An employee presents to an occupational health nurse with concerns that their hearing is worse on one side. Which of the following actions should the nurse take first to address the employee's concern?

Conduct a physical examination.

Irrigate the ear to remove any obstruction.

Advise the client on the use of ear plugs.

Refer the client to an audiologist.

Answer and Explanation

The Correct Answer is A

Choice A Reason:
Conducting a physical examination is the first step in addressing the employee's concern about hearing loss. This examination allows the nurse to assess the ear for any visible issues, such as earwax buildup, infection, or structural abnormalities. A thorough physical examination can help identify the cause of the hearing loss and determine the appropriate next steps. It is essential to rule out any immediate and easily treatable conditions before proceeding with more specialized interventions.

Choice B Reason:
Irrigating the ear to remove any obstruction, such as earwax, can be an effective treatment for hearing loss caused by cerumen impaction. However, this should only be done after a physical examination confirms that earwax is the cause of the hearing loss. Irrigation without proper assessment can potentially cause harm, especially if there is an underlying infection or perforation of the eardrum.

Choice C Reason:
Advising the client on the use of ear plugs is a preventive measure to protect hearing, particularly in noisy environments. However, this advice does not address the immediate concern of unilateral hearing loss. Ear plugs are more relevant for preventing further hearing damage rather than diagnosing or treating existing hearing issues.

Choice D Reason:
Referring the client to an audiologist is an important step if the initial physical examination does not reveal the cause of the hearing loss or if the hearing loss persists despite initial treatment. Audiologists specialize in diagnosing and treating hearing disorders and can perform comprehensive hearing tests. However, this referral should come after the nurse has conducted a preliminary assessment to rule out any obvious and treatable causes.

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Correct Answer is D

Explanation

Choice A reason: Lack of mentoring
Lack of mentoring can affect a child's academic performance, but it is less likely to be the primary cause of a short attention span and inability to focus. Mentoring programs can help improve academic outcomes by providing guidance, support, and motivation. However, the symptoms described—short attention span and inability to focus—are more directly linked to other underlying issues.

Choice B reason: Transportation challenges
Transportation challenges can lead to increased absenteeism and lower academic performance. However, they are not typically associated with a short attention span or inability to focus. While transportation issues can cause stress and fatigue, they do not directly impact a child's cognitive abilities in the same way that other factors might.

Choice C reason: Unhealthy family relationships
Unhealthy family relationships can significantly impact a child's emotional and psychological well-being, which in turn can affect their academic performance. Children from families with poor communication, high conflict, or lack of support may struggle with concentration and focus. However, the primary symptoms described—short attention span and inability to focus—are more commonly associated with other specific issues.

Choice D reason: Food insecurity
Food insecurity is directly linked to cognitive and behavioral issues in children. Lack of adequate nutrition can lead to difficulties in concentration, short attention span, and overall poor academic performance. Children who do not have reliable access to nutritious food are more likely to experience fatigue, irritability, and difficulty focusing, which aligns with the symptoms described in the scenario.

A. The client reports there are bike paths or running trails in their community. B. The client reports contaminants in their drinking water at home. C. The client reports that there is limited public parking on their street. D. The client reports a lack of community centers in their neighborhood.

Correct Answer is B

Explanation

Choice A Reason:
The client reports there are bike paths or running trails in their community. This statement indicates a positive aspect of the built environment. The presence of bike paths and running trails promotes physical activity and overall well-being. It does not suggest any faults in the built environment.

Choice B Reason:
The client reports contaminants in their drinking water at home. This statement clearly indicates a faulty built environment. Contaminated drinking water poses significant health risks and reflects poor infrastructure or inadequate maintenance of water supply systems. Ensuring access to clean and safe drinking water is a fundamental aspect of a healthy built environment.

Choice C Reason:
The client reports that there is limited public parking on their street. While limited public parking can be an inconvenience, it does not directly indicate a faulty built environment. Parking availability is more related to urban planning and transportation policies rather than the overall quality of the built environment.

Choice D Reason:
The client reports a lack of community centers in their neighborhood. Although the absence of community centers can affect social interactions and community engagement, it does not necessarily indicate a faulty built environment. It highlights a gap in community resources but does not directly impact the safety or health of the environment.

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An employee presents to an occupational health nurse with concerns that their hearing is worse on one side. Which of the following actions should the nurse take first to address the employee's concern?

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