A nurse examines a patient’s tympanic membranes with an otoscope. The nurse understands the normal tympanic membrane exhibits which normal characteristic?

Choice A reason: Tenderness is assessed by palpation, not auscultation, which focuses on sounds. Auscultation precedes to avoid altering bowel sounds, so this is incorrect for the reason given.

Choice B reason: Patient relaxation is beneficial but not the primary reason for auscultation first. Preventing bowel sound distortion by avoiding percussion and palpation is key, so this is incorrect.

Choice C reason: Vascular sounds like bruits are less affected by percussion/palpation than bowel sounds. Bowel sound distortion is the main concern, so this is incorrect for the primary reason.

Choice D reason: Auscultation before percussion and palpation prevents distortion of bowel sounds, which can be altered by manipulation. This is the correct reason, reflecting proper abdominal assessment technique.

Choice A reason: Reading handheld print tests reading near vision, not standard visual acuity, which requires distance assessment. The Snellen chart at 20 feet is the standard, so this is incorrect for acuity testing.

Choice B reason: The Snellen chart, positioned 20 feet away, is the standard method for assessing visual acuity in adolescents, providing a reliable measure of distance vision. This is the correct procedure for the nurse.

Choice C reason: The confrontation test assesses peripheral vision, not central acuity. The Snellen chart measures sharpness of vision, so this is incorrect for the purpose of visual acuity assessment.

Choice D reason: Reading newsprint at 12–14 inches tests near vision, not distance acuity, which is the standard for screening. The Snellen chart at 20 feet is appropriate, so this is incorrect.