A newly licensed nurse is applying prescribed wrist restraints on a client.
Which of the following actions should the nurse take?

The correct answer is choice D.

Choice A rationale:

Assisting the client to a side-lying position is not necessary when administering nasal decongestant drops. The client can be in an upright position or slightly tilted back.

Choice B rationale:

Holding the dropper 2 cm (1 in) above the naris is not a standard guideline for administering nasal decongestant drops. The dropper should be inserted into the nostril without touching the inside of the nostril to avoid contamination.

Choice C rationale:

Instructing the client to stay in the same position for 2 min is not necessary. After the administration of the nasal decongestant drops, the client can resume their normal activities.

Choice D rationale:

Telling the client to blow her nose gently before the instillation is the correct action. This action will help remove any secretions or crusts that could interfere with the distribution and absorption of the medication.

This question evaluates communication adaptations for clients experiencing hearing impairment. The nurse must apply therapeutic communication principles that maximize auditory perception and minimize environmental interference. Knowledge of sensory deficits, lip-reading facilitation, sound discrimination, and appropriate assistive communication strategies is required to identify the safest intervention.

Choice A rationale: Reducing competing environmental sounds improves speech discrimination and auditory processing in hearing-impaired clients. Background noise interferes with interpretation of consonants and speech frequencies. Quiet environments enhance comprehension, decrease communication fatigue, and promote accurate understanding of discharge instructions and healthcare information.

Choice B rationale: Braille communication assists clients with severe visual impairment, not hearing impairment. Hearing loss primarily affects auditory sensory pathways involving cochlear hair cells or auditory nerve transmission. Providing Braille would not improve comprehension unless the client additionally has blindness or significant visual disability.

Choice C rationale: Standing directly beside the client limits visibility of facial expressions and lip movements essential for speech interpretation. Effective communication with hearing-impaired individuals requires face-to-face positioning, adequate lighting, and clear articulation to support residual hearing and visual speech cues simultaneously.

Choice D rationale: Repeating misunderstood phrases identically often fails because the original wording remains difficult to discriminate acoustically. Rephrasing sentences with different vocabulary improves semantic processing and contextual interpretation. Therapeutic communication emphasizes clarification rather than repetitive unchanged verbalization during hearing-related misunderstandings.