ATI RN
health assessment practice questions Questions
Question 1 of 5
A 31-year-old patient tells the nurse that he is experiencing a progressive loss of hearing. He says that it does seem to help when people speak more loudly or if he turns up the volume. The most likely cause of his hearing loss is:
Correct Answer: A
Rationale: The correct answer is A: otosclerosis. Otosclerosis is a condition where abnormal bone growth in the middle ear causes hearing loss. In this case, the patient's symptoms of progressive hearing loss improving with louder sounds suggest conductive hearing loss, which is commonly seen in otosclerosis. Other choices are incorrect because presbycusis is age-related hearing loss, trauma to the bones would typically result in sudden hearing loss, and frequent ear infections are more likely to cause temporary hearing loss rather than progressive loss.
Question 2 of 5
A colleague is assessing an 80-year-old patient who has ear pain and asks him to hold his nose and swallow. Which of the following about this technique is true?
Correct Answer: D
Rationale: The correct answer is D because asking the patient to hold his nose and swallow causes the eustachian tube to open, equalizing pressure in the middle ear. This action will cause the eardrum to bulge slightly outward, making landmarks more visible. Choice A is incorrect as age alone does not preclude the use of this technique. Choice B is incorrect because this technique is not primarily used for assessing otitis media. Choice C is incorrect as it is not specific to upper respiratory infections.
Question 3 of 5
The nurse is assessing the hearing of a 7-month-old. What would be the expected response to clapping of hands?
Correct Answer: A
Rationale: The correct answer is A because at 7 months, infants typically have developed the ability to localize sounds. When clapping hands, the expected response is for the infant to turn their head towards the sound source, indicating their ability to detect and localize the sound. This behavior reflects the normal auditory development at this age. Choice B is incorrect because by 7 months, infants should show some response to noise, such as turning their head or showing some interest. Choice C is incorrect as the startle and acoustic blink reflex typically occur in response to sudden loud noises, but at 7 months, the infant should also be able to localize the source of the sound. Choice D is incorrect as stopping all movement and appearing to listen is not a typical response expected from a 7-month-old when hearing a sound. Infants at this age are more likely to actively turn towards the sound source to investigate.
Question 4 of 5
The mother of a 2-year-old is concerned about tympanostomy tubes that are going to be inserted in her son's ears. Which of the following would the nurse include in the teaching plan?
Correct Answer: D
Rationale: Rationale for Correct Answer D: Tympanostomy tubes are inserted into the eardrum to help drain fluid from the middle ear, relieve pressure, and prevent infections. This is important in children who have recurrent ear infections or fluid buildup. By allowing drainage, the tubes help improve hearing and reduce the risk of complications. Summary of Incorrect Choices: A) Incorrect - Tympanostomy tubes are placed in the middle ear, not the inner ear. B) Incorrect - Tympanostomy tubes are used for conductive hearing loss, not sensorineural loss. C) Incorrect - Tympanostomy tubes are not permanently inserted and are usually removed after a period of time once they are no longer needed.
Question 5 of 5
When performing an otoscopic examination on a 5-year-old child with a history of chronic ear infections, the nurse sees that his right tympanic membrane is amber-yellow in colour and there are air bubbles behind the tympanic membrane. The child reports occasional hearing loss and a popping sound with swallowing. The preliminary analysis based on this information would be that:
Correct Answer: A
Rationale: The correct answer is A: this is most likely serous otitis media. In a child with chronic ear infections, amber-yellow tympanic membrane color and air bubbles suggest fluid accumulation behind the eardrum, characteristic of serous otitis media. The occasional hearing loss and popping sound with swallowing are also common symptoms. Serous otitis media is a non-infectious condition caused by Eustachian tube dysfunction. Choice B: Acute purulent otitis media presents with more severe symptoms like fever and severe ear pain, which are not mentioned in the case. Choice C: Cholesteatoma is a more serious condition characterized by a cyst-like growth in the middle ear, not just fluid accumulation as seen in this case. Choice D: Perforation typically presents with a visible hole in the eardrum and is not consistent with the findings of fluid and air bubbles in this case.