A patient is diagnosed with left ear unilateral sensorineural hearing loss. During the performance of the Weber test, the nurse expects lateralization of the sound/vibration to the:

Choice A reason:
Peripheral vision is the ability to see objects and movement outside of the direct line of vision. This type of vision is assessed using different methods, such as confrontation visual field testing, where the examiner moves objects into the patient's side vision from different angles. Standing 20 feet away from a chart would not be the appropriate method to assess peripheral vision.
Choice B reason:
The assessment of external eye structures involves examining the physical appearance and condition of the eyelids, sclera, conjunctiva, and surrounding areas. This is typically done at a close range and does not require the patient to stand at a distance from a chart. The nurse would inspect these structures directly, often with the aid of a penlight for better visibility.

Choice C reason:
Distant vision is the ability to see objects far away, and it is what the nurse is preparing to assess when the client is asked to stand 20 feet from a chart. This distance is standard for the Snellen eye chart, which is used to measure visual acuity. The chart has rows of letters that decrease in size, and the patient is asked to read the smallest line of letters they can see clearly. The Snellen chart is the most common method used by eye doctors to measure visual acuity.
Choice D reason:
Near vision is the ability to see objects that are close to the eyes clearly. It is assessed using different charts, such as the Jaeger eye chart, which contains blocks of text in various type sizes. The patient is asked to read the text at a close range, typically around 14 inches, not 20 feet. Therefore, standing 20 feet away from a chart would not be the method to assess near vision.

Choice a reason:
Obtaining and checking the needed equipment is essential before conducting a physical examination. This ensures that all necessary tools are functional and readily available, which facilitates a smooth and efficient assessment process. It also minimizes interruptions that could cause discomfort or anxiety for the client.
Choice b reason:
While turning on relaxing music of the client's choice may create a calming environment, it is not a standard procedure before a physical examination. Music preferences are subjective, and what is relaxing for one person may be distracting for another. Additionally, music could interfere with the ability to hear heart, lung, or bowel sounds during auscultation.
Choice c reason:
Identifying ways to ensure client privacy is a fundamental nursing responsibility. It respects the client's dignity and promotes a sense of safety and comfort. Privacy can be ensured by closing curtains, securing the area, and making sure the examination is conducted in a private setting.
Choice d reason:
Washing hands is a critical step before any physical examination. It is a primary measure for infection control, protecting both the nurse and the client from potential transmission of microorganisms.
Choice e reason:
Dimming the lighting to promote comfort is not typically recommended before a physical examination. Adequate lighting is crucial for the inspection phase of the examination, allowing the nurse to observe the client's general appearance, skin color, and other physical characteristics accurately.