The nurse is performing a middle ear assessment on a 15-year-old patient who has had a history of chronic ear infections. When examining the right tympanic membrane, the nurse sees the presence of dense white patches. The tympanic membrane is otherwise unremarkable. It is pearly, with the light reflex at 5 o'clock and landmarks visible. What should the nurse do?

A. Whisper a set of random numbers and letters, and then ask the patient to repeat them: The whispered voice test is a simple and reliable screening method for hearing loss. The nurse stands about 2 feet behind the patient, whispers a series of random numbers or letters, and asks the patient to repeat them. This helps assess high-frequency hearing loss.

B. Shield the lips so that the sound is muffled: While the test is performed without the patient seeing the nurse’s lips to prevent lip reading, deliberately muffling the sound is unnecessary and may alter the accuracy of the assessment.

C. Stand approximately 6 feet away to ensure that the patient can really hear at this distance: The whispered voice test is conducted at a standard distance of about 2 feet, not 6 feet. Increasing the distance may make the test unreliable.

D. Ask the patient to place his or her finger in their ears to occlude outside noise: The test should be performed in a quiet environment, but instructing the patient to occlude their ears is unnecessary. Instead, the nurse tests one ear at a time by covering the opposite ear.

A. To facilitate the movement of air through the nares: While the ciliated mucous membrane does help in the overall functioning of the nasal passages, its primary role is not to facilitate air movement but to filter and trap particles.

B. To filter coarse particles from inhaled air: The primary purpose of the ciliated mucous membrane in the nose is to trap and filter out coarse particles, such as dust, pollen, and microbes, from inhaled air. The cilia beat in a coordinated manner to move mucus and trapped particles towards the throat, where they can be swallowed or expelled, helping to keep the airways clear and protect the respiratory system.

C. To filter out odors: While the nasal cavity does play a role in detecting odors through the olfactory receptors located in the upper part of the nasal cavity, the ciliated mucous membrane itself is not primarily responsible for filtering odors.

D. To warm the inhaled air: The nasal passages do help warm inhaled air as it passes through, but this is more a function of the rich blood supply and the large surface area of the nasal cavity rather than the role of the ciliated mucous membrane specifically. The primary action of the ciliated mucous membrane is focused on filtering particles from the air.