The young client says, “I’m really stressed out about this pregnancy.” When the Practical Nurse (PN) responds, “What about this pregnancy worries you?”, he or she is using the technique of:

Choice A reason: Speaks in a normal tone is an approach that can best facilitate communication with a 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: Speaks frequently is not an approach that can best facilitate communication with a client who is hearing-impaired. Speaking frequently can overwhelm or fatigue the client, and reduce their ability to process or retain the information. Speaking frequently can also interrupt the client’s thoughts or responses, and prevent them from expressing their needs or concerns. Speaking clearly and concisely, and allowing pauses or breaks, can enhance communication with a client who is hearing-impaired. Therefore, this choice is incorrect.

Choice C reason: Speaks directly into the unaffected ear is not an approach that can best facilitate communication with a client who is hearing-impaired. Speaking directly into the unaffected ear can create an uncomfortable or unnatural position for the client and the nurse, and interfere with eye contact or facial expressions. Speaking directly into the unaffected 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: Speaks in a normal volume is an approach that can best facilitate communication with a client who is hearing-impaired. Speaking in a normal volume can help the client to hear the voice without difficulty or strain, and to avoid embarrassment or irritation. Speaking in a loud volume can make the voice harder to hear or understand, as it can cause background noise, echo, or feedback. Speaking in a loud volume can also imply shouting or anger, which can be disrespectful or offensive to the client. Therefore, this choice is correct.

Choice A reason: This is incorrect because it shows that the problem is not suspected, but rather the client has a desire to improve or maintain a level of health. A wellness nursing diagnosis describes a potential or actual health state that can be enhanced.

Choice B reason: This is incorrect because it shows that the problem is not suspected, but rather the client has a cluster of related problems that are associated with a specific situation or event. A syndrome nursing diagnosis describes a patern of responses that are linked by a common cause.

Choice C reason: This is correct because it shows that the problem is suspected, but lacks enough data to support it. A ‘risk for’ nursing diagnosis describes a potential problem that may occur if certain risk factors are present.

Choice D reason: This is incorrect because it shows that the problem is not suspected, but rather the client has signs and symptoms that indicate an actual health issue. An actual nursing diagnosis describes a current problem that has been validated by data.