While inspecting the tympanic membrane the nurse notes a pearly gray and shiny appearance. What would this finding indicate?

Choice A reason: Annual hearing screenings detect loss, not prevent it. In manufacturing, where noise exposure is immediate, this reactive measure doesn’t address the primary risk of loud machinery damaging cochlear hair cells, missing proactive protection entirely.

Choice B reason: Avoiding ototoxic drugs like aminoglycosides prevents chemical hearing damage, but manufacturing noise is the dominant risk. This advice is secondary to physical noise control, less relevant to the plant’s environmental hazard than direct protective measures here.

Choice C reason: Hearing protectors, like earplugs, block noise above 85 decibels, preventing cochlear damage in loud manufacturing settings. This primary prevention targets the main risk—prolonged sound exposure—directly safeguarding workers’ auditory health effectively and immediately in context.

Choice D reason: Stating noise above 85 decibels causes loss educates but doesn’t prevent. It’s factual—hair cells die from overexposure—but lacks actionable protection for manufacturing workers facing this risk daily, making it less practical than wearing protectors.

Choice A reason: Tonsils touching the uvula indicate 4+ grading, where they obstruct over 75% of the oropharynx. This severe enlargement, with sore throat, fits the highest scale, reflecting significant inflammation or infection impacting airway and swallowing, accurately documented here.

Choice B reason: 1+ tonsils are slightly enlarged, less than 25% of the oropharynx, visible but not near the uvula. This underestimates the finding of tonsils contacting the uvula, misrepresenting the degree of obstruction and inflammation present in this case entirely.

Choice C reason: 2+ tonsils occupy 25-50% of the oropharynx, not touching the uvula. This moderate grade doesn’t match the observed contact, understating the severity of enlargement and potential airway compromise noted during the inspection clearly and significantly.

Choice D reason: 3+ tonsils cover 50-75% of the oropharynx, nearing but not contacting the uvula. This is close but inaccurate, as the finding shows full contact, warranting the higher 4+ grade for precise documentation of this advanced tonsillar size fully.