: CORRECT
    • An 18-month-old infant who lives with an individual who smokes cigarettes is at risk of being an otitis prone child, as passive and gestational smoke are risk factors for OM.
  13. Mr. and Mrs. Caper bring their son to the office for a routine examination. Which of the following would best describe ears that appear larger than expected (> 10 cm vertically)?
    A) Auricular hypertrophy
    B) Macroauricular
    C) Macrotia
    D) Pinnicolosis
    • C) Macrotia Feedback: CORRECT
    • Macrotia is the term that best describes ears that appear larger than expected (> 10 cm vertically).
  14. During examination of a 39-year-old female patient, you ask her to swallow while holding her nose (insufflation). This procedure is performed to assess the:
    A) ability of the eustachian tube to equalize pressure.
    B) mobility of the tympanic membrane.
    C) presence of fluid in the middle ear.
    D) mobility of the inner ear bones.
    • B) mobility of the tympanic membrane. Feedback: CORRECT
    • Swallowing while holding the nose (insufflation) is performed to assess the mobility of the tympanic membrane.
  15. The Weber test is generally performed on an individual who complains of:
    A) hearing better in one ear than the other.
    B) ringing in the ears.
    C) pain in one ear.
    D) pain while swallowing.
    • A) hearing better in one ear than the other. Feedback: CORRECT
    • The Weber test is generally performed on an individual who complains of hearing better in one ear than the other.
  16. The position of the tympanic membrane in the infant is more ________________ than in the adult, making it difficult to visualize with the otoscope.
    A) horizontal
    B) vertical
    C) perpendicular
    D) oblique
    • A) horizontal Feedback: CORRECT
    • The position of the tympanic membrane in the infant is more horizontal than in the adult, making it difficult to visualize with the otoscope.
  17. When testing the hearing of a newborn infant, which of the following responses should you observe after the examiner makes a loud noise, such as a hand-clap?
    A) The infant's head turns toward the noise.
    B) The infant displays the startle (Moro) reflex.
    C) The infant's eyes close tightly.
    D) The infant begins to coo and tries to mimic the sound.
    • B) The infant displays the startle (Moro) reflex. Feedback: CORRECT
    • When testing the hearing of a newborn infant, the infant should display the startle (Moro) reflex after the examiner makes a loud noise, such as a hand-clap.
  18. Which of the following behaviors is indicative of a young child with a hearing loss?
    A) The child appears to pay more attention to casual conversation.
    B) The child reacts more to movement and facial expressions than to sound.
    C) The child is more sociable and outgoing than would be expected.
    D) The child continues to repeat phrases and words.
    • B) The child reacts more to movement and facial expressions than to sound. Feedback: CORRECT
    • When a child reacts more to movement and facial expressions than to sound it could indicate a hearing loss.
  19. Mrs. Anthony is a 69-year-old patient who comes to the clinic for a routine follow-up examination. The health care provider can expect the tympanic membrane to be which of the following during the otoscope exam?
    A) Pinker than expected
    B) Thinner than expected
    C) Whiter than expected
    D) More mobile than expected
    • C) Whiter than expected Feedback: CORRECT
    • The tympanic membrane of an older adult may be whiter than expected.
  20. Which of the following separates the middle ear from the external ear?
    A) The pars flaccida
    B) The tympanic membrane
    C) The auricle
    D) The malleus
    • B) The tympanic membrane Feedback: CORRECT
    • The tympanic membrane separates the middle ear from the external ear.
  21. The nasopharynx is connected to the middle ear by the:
    A) eustachian tube.
    B) cochlea.
    C) auditory canal.
    D) umbo.
    A) eustachian tube. Feedback: CORRECT The nasopharynx is connected to the middle ear by the eustachian tube
    (this multiple choice question has been scrambled)
  22. The middle ear functions to:
    A) reduce amplification of sound to protect the inner ear.
    B) sort out extraneous sounds.
    C) maintain balance.
    D) equilibrate pressure between the external ear and the inner ear.
    • A) reduce amplification of sound to protect the inner ear. Feedback: CORRECT
    • The middle ear functions to reduce amplification of sound to protect the inner ear.
  23. The vestibule and the semicircular canals of the inner ear are primarily responsible for:
    A) sound conduction to the brain.
    B) pressure equalization.
    C) equilibrium.
    D) sound differentiation.
    • C) equilibrium. Feedback: CORRECT
    • The vestibule and the semicircular canals of the inner ear are primarily responsible for equilibrium.
  24. Binaural interaction at the level of the brain stem permits which of the following to occur?
    A) Interpretation of sound
    B) Identification and location of the direction of the sound
    C) Amplification of sound
    D) Direction of sound toward the appropriate conduction pathway
    • B) Identification and location of the direction of the sound Feedback: CORRECT
    • Binaural interaction at the level of the brain stem permits identification and location of the direction of the sound.
  25. Bone conduction of sound permits direct transmission of sound from the bone to:
    A) the organ of Corti.
    B) the cochlea.
    C) Cranial nerve VIII.
    D) the eustachian tube.
    • C) Cranial nerve VIII. Feedback: CORRECT
    • Bone conduction of sound permits direct transmission of sound from the bone to cranial nerve VIII.
  26. Mr. Scotts is a 38-year-old patient who was diagnosed with a perforated tympanic membrane in the emergency room. He comes to the clinic for follow-up. An individual with this condition is at risk for experiencing which type of hearing loss?
    A) Sensorineural
    B) Conductive
    C) Mixed
    D) Otosclerotic
    • B) Conductive Feedback: CORRECT
    • A patient with a perforated tympanic membrane is at risk of experiencing conductive hearing loss.
  27. Which of the following individuals would be most at risk for developing presbycusis?
    A) A 3-year-old with chronic ear infections
    B) A 25-year-old individual who frequents rock concerts
    C) A 45-year-old individual with an impacted cerumen
    D) A 75-year-old individual who lives in an assisted-living apartment
    • D) A 75-year-old individual who lives in an assisted-living apartment Feedback: CORRECT
    • A 75-year-old individual who lives in an assisted-living apartment is most at risk for developing presbycusis.
  28. Which of the following manifestations related to hearing occurs in older adults?
    A) Increased amplification of sound
    B) Increased auditory reaction time
    C) Increased conduction of sound
    D) Increased ear infections
    • B) Increased auditory reaction time Feedback: CORRECT
    • Increased auditory reaction time occurs in older adults.
  29. Which of the following behaviors demonstrated by an individual may be indicative of hearing loss?
    A) Not looking at the examiner when being questioned
    B) Frequently asking for a question to be repeated
    C) Talking in a high-pitched voice
    D) Speaking slowly with well-articulated consonants
    • B) Frequently asking for a question to be repeated Feedback: CORRECT
    • Frequently asking for a question to be repeated may be indicative of hearing loss.
  30. Mrs. Oliver is a 52-year-old patient who complains of hearing loss. During your assessment, you determine that she has tinnitus. Which of the following must the examiner consider as possible causes?
    A) Excessive environmental noise
    B) Age
    C) Medications
    D) Otitis media
    • C) Medications Feedback: CORRECT
    • When assessing a patient for tinnitus, the examiner must consider the patient’s medications, as many are ototoxic.
  31. In children, which of the following, if present, increases the risk of developing a hearing deficit?
    A) Darwin's tubercle
    B) Dry cerumen
    C) Illness with a persistent high fever
    D) Microtia
    • C) Illness with a persistent high fever Feedback: CORRECT
    • Illness in a child that is accompanied by a persistent high fever increases the risk of developing a hearing deficit.
  32. Ms. Mills is a 34-year-old patient who presents with complaints of ear pain. On examination of her tympanic membrane with the otoscope, you notice a dense white patch that is probably related to which of the following?
    A) Scarring related to repeated ear infections
    B) Hardening of the bones of the inner ear
    C) Hypertrophy of a portion of the membrane
    D) Impaction of the middle ear
    • A) Scarring related to repeated ear infections Feedback: CORRECT
    • A dense white patch on the tympanic membrane is probably related to scarring from repeated ear infections.
  33. Which of the following is true about the alternate screening measures that are used in the clinical examination for hearing?
    A) They give a precise determination of the degree of hearing loss.
    B) They can document the presence of a hearing loss but not the degree of loss.
    C) They rely on the examiner's hearing ability.
    D) They are only useful when the individual may have a conductive hearing loss.
    • B) They can document the presence of a hearing loss but not the degree of loss. Feedback: CORRECT
    • The alternate screening measures that are used in the clinical examination for hearing can document the presence of a hearing loss but not the degree of loss.

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