A nurse is completing an admission assessment for a client who has hearing loss. Which of the following actions should the nurse take?

Limit the use of hand gestures when communicating with the client.

Speak to the client with an increased pitch.

Use written materials to assist with communication.

Limit visitors to avoid communication misunderstandings.

Answer and Explanation

The Correct Answer is C

A. Limit the use of hand gestures when communicating with the client. Hand gestures enhance communication for clients with hearing loss. Visual cues such as gestures, facial expressions, and lip reading can help improve understanding.

B. Speak to the client with an increased pitch. Speaking in an increased pitch is not recommended because higher frequencies are often harder for clients with hearing loss to detect. Instead, the nurse should speak clearly, slowly, and in a lower tone.

C. Use written materials to assist with communication. Written materials help clients with hearing loss understand important information, especially if they rely on lip reading or have significant hearing impairment.

D. Limit visitors to avoid communication misunderstandings. Limiting visitors is unnecessary and may lead to social isolation. Instead, the nurse should encourage communication using appropriate strategies, such as writing or sign language.

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Correct Answer is B

Explanation

A. Dryness – Infiltration leads to swelling and fluid accumulation, not dryness.

B. Edema – Infiltration occurs when IV fluids leak into surrounding tissue, causing swelling (edema).

C. Erythema – While redness (erythema) can indicate phlebitis, it is not a primary sign of infiltration.

D. A distended vein – A distended vein is more likely seen with fluid overload or thrombosis, not infiltration.

A. “The body produces antibodies in response to an antigen with active immunity." B. "There is lifelong immunity with passive immunity." C. "The body is able to recognize previous exposure to antigens with passive immunity." D. "There is a short duration of immunity with active immunity."

Correct Answer is A

Explanation

A. "The body produces antibodies in response to an antigen with active immunity." Active immunity develops after exposure to an antigen, leading to antibody production.

B. "There is lifelong immunity with passive immunity." Passive immunity is temporary (e.g., maternal antibodies).

C. "The body is able to recognize previous exposure to antigens with passive immunity." Passive immunity does not create immune memory.

D. "There is a short duration of immunity with active immunity." Active immunity is long-lasting and sometimes lifelong.

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A nurse is completing an admission assessment for a client who has hearing loss. Which of the following actions should the nurse take?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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