Short answer, never trust the controller. If the worst happens all the controller will have is paperwork to do and lots of meetings. But your family will have your funeral to tend to. As PIC you are the sole authority as to the safety of your flight. As for listening, IMHO, it's more important to listen carefully at takeoff and landings.
We train ourselves, while in the air to listen for the 1st word which is the call-sign of the aircraft and if it's ours then it has our attention and if there are other passengers on my plane my hand goes up for them to keep quiet.
But during landing, approaches, etc, we must familiarize ourselves not with just the approach or runway we are landing on but we should know the configuration of the airport in general. In single runway airports, it's not as hard. You just have to know which runway is landing and taking off and if you hear other wise then you speak up. In multiple runway airports, especially with low visibility if you are still high enough, do not be afraid to key up and ask a question. Just as you would key up even without a call-sign and ask 'Wind Check'. The controllers then broadcast the current winds in the blind.
But if you are on short final and are still unsure, there is only one thing that is the safest. Abort the landing, and do a go-around as you are informing the tower you are going around because of unclear instructions.
If they give you a number to call because you messed up their nice string of pearls they were setting up, giving them more workload, or messed with their approaches and departures, that's fine. Like I said above, I'd rather be on the ground talking to, explaining to or writing up documents (especially a NASA form) than having someone crawling over the mangled mess of my airplane trying to figure out which part was part of me or someone else.