GNUR 290 Exam 2 questions with
complete solutions A+
A 62-year-old who has worked on an assembly line since he was 24 years old began taking
aspirin for arthritis 6 months ago. The client presents to the nurse with hearing problems and
ringing in the ears. Which of the following problems should the nurse suspect? A) Tinnitus B)
Vertigo C) Ototoxicity D) Impacted cerumen - correct answer ✔✔Ans: CThe older adult has
symptoms of ototoxicity. Aspirin is a known ototoxic drug. Tinnitus is the persistent sensation of
ringing in the ears, which is one of this client's symptoms. Vertigo is a sensation of motion,
which is not a reported symptom for this client. Although common, impacted cerumen would
not lead to ringing in the ears.
A new nursing assistant asks the nurse how best to approach a hearingimpaired older adult.
Which of the following approaches should the nurse recommend? A) Raise the volume of your
voice. B) Leave the radio on to calm the older adult. C) Lower the tone of your voice. D) Use
exaggerated lip movements. - correct answer ✔✔Ans: C Communication interventions for the
hearing impaired should aim at clarity of words. This is accomplished by slowing the rate of
speech and eliminating environmental noise and distractions. When communicating, lower the
tone while speaking in a moderately loud voice
A nurse is teaching a group of hearingimpaired nursing home residents about hearing aids.
Which of the following points should the nurse emphasize? A) It is not necessary to use the
hearing aid for one-on-one conversations. B) The hearing aid should be used only in the dining
room or social area. C) While inserting the hearing aid, make sure the volume is turned off. D) If
whistling is heard, the volume of the hearing aid may need to be increased - correct answer
✔✔Ans: C The hearing aid should be inserted with the volume off with the canal portion
pointing into the ear. A hearing aid should be used for one-on-one conversation and should not
be used in a dining room where there is background noise. If whistling is heard, the volume
should be decreased
A nurse notes that a client who has heart failure could hear well during the last home visit, and
is having difficulty hearing today. Which of the following laboratory findings is most likely
,associated with impaired hearing? A) Albumin of 4.1 B) Creatinine of 4.2 C) Potassium of 4.3 D)
Sodium of 144 - correct answer ✔✔Ans: B Older adults with heart failure are at increased risk
for hearing loss caused by medications (e.g., diuretics) and decreased renal and cardiac
perfusion. Normal levels of albumin, potassium, and sodium are not associated with hearing
loss
An 85-year-old woman who lives alone says to the nurse, "There is nothing I can do about my
hearing. I am 85 years old, and I am not really interested in listening to television programs
anymore." Which of the following would be the nurse's best response?A)"You are lucky you still
live alone at 85, and I understand why you don't care about the programs on
television."B)"Have you talked with your health care provider about a hearing evaluation? This
would determine the problem and possible solutions to it."C)"I know a hearing aid dealer who
offers free testing. Have you thought about trying a hearing aid?"D)"Did you know that there
are closedcaption television sets that would allow you to enjoy some shows?" - correct answer
✔✔Ans: B The first step would be to determine what the problem is. Free testing is not
comprehensive in its evaluative scope. Telling the client she is lucky to be living alone at 85
years of age is nontherapeutic communication and suggesting that the woman use
closedcaption television does not address the hearing issue.
A 76-year-old adult expresses frustration to the nurse regarding hearing loss despite a lifetime
of being conscientious about avoiding known causes of hearing damage. Which of the following
age-related changes may result in hearing loss? A) Degeneration of the inner ear structures B)
Decreased viscosity and quantity of cerumen C) Plaque formation and occlusion of the
Eustachian tubes D) Hypertrophy of the external ear structures - correct answer ✔✔Ans: A Age-
related changes of the inner ear include loss of hair cells, reduction of blood supply, diminution
of endolymph production, decreased basilar membrane flexibility, degeneration of spiral
ganglion cells, and loss of neurons in the cochlear nuclei. These inner ear changes result in the
degenerative hearing impairment termed presbycusis. Cerumen often becomes more viscous
with age, and occlusion of the Eustachian tubes is not a normal, age-related change. Changes to
the external ear structures are not implicated in age-related hearing loss
A nurse who regularly visits an adult daycare center has noted evidence of a hearing deficit in a
man who has no documented history of hearing loss. Which of the following factors should the
nurse consider when attempting to ascertain the etiology of the man's hearing loss? (Select all
that apply.) A) Genetic factors B) Environmental conditions C) Fluid and electrolyte imbalances
, D) Ototoxic medications E) Atherosclerosis or thrombotic events - correct answer ✔✔Ans: A, B,
D Medications, genetic factors, and environmental factors are all among the many potential
contributors to hearing loss in older adults. Fluid and electrolyte imbalances, atherosclerosis,
and thrombosis are not commonly implicated in hearing loss among older adults
The incidence of hearing loss in a longterm care facility is high, especially among white men.
What strategy should care providers adopt when communicating with older adults who have
hearing loss?A)Use less complex concepts when communicating with hearing-impaired older
adults.B) Use a high, consistent tone and pitch when speaking to adults with hearing
loss.C)Speak at a high volume directly into the less affected ear when talking to an older adult
with a hearing deficit.D)Make eye contact before and during a conversation with hearing-
impaired adults. - correct answer ✔✔Ans: D Eye contact helps facilitate communication with
individuals who have hearing loss. It is unnecessary, and likely inappropriate, to simplify the
content of conversations, and a low tone is more beneficial than a high tone. It is not normally
necessary to speak directly into the ear of the older adult
As part of a comprehensive physical assessment of an older adult client, a nurse is performing
an otoscopic examination. Which of the following assessment findings most clearly warrants
further assessment and possible intervention? A) There is a small amount of cerumen visible in
the ear canal. B) The epithelial lining is bright red. C) The tympanic membrane is intact. D) The
tympanic membrane is a pearl-gray color - correct answer ✔✔Ans: B Bright red epithelial lining
in the ear is an abnormal finding; the lining should be pinkish white. A small amount of cerumen
and an intact, pearl-gray tympanic membrane are expected findings
A nurse has been caring for an 83-yearold resident of a nursing home for 2 years and has
developed a high level of trust with the resident. Which of thefollowing recent changes in the
resident's behavior may signal the possibility of hearing loss? A) The resident's statements
occasionally suggest that he is not oriented to time.B)The resident had a recent episode where
he became visibly angry at a nursing assistant. C) The resident's attention span is short and he is
easily distracted. D) The resident has become increasingly disagreeable and terse in his
demeanor - correct answer ✔✔Ans: CShort attention span and easy distractibility are indicators
of hearing loss. Aggression and agitation more often suggest alternative etiologies, such as
neurologic health problems
complete solutions A+
A 62-year-old who has worked on an assembly line since he was 24 years old began taking
aspirin for arthritis 6 months ago. The client presents to the nurse with hearing problems and
ringing in the ears. Which of the following problems should the nurse suspect? A) Tinnitus B)
Vertigo C) Ototoxicity D) Impacted cerumen - correct answer ✔✔Ans: CThe older adult has
symptoms of ototoxicity. Aspirin is a known ototoxic drug. Tinnitus is the persistent sensation of
ringing in the ears, which is one of this client's symptoms. Vertigo is a sensation of motion,
which is not a reported symptom for this client. Although common, impacted cerumen would
not lead to ringing in the ears.
A new nursing assistant asks the nurse how best to approach a hearingimpaired older adult.
Which of the following approaches should the nurse recommend? A) Raise the volume of your
voice. B) Leave the radio on to calm the older adult. C) Lower the tone of your voice. D) Use
exaggerated lip movements. - correct answer ✔✔Ans: C Communication interventions for the
hearing impaired should aim at clarity of words. This is accomplished by slowing the rate of
speech and eliminating environmental noise and distractions. When communicating, lower the
tone while speaking in a moderately loud voice
A nurse is teaching a group of hearingimpaired nursing home residents about hearing aids.
Which of the following points should the nurse emphasize? A) It is not necessary to use the
hearing aid for one-on-one conversations. B) The hearing aid should be used only in the dining
room or social area. C) While inserting the hearing aid, make sure the volume is turned off. D) If
whistling is heard, the volume of the hearing aid may need to be increased - correct answer
✔✔Ans: C The hearing aid should be inserted with the volume off with the canal portion
pointing into the ear. A hearing aid should be used for one-on-one conversation and should not
be used in a dining room where there is background noise. If whistling is heard, the volume
should be decreased
A nurse notes that a client who has heart failure could hear well during the last home visit, and
is having difficulty hearing today. Which of the following laboratory findings is most likely
,associated with impaired hearing? A) Albumin of 4.1 B) Creatinine of 4.2 C) Potassium of 4.3 D)
Sodium of 144 - correct answer ✔✔Ans: B Older adults with heart failure are at increased risk
for hearing loss caused by medications (e.g., diuretics) and decreased renal and cardiac
perfusion. Normal levels of albumin, potassium, and sodium are not associated with hearing
loss
An 85-year-old woman who lives alone says to the nurse, "There is nothing I can do about my
hearing. I am 85 years old, and I am not really interested in listening to television programs
anymore." Which of the following would be the nurse's best response?A)"You are lucky you still
live alone at 85, and I understand why you don't care about the programs on
television."B)"Have you talked with your health care provider about a hearing evaluation? This
would determine the problem and possible solutions to it."C)"I know a hearing aid dealer who
offers free testing. Have you thought about trying a hearing aid?"D)"Did you know that there
are closedcaption television sets that would allow you to enjoy some shows?" - correct answer
✔✔Ans: B The first step would be to determine what the problem is. Free testing is not
comprehensive in its evaluative scope. Telling the client she is lucky to be living alone at 85
years of age is nontherapeutic communication and suggesting that the woman use
closedcaption television does not address the hearing issue.
A 76-year-old adult expresses frustration to the nurse regarding hearing loss despite a lifetime
of being conscientious about avoiding known causes of hearing damage. Which of the following
age-related changes may result in hearing loss? A) Degeneration of the inner ear structures B)
Decreased viscosity and quantity of cerumen C) Plaque formation and occlusion of the
Eustachian tubes D) Hypertrophy of the external ear structures - correct answer ✔✔Ans: A Age-
related changes of the inner ear include loss of hair cells, reduction of blood supply, diminution
of endolymph production, decreased basilar membrane flexibility, degeneration of spiral
ganglion cells, and loss of neurons in the cochlear nuclei. These inner ear changes result in the
degenerative hearing impairment termed presbycusis. Cerumen often becomes more viscous
with age, and occlusion of the Eustachian tubes is not a normal, age-related change. Changes to
the external ear structures are not implicated in age-related hearing loss
A nurse who regularly visits an adult daycare center has noted evidence of a hearing deficit in a
man who has no documented history of hearing loss. Which of the following factors should the
nurse consider when attempting to ascertain the etiology of the man's hearing loss? (Select all
that apply.) A) Genetic factors B) Environmental conditions C) Fluid and electrolyte imbalances
, D) Ototoxic medications E) Atherosclerosis or thrombotic events - correct answer ✔✔Ans: A, B,
D Medications, genetic factors, and environmental factors are all among the many potential
contributors to hearing loss in older adults. Fluid and electrolyte imbalances, atherosclerosis,
and thrombosis are not commonly implicated in hearing loss among older adults
The incidence of hearing loss in a longterm care facility is high, especially among white men.
What strategy should care providers adopt when communicating with older adults who have
hearing loss?A)Use less complex concepts when communicating with hearing-impaired older
adults.B) Use a high, consistent tone and pitch when speaking to adults with hearing
loss.C)Speak at a high volume directly into the less affected ear when talking to an older adult
with a hearing deficit.D)Make eye contact before and during a conversation with hearing-
impaired adults. - correct answer ✔✔Ans: D Eye contact helps facilitate communication with
individuals who have hearing loss. It is unnecessary, and likely inappropriate, to simplify the
content of conversations, and a low tone is more beneficial than a high tone. It is not normally
necessary to speak directly into the ear of the older adult
As part of a comprehensive physical assessment of an older adult client, a nurse is performing
an otoscopic examination. Which of the following assessment findings most clearly warrants
further assessment and possible intervention? A) There is a small amount of cerumen visible in
the ear canal. B) The epithelial lining is bright red. C) The tympanic membrane is intact. D) The
tympanic membrane is a pearl-gray color - correct answer ✔✔Ans: B Bright red epithelial lining
in the ear is an abnormal finding; the lining should be pinkish white. A small amount of cerumen
and an intact, pearl-gray tympanic membrane are expected findings
A nurse has been caring for an 83-yearold resident of a nursing home for 2 years and has
developed a high level of trust with the resident. Which of thefollowing recent changes in the
resident's behavior may signal the possibility of hearing loss? A) The resident's statements
occasionally suggest that he is not oriented to time.B)The resident had a recent episode where
he became visibly angry at a nursing assistant. C) The resident's attention span is short and he is
easily distracted. D) The resident has become increasingly disagreeable and terse in his
demeanor - correct answer ✔✔Ans: CShort attention span and easy distractibility are indicators
of hearing loss. Aggression and agitation more often suggest alternative etiologies, such as
neurologic health problems
