Ateneo de Zamboanga University

COLLEGE OF NURSING
PERFORMANCE EVALUATION CHECKLIST
NAME: _____________________________________ DATE PERFORMED: _________________
YEAR & SECTION: ______________

ASSESSING THE EARS AND HEARING

PROCEDURE
Position the client comfortably—seated, if possible.
Assessment

External Ear Canal and Tympanic Membrane

1. Inspect the auricles. Inspect the external ear canal for
cerumen, skin lesions, pus, and blood.

2. Visualize the tympanic membrane using an otoscope.

Attach a speculum to the otoscope.

Tip the client’s head away from you and straighten the
ear canal.
 Hold the otoscope either right side up, with your fingers
between the otoscope handle and the client’s head, or
upside down, with your fingers and the ulnar surface of
your hand against the client’s head. (Choose ONE.)

Inserting an otoscope.

Gently insert the tip of the otoscope into the ear canal,
avoiding pressure by the speculum against either side
of the ear canal.

3. Inspect the tympanic membrane for color and gloss.

Normal Findings: Pearly gray color, semitransparent

Gross Hearing Acuity Tests

4. Assess client’s response to normal voice tones. If client
has difficulty hearing the normal voice, proceed with the
following tests.
5. Perform the watch tick test.

Have the client occlude one ear. Out of the client’s

sight, place a ticking watch 2–3 cm (1–2 inches) from
the unoccluded ear.
Ask what the client can hear. Repeat with the other ear.
Tuning Fork Tests
 6. Perform Weber test.
 Hold the tuning fork at its base. Activate it by
tapping the fork gently against the back of your hand
near the knuckles or by stroking the fork between
your thumb and index finger.
 Place the base of the vibrating fork on top of the
client’s head and ask where the client hears the
noise.
Normal Findings: Sound is heard in both ears.

Placing the base of the tuning fork on the client’s skull (Weber’s test).
7. Conduct Rinne test.
 Hold the handle of the activated tuning fork on the
mastoid process of one ear until the client states
that the vibration no longer can be heard.

Rinne test tuning fork placement: Base of the tuning fork on the mastoid
process
 Immediately hold still the vibrating fork prongs in
front of the client’s ear canal. Ask whether the client
now hears the sound.

Rinne test tuning fork placement: Tuning fork prongs placed in front of client’s ear
Normal findings: Air-conducted hearing is greater
than bone-conducted hearing.

8. Document findings in the client record.

TOTAL
______________________
Clinical Instructor
(Sign over printed name)