A nurse is caring for an older adult client who reports recent difficulty hearing in his right ear. In addition, he has a large amount of cerumen in the same ear that is difficult to remove. Which type of hearing loss does the nurse expect when assessing this client?

Hearing impairment is classified into conductive, sensorineural, and mixed types based on the anatomical site of dysfunction. Conductive hearing loss occurs when sound transmission through the external or middle ear is mechanically blocked, commonly due to cerumen impaction, otitis media, or structural abnormalities affecting sound conduction to the inner ear. Rationale: A. Presbyopia is an age-related visual disorder affecting lens elasticity and near vision accommodation. It has no relationship to auditory pathways or hearing function. Therefore visual accommodation failure makes this option incorrect for hearing impairment. B. Presbycusis is age-related sensorineural hearing loss caused by degeneration of cochlear hair cells and auditory nerve pathways. It is typically bilateral and progressive. Cerumen impaction is not involved, making this unrelated to the client’s presentation. C. Conductive hearing loss occurs due to obstruction of sound transmission in the external auditory canal, such as cerumen impaction, which physically blocks sound waves from reaching the tympanic membrane. The presence of significant earwax strongly supports this diagnosis. D. Otitis refers to inflammation or infection of the ear, which may cause conductive hearing loss but is usually accompanied by pain, fever, or discharge. No inflammatory symptoms are described, making infectious etiology less likely in this case.