An older adult female client is hospitalized with a fractured femur. During a routine nursing assessment, she repeatedly asks the nurse to “speak up” so that she can hear the questions. Which action is best for the nurse to take?
Raise voice volume to a shout
Over-enunciate word syllables
Decrease speaking speed
Exaggerate nonverbal expressions
The Correct Answer is C
Choice A reason: Shouting increases volume but may distort speech, worsening comprehension for an older adult with hearing loss. Age-related presbycusis impairs high-frequency sound perception, and shouting can cause discomfort without improving clarity, making this an ineffective communication strategy for the client.
Choice B reason: Over-enunciating syllables may help slightly but can sound unnatural, confusing the client. It does not address the primary issue of processing speed in age-related hearing loss, where slower speech allows better auditory processing, making this less effective than reducing speaking speed.
Choice C reason: Decreasing speaking speed is best, as presbycusis slows auditory processing in older adults. Slower speech allows the client to process sounds clearly, improving comprehension without distortion, addressing the client’s difficulty hearing questions effectively and enhancing communication during the assessment.
Choice D reason: Exaggerating nonverbal expressions aids visual cues but does not address auditory comprehension. Hearing loss requires auditory adjustments, and nonverbal cues alone are insufficient for understanding spoken questions, making this less effective than slowing speech to improve verbal clarity.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: Chronic constipation and gastrin levels are irrelevant to pancreatitis. Gastrin relates to gastric acid production, not pancreatic inflammation. Pancreatitis is confirmed by amylase/lipase elevation, and constipation does not reflect its severity, making this information less valuable for reporting.
Choice B reason: Bowel sounds and abdominal pain degree provide general data but are non-specific. Pancreatitis requires amylase/lipase levels for diagnosis, and nausea/vomiting severity better indicates clinical status, making this information secondary to laboratory confirmation and symptom severity.
Choice C reason: Severity of nausea and vomiting and serum amylase results are critical, as elevated amylase confirms pancreatitis, and nausea/vomiting severity reflects disease impact. These directly inform the provider about pancreatic inflammation and clinical status, making this the most valuable information to report.
Choice D reason: H. pylori antibodies and urine output are unrelated to pancreatitis. H. pylori causes gastritis, and urine output monitors hydration, but amylase and nausea/vomiting directly address pancreatitis’s diagnosis and severity, making this information less relevant for immediate reporting.
Correct Answer is C
Explanation
Choice A reason: Monitoring urine output assesses fluid status but does not directly prevent hypernatremia, which results from excess sodium or water loss. Reducing dietary sodium intake is more proactive, as urine output is a secondary indicator, making this instruction less effective for management.
Choice B reason: Using salt tablets after exercise is dangerous, as they increase sodium intake, worsening hypernatremia. This condition requires sodium reduction and water replacement, making this instruction harmful, as it exacerbates elevated serum sodium levels, risking neurological complications.
Choice C reason: Reviewing food labels for sodium content is critical, as hypernatremia results from high sodium intake or water loss. Limiting dietary sodium prevents further elevation of serum sodium, protecting against cerebral edema or seizures, making this the most effective discharge instruction.
Choice D reason: Drinking water when thirsty helps hydration but is reactive and insufficient for hypernatremia, which requires proactive sodium reduction. Thirst may be impaired in some patients, and dietary sodium control is more direct, making this instruction less comprehensive than label review.
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