A nurse is caring for a client who has hearing loss. While communicating with the client, which of the following actions should the nurse take?

Emphasize vowel sounds when speaking.

Sit next to the client when speaking to them.

Lower the tone of voice at the end of each sentence.

Decrease background noise when talking with the client.

Answer and Explanation

The Correct Answer is D

A. Emphasize vowel sounds when speaking. Consonants are typically more difficult to hear than vowels, and overemphasizing vowels can distort speech and make it harder to understand. Clear, natural enunciation is more effective.
B. Sit next to the client when speaking to them. Sitting in front of the client is more effective, as it allows the client to read lips and observe facial expressions, both of which are important in supporting communication for individuals with hearing loss.
C. Lower the tone of voice at the end of each sentence. Lowering pitch or volume at the end of sentences can make speech harder to follow. A steady, moderate tone throughout conversation is more helpful and easier to understand.
D. Decrease background noise when talking with the client. Reducing environmental noise helps the client focus on the speaker’s voice, improving their ability to hear and comprehend the message. It’s one of the most effective strategies in communication with hearing-impaired individuals.

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Correct Answer is C

Explanation

A. A client who has a forehead wound that is bleeding copiously. Although bleeding may appear dramatic, most scalp wounds bleed heavily and can be controlled with pressure. This is not immediately life-threatening if the client is stable.
B. A client who has a compound fracture of the femur and is crying in pain. This is a serious injury with risk for blood loss and infection, but the client is alert and stable enough to express pain, suggesting less immediate neurologic risk than other clients.
C. A client who was unconscious at the scene and now reports diplopia and nausea. This client likely has a head injury with signs of increased intracranial pressure or concussion (diplopia = double vision, nausea, and prior loss of consciousness). These are neurological red flags and require immediate evaluation to prevent deterioration.
D. A client who has several missing teeth and a swollen, ecchymotic upper lip. While painful and concerning, oral trauma without airway compromise is less urgent than potential brain injury.

A. Temperature 38.2° C (100.8° F) B. Heart rate 104/min C. Client reports feeling unwell D. Lung sounds clear but diminished in the bases E. Fundus boggy but firmed with massage F. Moderate amount of dark brown, foul-smelling lochia noted G. No bowel movement since birth, hypoactive bowel sounds H. WBC count 33,000/mm3 (5,000 to 10,000/mm)

Correct Answer is ["A","B","C","D","E","F","G","H"]

Explanation

Client reports feeling unwell: This is clinically significant when combined with fever, foul-smelling lochia, and elevated WBCs; it could indicate systemic infection such as endometritis.
Fundus boggy but firms with massage: Indicates uterine atony, a risk factor for postpartum hemorrhage. Even if it responds to massage, repeated bogginess suggests the need for uterotonic medications and close monitoring.
Foul-smelling, dark brown lochia: These findings are highly suggestive of uterine infection (endometritis), especially when paired with uterine tenderness, fever, and elevated WBCs.
WBC count 33,000/mm³: Severely elevated — well above normal postpartum leukocytosis (typically up to 20,000/mm³). A level of 33,000 strongly suggests an ongoing infectious process.
Temperature 38.2°C (100.8°F): Slightly elevated, and while low-grade fever is common postpartum, when associated with uterine tenderness and abnormal lochia, it raises concern for infection and should be monitored and managed appropriately.
Lung sounds diminished in the bases: Could be due to post-surgical hypoventilation, immobility, or atelectasis. Should prompt encouragement of deep breathing, incentive spirometry, and ambulation.
No bowel movement since birth, hypoactive bowel sounds: This is a common post-cesarean finding due to anesthesia and immobility, but it still indicates delayed return of GI function and should be monitored for signs of ileus.

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A nurse is caring for a client who has hearing loss. While communicating with the client, which of the following actions should the nurse take?

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