Touhy Chapter 19: Diseases Affecting
Vision and Hearing
Which of the following diseases affects the eyesight of an older adult by damaging the
central part of the retina?
a.Glaucoma
b.Presbyopia
c.Cataract
d.Macular degeneration correct answers d.Macular degeneration
Macular degeneration is a disease characterized by damage to the central part of the
retina that leaves the outer edges of the visual field intact. Presbyopia, a gradual decline
in the flexibility of the lens, makes close-up focusing more difficult and is a common
age-related change but not a disease. Glaucoma, a disease marked by increased
pressure within the eye that potentially leads to optic nerve damage, is the most
common cause of blindness in those 65 years of age and older. A cataract is a disease
marked by clouding and blurring of the lens.
Which of the following is used to treat the most common cause of impairment to an
older person's hearing?
a.Hearing aids
b.Cochlear implants
c.Ear canal irrigation
d.Sign language correct answers c.Ear canal irrigation
Irrigation is used to dissolve and remove impacted cerumen, the most common cause of
impaired hearing in older adults. Hearing aids are useful for sensorineural hearing loss,
but the most common cause impairing the hearing of older persons is cerumen
impaction. Cochlear implants are useful for profound sensorineural deafness, but the
most common cause impairing the hearing of older persons is cerumen impaction. Sign
language has been used primarily by those who become deaf in childhood or at birth,
but it is not considered a treatment.
A medical illustration shows a man with the blunt end of a tuning fork pressed to the
center of his forehead. The man is being tested for which of the following?
a.Sensorineural hearing loss
b.Presbycusis
c.Tinnitus
d.Unilateral conductive hearing loss correct answers d.Unilateral conductive hearing
loss
, Weber's test, in which a vibrating tuning fork is placed on the center of the forehead,
detects the differences in hearing between one ear and the other caused by poor sound
conduction. During testing, the patient is asked to describe the sensation felt when the
tuning fork is activated and then placed on the forehead. If the patient's hearing by
conduction is intact, then he or she will feel vibrations conducted through the bones of
the skull from the tuning fork. Weber's test with the tuning fork is used to detect
conductive hearing loss. Presbycusis affects both ears and has a sensorineural origin.
The tuning fork test is used to detect conductive hearing loss in one ear. Tinnitus is a
hearing sensation not caused by an actual sound. The tuning fork test is used to detect
hearing loss caused by poor sound conduction.
Persons with normal age-related sensory changes are likely to have the most difficulty
distinguishing which of the following?
a.Spoken pairs of phrases such as "she's praised" and "fees raised"
b.Orange towel hanging on a beige wall
c."Go" and "to" in lowercase letters in fine print
d.Spoken word pairs like "cupful" and "capful" correct answers a.Spoken pairs of
phrases such as "she's praised" and "fees raised"
A person with presbycusis has trouble hearing the higher frequencies, where most of
the differences between consonant sounds occur. The contrast between a vivid color
such as orange and a pale color such as beige can help an older person distinguish
objects. The details of the letters may be poorly focused, but their overall shape, relative
to the line around them, helps distinguish them. Age-related hearing impairments affect
the hearing of consonants more than vowels. A person would have more trouble
distinguishing "cupful" and "couple."
Which of the following interventions should the nurse use when communicating with a
hearing impaired older patient?
a.Stand beside the patient's chair when speaking.
b.Always clearly identify yourself and others with you.
c.Exaggerate your voice, depending on the cause of the hearing loss.
d.Select colors for paint, furniture, and pictures with rich intensity. correct answers
b.Always clearly identify yourself and others with you.
Always speak promptly, and clearly identify yourself and others who are with you. State
when you are leaving to ensure that the person is aware of your departure. Get down to
the person's level and face him or her when speaking. Speak normally but not from a
distance; do not raise or lower your voice and continue to use gestures if doing so is
natural to your communication. Selecting colors for paint, furniture, and pictures with
rich intensity is for the visually impaired, not those with a hearing impairment.
Vision and Hearing
Which of the following diseases affects the eyesight of an older adult by damaging the
central part of the retina?
a.Glaucoma
b.Presbyopia
c.Cataract
d.Macular degeneration correct answers d.Macular degeneration
Macular degeneration is a disease characterized by damage to the central part of the
retina that leaves the outer edges of the visual field intact. Presbyopia, a gradual decline
in the flexibility of the lens, makes close-up focusing more difficult and is a common
age-related change but not a disease. Glaucoma, a disease marked by increased
pressure within the eye that potentially leads to optic nerve damage, is the most
common cause of blindness in those 65 years of age and older. A cataract is a disease
marked by clouding and blurring of the lens.
Which of the following is used to treat the most common cause of impairment to an
older person's hearing?
a.Hearing aids
b.Cochlear implants
c.Ear canal irrigation
d.Sign language correct answers c.Ear canal irrigation
Irrigation is used to dissolve and remove impacted cerumen, the most common cause of
impaired hearing in older adults. Hearing aids are useful for sensorineural hearing loss,
but the most common cause impairing the hearing of older persons is cerumen
impaction. Cochlear implants are useful for profound sensorineural deafness, but the
most common cause impairing the hearing of older persons is cerumen impaction. Sign
language has been used primarily by those who become deaf in childhood or at birth,
but it is not considered a treatment.
A medical illustration shows a man with the blunt end of a tuning fork pressed to the
center of his forehead. The man is being tested for which of the following?
a.Sensorineural hearing loss
b.Presbycusis
c.Tinnitus
d.Unilateral conductive hearing loss correct answers d.Unilateral conductive hearing
loss
, Weber's test, in which a vibrating tuning fork is placed on the center of the forehead,
detects the differences in hearing between one ear and the other caused by poor sound
conduction. During testing, the patient is asked to describe the sensation felt when the
tuning fork is activated and then placed on the forehead. If the patient's hearing by
conduction is intact, then he or she will feel vibrations conducted through the bones of
the skull from the tuning fork. Weber's test with the tuning fork is used to detect
conductive hearing loss. Presbycusis affects both ears and has a sensorineural origin.
The tuning fork test is used to detect conductive hearing loss in one ear. Tinnitus is a
hearing sensation not caused by an actual sound. The tuning fork test is used to detect
hearing loss caused by poor sound conduction.
Persons with normal age-related sensory changes are likely to have the most difficulty
distinguishing which of the following?
a.Spoken pairs of phrases such as "she's praised" and "fees raised"
b.Orange towel hanging on a beige wall
c."Go" and "to" in lowercase letters in fine print
d.Spoken word pairs like "cupful" and "capful" correct answers a.Spoken pairs of
phrases such as "she's praised" and "fees raised"
A person with presbycusis has trouble hearing the higher frequencies, where most of
the differences between consonant sounds occur. The contrast between a vivid color
such as orange and a pale color such as beige can help an older person distinguish
objects. The details of the letters may be poorly focused, but their overall shape, relative
to the line around them, helps distinguish them. Age-related hearing impairments affect
the hearing of consonants more than vowels. A person would have more trouble
distinguishing "cupful" and "couple."
Which of the following interventions should the nurse use when communicating with a
hearing impaired older patient?
a.Stand beside the patient's chair when speaking.
b.Always clearly identify yourself and others with you.
c.Exaggerate your voice, depending on the cause of the hearing loss.
d.Select colors for paint, furniture, and pictures with rich intensity. correct answers
b.Always clearly identify yourself and others with you.
Always speak promptly, and clearly identify yourself and others who are with you. State
when you are leaving to ensure that the person is aware of your departure. Get down to
the person's level and face him or her when speaking. Speak normally but not from a
distance; do not raise or lower your voice and continue to use gestures if doing so is
natural to your communication. Selecting colors for paint, furniture, and pictures with
rich intensity is for the visually impaired, not those with a hearing impairment.
