A nurse is caring for a client who has a hearing loss in her left ear. Which of the following nursing actions should the nurse take?

Over articulate words to improve client understanding.

Change voice volume during each sentence.

Minimize background noise to decrease distractions.

Sit in a chair to one side of the client.

Answer and Explanation

The Correct Answer is C

A. Over articulate words to improve client understanding: Can distort lip reading and make understanding more difficult.

B. Change voice volume during each sentence: Inconsistent volume may confuse the client.

C. Minimize background noise to decrease distractions: Reducing background noise enhances the client’s ability to focus and improves hearing.

D. Sit in a chair to one side of the client: Sitting on the side of the good ear is more effective, but the answer doesn’t specify which side, so C is better.

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Correct Answer is C

Explanation

A. Convince the client how helpful it will be to engage in the activity:
Logical persuasion is not therapeutic. Depressed clients often cannot be reasoned into participation.

B. Sit down with the client and ask her why she doesn't want to participate:
Asking “why” can make clients feel defensive and may not promote engagement.

C. Tell the client that it is time for the activity, and accompany her to the activity:
Matter-of-fact, structured support with encouragement and physical presence can help the client engage in activities without increasing pressure.

D. Tell the client that she has a self-defeating attitude and it will only make her feel worse:
This is judgmental and nontherapeutic. It may worsen the client’s sense of hopelessness.

A. Use a barrier cream when performing perineal care. B. Supervise clients to ensure adequate nutritional intake. C. Identify the clients at greatest risk for development of pressure ulcers. D. Turn and position each client every 2 hr.

Correct Answer is C

Explanation

A. Use a barrier cream when performing perineal care: Helps prevent skin breakdown, but alone is not enough to address pressure ulcer risk.

B. Supervise clients to ensure adequate nutritional intake: Nutrition is important for skin integrity, but prioritizing early risk identification ensures comprehensive prevention strategies.

C. Identify the clients at greatest risk for development of pressure ulcers: Clients with limited mobility, poor nutrition, incontinence, or medical conditions affecting circulation are at higher risk. Recognizing high-risk clients early allows for timely interventions such as repositioning, skin assessments, and nutritional support.

D. Turn and position each client every 2 hr: This is a key intervention, but without first identifying at-risk clients, the effectiveness of repositioning is limited.

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A nurse is caring for a client who has a hearing loss in her left ear. Which of the following nursing actions should the nurse take?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is C

Explanation

Correct Answer is C

Explanation

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