When examining the ear with an otoscope, how should the tympanic membrane look?

NURS330 Individual Assessment

Chapter 16 Quiz

Question 1When examining the ear with an otoscope, how should the tympanic membrane look?

 

  Light pink with a slight bulge

 

  Pearly gray and slightly concave

 

  Whitish with black flecks or dots

 

  Pulled in at the base of the cone of light

 

Question 2While 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?

 

  “Does your baby seem to startle with loud noises?”

 

  “Has your baby had any surgeries on her ears?”

 

  “Have you noticed any drainage from her ears?”

 

  “How many ear infections has your baby had since birth?”

 

Question 3A 17-year-old student is a swimmer on her high school’s swim team. She has had three bouts of otitis externa this season and wants to know what to do to prevent it. What should the nurse include in the instructions?

 

  Use a cotton-tipped swab to dry ear canals thoroughly after each swim.

 

  Use rubbing alcohol or 2% acetic acid eardrops after every swim.

 

  Irrigate the ears with warm water and a bulb syringe after each swim.

 

  Rinse the ears with a warmed solution of mineral oil and hydrogen peroxide.

 

Question 4The 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?

 

  The auditory canal may be occluded from increased cerumen.

 

  If the drum has ruptured, then purulent drainage will result.

 

  Bloody or clear watery drainage can indicate a basal skull fracture.

 

  Foreign bodies from the accident may cause occlusion of the ear canal.

 

Question 5How should the nurse perform an examination of a 2-year-old child with a suspected ear infection?

 

  Pull the ear up and back before inserting the speculum.

 

  Omit the otoscopic examination if the child has a fever.

 

  Ask the mother to leave the room while examining the child.

 

  Perform the otoscopic examination at the end of the assessment.

 

Question 6The 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. Based on these findings, what does the nurse suspect?

 

  Most likely a keloid

 

  Probably a benign sebaceous cyst

 

  Could be a potential carcinoma, and the patient should be referred for a biopsy

 

  A tophus, which is common in the older adult and is a sign of gout

 

Question 7A 31-year-old patient tells the nurse that he has noticed pain in his left ear when people speak loudly to him. What does this finding indicate?

 

  A cerumen impaction

 

  Normal for people of his age

 

  Possible middle ear infection

 

  A characteristic of recruitment

 

Question 8The nurse assesses the hearing of a 7-month-old by clapping hands. What is the expected response?

 

  The infant shows no obvious response to the noise.

 

  The infant shows a startle and acoustic blink reflex.

 

  The infant turns his or her head to localize the sound.

 

  The infant stops any movement, and appears to listen for the sound.

 

Question 9A 70-year-old patient tells the nurse that he has noticed that he is having trouble hearing, especially in large groups. He says “I can’t always tell where the sound is coming from” and that the words often sound “mixed up.” What might the nurse suspect as the cause for this change?

 

  Atrophy of the apocrine glands

 

  Cilia becoming coarse and stiff

 

  Nerve degeneration in the inner ear

 

  Scar tissue in the tympanic membrane

 

Question 10The 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?

 

  The tubes are placed in the inner ear.

 

  The tubes are used in children with sensorineural loss.

 

  The tubes are permanently inserted during a surgical procedure.

 

  The purpose of the tubes is to decrease the pressure and allow for drainage.

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