A patient came with a right ear sensorineural hearing loss. What should the nurse expect while performing the Weber test?

A. Assist the client to a standing position: While positioning can be important for various assessments, inspecting the apical impulse is best done with the client in a supine or left lateral position. Standing may not provide the best view or palpation for the apical impulse, which is usually assessed more accurately in a different position.

B. Focus a penlight on the client's chest: A penlight alone may not provide sufficient illumination for detailed inspection of the apical impulse. It is more important to use appropriate lighting techniques to ensure a clear view of the heart's movements.

C. Use tangential lighting: Tangential lighting is particularly useful for inspecting and palpating the apical impulse because it casts light across the surface, highlighting contours and movements. This type of lighting helps the nurse visualize the apical impulse more clearly by creating shadows that accentuate the impulse's presence and movements.

D. Use perpendicular lighting: Perpendicular lighting might not be as effective in highlighting the subtle movements of the apical impulse. Tangential lighting is preferred because it creates shadows and contrasts that make the apical impulse more visible and easier to assess.

A) Diabetic Neuropathy: Diabetic neuropathy is a common complication of diabetes that affects the nerves, particularly in the extremities. Symptoms include decreased sensation, numbness, and the development of non-healing ulcers on the feet due to loss of protective sensation and poor wound healing. This condition aligns with the patient's symptoms of decreased sensation and non-healing foot ulcers.
B) Chronic Arterial Insufficiency: Chronic arterial insufficiency typically presents with symptoms such as intermittent claudication (pain or cramping in the legs during activity), cold or pale extremities, and ulcers on the toes or feet that often have a more well-defined border. The non-healing ulcers and decreased sensation described are more characteristic of diabetic neuropathy than arterial insufficiency.
C) Lymphedema: Lymphedema is characterized by swelling due to lymph fluid accumulation, often affecting the lower extremities. While it can cause skin changes and ulcers, it is less commonly associated with decreased sensation and is more likely to present with swelling and skin changes rather than the specific combination of symptoms described.
D) Chronic Venous Insufficiency: Chronic venous insufficiency involves issues with blood return from the legs to the heart, leading to symptoms such as swelling, varicose veins, and ulcers typically around the ankles. It is usually associated with aching, heaviness, and swelling rather than the decreased sensation and non-healing ulcers seen in diabetic neuropathy.