In performing a voice test to assess hearing, which of these actions would the nurse perform?

Shield the lips so that the sound is muffled.

Whisper a set of random numbers and letters, and then ask the patient to repeat them.

Ask the patient to place his finger in his ear to occlude outside noise.

Stand approximately 4 feet away to ensure that the patient can really hear at this distance.

Answer and Explanation

The Correct Answer is B

A. Shield the lips: Shielding the lips ensures the patient is not lip-reading but should not muffle the sound.

B. Whisper random numbers and letters: The whisper test involves standing behind the patient, whispering a series of numbers and letters, and asking the patient to repeat them.

C. Occlude outside noise: Asking the patient to occlude one ear may alter test results.

D. Stand approximately 4 feet away: The whisper test is typically performed from 1-2 feet behind the patient.

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Correct Answer is D

Explanation

A. Subjective vertigo: Subjective vertigo refers to the sensation of being dizzy but without the room spinning. The patient described the sensation of the room spinning.

B. Tinnitus: Tinnitus refers to a ringing or buzzing sound in the ears, not the sensation of the room spinning.

C. Dizziness: Dizziness can refer to a range of symptoms, but the description of the room spinning suggests vertigo, not just dizziness.

D. Objective vertigo: Objective vertigo refers to the sensation that the room is spinning, which the patient describes. This is typically a vestibular issue involving the inner ear.

A. Progressive atrophy of the intramuscular calf veins, causing venous insufficiency B. Narrowing of the inferior vena cava, causing low blood flow and increases in venous pressure resulting in varicosities. C. Peripheral blood vessels growing more rigid with age, producing a rise in systolic blood pressure D. Hormonal changes causing vasodilation and a resulting drop in blood pressure

Correct Answer is C

Explanation

A. Atrophy of calf veins: Vein atrophy is not a normal aging process, although venous insufficiency is common due to other causes.

B. Narrowing of the inferior vena cava: This is not a typical age-related change.

C. Peripheral blood vessels growing more rigid: Arteriosclerosis (hardening of the arteries) is common with aging and leads to increased systolic blood pressure.

D. Hormonal changes causing vasodilation: Aging tends to cause vascular rigidity, not vasodilation, and is more likely to lead to hypertension.

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In performing a voice test to assess hearing, which of these actions would the nurse perform?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

During an examination, the nurse notices that the patient stumbles a little while walking, and, when she sits down, she holds on to the sides of the chair. The patient states, "It feels like the room is spinning!" The nurse notices that the patient is experiencing:

Correct Answer is D

Explanation

During an assessment of an older adult, the nurse should expect to notice which finding as a normal physiologic change associated with the aging process?

Correct Answer is C

Explanation

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