A Practical Nurse (PN) is planning on leaving the room of a patient with a tracheotomy. The PN ensures that the client has which of the following means of communication before leaving the room?

Choice A reason: This is correct because it shows that the PN is respectful and sensitive to the client’s cognitive impairment. Long explanations can confuse and overwhelm the client, who may have difficulty processing and retaining information.

Choice B reason: This is correct because it shows that the PN is respectful and sensitive to the client’s cognitive impairment. Asking one question at a time can help the client focus and respond more easily, without feeling pressured or frustrated.

Choice C reason: This is correct because it shows that the PN is respectful and sensitive to the client’s cognitive impairment. Using short sentences can help the client understand and remember the message, without being distracted or confused by unnecessary words.

Choice D reason: This is incorrect because it shows that the PN is rude and disrespectful to the client’s hearing ability. Talking loudly can make the client feel annoyed or threatened, and may not improve communication if the client has hearing loss. The PN should talk in a normal tone and check for understanding.

Choice A reason: The nursing assistant is speaking in a normal tone is an action that the PN should not intervene in during communication with the client who is hearing impaired. Speaking in a normal tone can help the client to hear the natural variations and inflections of the voice, and to avoid distortion or confusion. Speaking in a high-pitched or

low-pitched tone can make the voice harder to hear or understand, especially if the client has a hearing loss in a specific frequency range. Therefore, this choice is correct.

Choice B reason: The nursing assistant is facing the client while speaking is an action that the PN should not intervene in during communication with the client who is hearing impaired. Facing the client while speaking can help the client to see the facial expressions and lip movements of the speaker, and to enhance visual cues and feedback. Facing away from the client while speaking can make the voice muffled or unclear, and can interfere with eye contact or rapport. Therefore, this choice is correct.

Choice C reason: The nursing assistant is speaking directly into the impaired ear is an action that the PN should intervene in during communication with the client who is hearing impaired. Speaking directly into the impaired ear can create an uncomfortable or unnatural position for the client and the speaker, and interfere with eye contact or facial expressions. Speaking directly into the impaired ear can also create a loud or distorted sound that may be unpleasant or painful for the client. Speaking face-to-face, and slightly toward the unaffected ear, can improve communication with a client who is hearing impaired. Therefore, this choice is incorrect.

Choice D reason: The nursing assistant is speaking clearly to the client is an action that the PN should not intervene in during communication with the client who is hearing impaired. Speaking clearly to the client can help the client to hear and understand the words and sentences of the speaker, and to avoid miscommunication or misunderstanding. Speaking unclearly to the client can make the voice garbled or incomprehensible, and can cause frustration or confusion. Therefore, this choice is correct.