The nurse suspects that a patient has bone-conductive hearing ...

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The nurse suspects that a patient has bone-conductive hearing loss. Which assessment technique should the nurse use to differentiate between bone conduction loss and air conduction loss?
 
  1. Rinne test
  2. Weber test
  3. assessment of balance and body position
  4. palpation of mastoid process

Question 2

A patient has a tonometer test result of 28 mmHg. Which explanation by the nurse about this pressure reading is most accurate?
 
  1. The pressure in the eye has been measured and is too low. Medication will be required to increase the pressure and prevent blindness from retinal damage.
  2. The pressure in the inner ear has been measured to evaluate the semicircular canals' function related to nerve damage and is within the normal range.
  3. The pressure in the middle ear that builds up with mastoiditis has been measured. The condition needs to be treated with surgical insertion of tubes to drain the fluid behind the tympanic membrane.
  4. The pressure in the eye has been measured and is above normal. This condition could lead to possible retinal changes if not treated.

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Answer to Question 1

Correct Answer: 1
A Rinne test is a hearing test that compares air conduction of sound to bone conduction. In conductive hearing loss, bone conduction is equal to or greater than air conduction. A Weber test identifies a hearing loss by lateralization (increase in sound) to the ear with a conductive hearing loss. Thus this test would be helpful to identify a difference between left and right ear changes that might be related to a conductive hearing loss. Balance and body position changes would reflect a disturbance in the inner ear and possible nerve damage. If balance and body position are affected, this information does not differentiate between conductive hearing loss, nerve loss, and a combination of both types of losses. Palpation of the mastoid process would assess for pain or swelling, which can indicate inflammation of the external auditory canal and mastoid sinuses. Mastoiditis can lead to fluid or scarring within the middle ear, which could interfere with sound conduction from the external to the inner ear. This assessment would be helpful to identify a source for conduction hearing loss.

Answer to Question 2

Correct Answer: 4
Tonometry is used to diagnose increased intraocular pressure in glaucoma. A handheld tonometer or computerized device may be used. The cornea is anesthetized prior to being touched with the device. The normal range is 1022 mmHg. A tonometer measures eye pressure, not ear pressure. Typanometry is performed to evaluate the response of the tympanic membrane to changes in air pressure and middle ear function.