A nurse is providing a subjective data assessment for an older female. The client verbalizes a list of symptoms regarding their concern. Which findings would lead the nurse to supply education about menopause?

Choice A reason: Speaking very slowly distorts speech, worsening comprehension in presbycusis, an age-related high-frequency hearing loss. Facing the client aids lip-reading, but excessive slowness disrupts natural cadence, reducing clarity for those with sensorineural deficits typically seen here.

Choice B reason: Speaking directly, slightly slower, in a clear voice enhances understanding in presbycusis. Facing the client supports visual cues, while normal volume avoids distortion, addressing high-frequency loss effectively without assuming blockage or overcompensating unnecessarily for this condition.

Choice C reason: Presbycusis is sensorineural, not conductive from blockages like cerumen. Preparing to remove nonexistent wax misdiagnoses this age-related cochlear degeneration, wasting time and missing the communication adjustments needed for effective care in this scenario entirely.

Choice D reason: Raising the voice distorts sound, worsening presbycusis comprehension, as shouting amplifies lower frequencies, not the lost high ones. Assuming a “good ear” ignores bilateral degeneration, making this less effective than clear, direct speech for communication here.

Choice A reason: Medications like antipsychotics can cause tremors, but tongue fasciculations often signal neurological issues, not just drug effects. Reviewing regimen is secondary to assessing cranial nerve XII (hypoglossal), which controls tongue movement, for a more immediate etiology here.

Choice B reason: Diet recall might explore nutritional deficits, but tongue fasciculations tie to nerve or muscle pathology, not food intake. This lacks a direct link to neurological signs, making it less relevant than assessing nerve function for this specific finding fully.

Choice C reason: Thyroid issues cause coarse tremors, not fine fasciculations, which are more neuromuscular. Preparing for screening diverts from the priority of cranial nerve XII assessment, misaligning with the neurological basis of tongue movement observed in this examination entirely.

Choice D reason: Fasciculations suggest cranial nerve XII dysfunction, like in ALS or stroke, affecting tongue motor control. Assessing cranial nerves, especially hypoglossal, directly targets the finding’s neurological root, making it the best response to evaluate this abnormality accurately and promptly.