A nurse is caring for a client who has expressive aphasia. Which of the following techniques should the nurse use to meet the communication needs of this client?

Instruct the client to blink his eyes as a response.

Increase voice volume when speaking to the client.

Avoid using hand gestures.

Enunciate words slowly.

Answer and Explanation

The Correct Answer is A

A. Instruct the client to blink his eyes as a response: Expressive aphasia affects a person's ability to speak or write, but comprehension is often intact. Encouraging nonverbal communication methods such as blinking for "yes" or "no" responses can help the client effectively express needs and participate in care decisions without requiring speech.

B. Increase voice volume when speaking to the client: Raising the volume does not assist clients with expressive aphasia, as their difficulty lies in expression rather than hearing. Speaking louder can be perceived as frustrating or disrespectful and may not improve understanding or communication for the client.

C. Avoid using hand gestures: Hand gestures and facial expressions can enhance communication for individuals with aphasia by providing visual cues. Avoiding gestures removes a valuable tool that may help the client interpret and respond to messages, especially when they cannot verbalize thoughts.

D. Enunciate words slowly: While speaking clearly is beneficial in many communication disorders, expressive aphasia primarily impairs output, not comprehension. Enunciating slowly may not help the client respond more effectively and is more useful in receptive or global aphasia cases.

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Correct Answer is D

Explanation

A. Close-up of eyes with yellow sclera: Could indicate jaundice or liver dysfunction, which is not an expected part of aging and requires further evaluation.

B. Older adult man with a rounded back and head tilted forward: Suggests kyphosis, which can occur with aging but is usually linked to osteoporosis or vertebral fractures, not considered an inevitable, expected change.

C. Close-up of nose with a reddish-purple spot (possible bruise): Might result from trauma, coagulopathy, or medication side effects like anticoagulants, not a routine age-related change.

D. Hands with prominent veins, thin skin, and wrinkles: Thinning skin due to decreased subcutaneous fat. Wrinkles from reduced skin elasticity. Prominent veins due to loss of skin turgor and connective tissue. These are all normal physical findings in older adults.

A. "My doctor will choose which medical procedures I will have." B. "I can revise my living will if I change my mind." C. "My family can change the decisions in my living will." D. "I need an attorney to write my living will."

Correct Answer is B

Explanation

A. "My doctor will choose which medical procedures I will have." A living will allows the client to specify their own wishes regarding medical treatment, rather than leaving decisions solely to the doctor. It is a legal document that guides providers based on the client’s preferences.

B. "I can revise my living will if I change my mind." Clients have the right to update or revoke their living will at any time, reflecting changes in their preferences or health status. This flexibility is an important aspect of advance directives and indicates understanding.

C. "My family can change the decisions in my living will." The family cannot override the client’s living will unless legally appointed as a healthcare proxy. The living will represents the client’s autonomous decisions and must be honored by healthcare providers.

D. "I need an attorney to write my living will." While legal advice can be helpful, clients do not need an attorney to create a living will. Many states provide standardized forms that individuals can complete without legal assistance.

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A nurse is caring for a client who has expressive aphasia. Which of the following techniques should the nurse use to meet the communication needs of this client?

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