Answer to Question 1
Correct Answer: 1, 2, 3
Tuning forks are used to determine whether a hearing loss is conductive or sensorineural. The sound will be louder on the impaired side with a conductive hearing loss. The sound will be softer on the impaired side with a sensorineural hearing loss. If the sound is not heard equally in both ears, the cause may be an infection such as otitis media. The test cannot measure degree of hearing loss. The Rinne test is not used to assess for the presence of a tumor in the middle ear.
Answer to Question 2
Correct Answer: 1
Visual inspection of the external ear will give information about possible obstruction by cerumen, drainage, redness, swelling, or objects present in the external canal. Visual inspection can also show the condition of the tympanic membrane (intact or ruptured), swelling, redness, and scarring. Pain also might be identified when using the otoscope to visualize the structures in the external canal. A Weber test is done to identify the equality of sound heard in both ears. This would be the next step in the assessment process. Normally, sound is heard equally in both ears. A Rinne test is done to identify the difference between bone and air conduction of sound by each ear. This is the third step. Normally, sound can be heard twice as long by air conduction as by bone conduction. Tympanograms are done to measure the pressure of the middle ear by evaluating the tympanic membrane's response to waves of pressure. This test would be done last, only if other symptoms were noted or indicated by the nurse's findings.
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