The client is undergoing a tuning fork test to assess for hearing conduction. The nurse performs a Rinne test. How will this test be performed?
A.
Have the client close their eyes, lightly rub fingers together 12 inches away from the ear, and have the client identify which side the sound is heard.
B.
First, place the tuning fork on the mastoid process behind the ear. When the client states the sound is no longer heard, place the tuning fork beside the ear.
C.
Strike the tuning fork and place it in the center of the skull.
D.
Stand three feet away and have the client repeat back what you have whispered.
The correct answer and Explanation is :
The correct answer is B: First, place the tuning fork on the mastoid process behind the ear. When the client states the sound is no longer heard, place the tuning fork beside the ear.
Explanation:
The Rinne test is a specific procedure used to evaluate a patient’s hearing, comparing air conduction (AC) and bone conduction (BC). It helps identify whether hearing loss is due to a conductive issue (obstruction or damage in the outer or middle ear) or a sensorineural issue (damage to the inner ear or auditory nerve).
How the test is performed:
- Bone Conduction (BC): The nurse first strikes the tuning fork to generate vibrations and places the base of the vibrating tuning fork on the client’s mastoid process (the bone behind the ear). This tests bone conduction by transmitting sound through the bones of the skull to the inner ear. The client listens and signals when they can no longer hear the sound.
- Air Conduction (AC): Once the client can no longer hear the sound through bone conduction, the nurse moves the still-vibrating tuning fork near the external ear canal (about 1-2 cm away). This tests air conduction, which is the normal pathway for sound waves.
- Results Interpretation:
- Normal Hearing: Air conduction is greater than bone conduction, meaning the client will hear the sound through the air after they can no longer hear it through the bone.
- Conductive Hearing Loss: Bone conduction is equal to or greater than air conduction, indicating a problem in the outer or middle ear preventing sound from reaching the inner ear properly.
- Sensorineural Hearing Loss: Both air and bone conduction are reduced, but air conduction remains greater than bone conduction.
The Rinne test is often performed alongside the Weber test (option C), which helps differentiate between unilateral conductive and sensorineural hearing loss.