Health Assessment

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

Which of the following is not a function of the middle ear?
A) Sound conduction
B) Amplification of sound
C) Reduction of sound amplitude
D) Pressure equalization

At the peripheral level of hearing, which of the following functions takes place?
A) Conversion of air conduction to bone conduction
B) Interpretation of sound variations
C) Differentiation of pitch and frequency
D) Conversion of vibrations into electrical impulses

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) a mechanical dysfunction of the external or the middle ear occurs.
B) electrical impulses are trapped in the brain stem.
C) sound is dampened by excessive amplitude reduction.
D) air conduction is converted to bone conduction.

The labyrinth of the inner ear is responsible for maintaining the body's:
A) binaural interaction.
B) equilibrium.
C) pressure equalization.
D) air conduction.

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) Ossicles
B) Tympanic membrane
C) Eustachian tube
D) Organ of Corti

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.

An individual who may act irritable or show a startle reflex when hearing a raised voice is demonstrating:
A) a conductive hearing loss.
B) recruitment.
C) otorrhea.
D) presbycusis.

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 looked directly at you when you spoke to her and maintained appropriate eye contact.
B) The patient’s speech was well articulated and clear.
C) The patient spoke in an inappropriately soft voice.
D) The patient’s voice had a flat, monotonous tone.

The eardrum is connected to which of the middle ear ossicles?
A) Cochlea
B) Incus
C) Malleus
D) Stapes

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) "I have difficulty hearing certain sounds.”
B) "I have a ringing in my ears."
C) "The room is spinning around me.”
D) "I feel like I am about to faint."

Which of the following individuals is at risk of being an otitis-prone child?
A) An 18-month-old infant who has had three episodes of ear infections in a 5-month period
B) An 18-month-old infant who lives with an individual who smokes cigarettes
C) A 6-month-old infant with a sibling who had tubes inserted at 3 years of age
D) A 2-year-old child who has had two ear infections in the past 6 months

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) Pinnicolosis
D) Macrotia

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) mobility of the tympanic membrane.
B) presence of fluid in the middle ear.
C) mobility of the inner ear bones.
D) ability of the eustachian tube to equalize pressure.

The Weber test is generally performed on an individual who complains of:
A) ringing in the ears.
B) pain while swallowing.
C) pain in one ear.
D) hearing better in one ear than the other.

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) perpendicular
C) vertical
D) oblique

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 displays the startle (Moro) reflex.
B) The infant begins to coo and tries to mimic the sound.
C) The infant's eyes close tightly.
D) The infant's head turns toward the noise.

Which of the following behaviors is indicative of a young child with a hearing loss?
A) The child reacts more to movement and facial expressions than to sound.
B) The child appears to pay more attention to casual conversation.
C) The child is more sociable and outgoing than would be expected.
D) The child continues to repeat phrases and words.

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) Thinner than expected
B) Pinker than expected
C) More mobile than expected
D) Whiter than expected

Which of the following separates the middle ear from the external ear?
A) The auricle
B) The pars flaccida
C) The malleus
D) The tympanic membrane

The nasopharynx is connected to the middle ear by the:
A) auditory canal.
B) eustachian tube.
C) umbo.
D) cochlea.

The middle ear functions to:
A) equilibrate pressure between the external ear and the inner ear.
B) maintain balance.
C) reduce amplification of sound to protect the inner ear.
D) sort out extraneous sounds.

The vestibule and the semicircular canals of the inner ear are primarily responsible for:
A) pressure equalization.
B) sound conduction to the brain.
C) equilibrium.
D) sound differentiation.

Binaural interaction at the level of the brain stem permits which of the following to occur?
A) Amplification of sound
B) Identification and location of the direction of the sound
C) Direction of sound toward the appropriate conduction pathway
D) Interpretation of sound

Bone conduction of sound permits direct transmission of sound from the bone to:
A) the cochlea.
B) the organ of Corti.
C) the eustachian tube.
D) Cranial nerve VIII.

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) Otosclerotic
B) Mixed
C) Conductive
D) Sensorineural

Which of the following individuals would be most at risk for developing presbycusis?
A) A 25-year-old individual who frequents rock concerts
B) A 3-year-old with chronic ear infections
C) A 45-year-old individual with an impacted cerumen
D) A 75-year-old individual who lives in an assisted-living apartment

Which of the following manifestations related to hearing occurs in older adults?
A) Increased conduction of sound
B) Increased auditory reaction time
C) Increased ear infections
D) Increased amplification of sound

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) Talking in a high-pitched voice
C) Speaking slowly with well-articulated consonants
D) Frequently asking for a question to be repeated

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) Age
B) Medications
C) Excessive environmental noise
D) Otitis media

In children, which of the following, if present, increases the risk of developing a hearing deficit?
A) Microtia
B) Dry cerumen
C) Darwin's tubercle
D) Illness with a persistent high fever

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) Hypertrophy of a portion of the membrane
C) Impaction of the middle ear
D) Hardening of the bones of the inner ear

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 rely on the examiner's hearing ability.
C) They are only useful when the individual may have a conductive hearing loss.
D) They can document the presence of a hearing loss but not the degree of loss.