Author Question: Which interventions should the nurse perform when an older patient reports a change in hearing? ... (Read 77 times)

biggirl4568 · **on:** Jul 11, 2018

Which interventions should the nurse perform when an older patient reports a change in hearing? Standard Text: Select all that apply.

1. Perform a Rinne test.
2. Eliminate extraneous noise.
3. Review prescribed medications.
4. Report the change to the physician.
5. Speak in a tone that includes shouting.

Question 2

The nurse is assisting a graduate nurse to develop a plan of care for a newly admitted client. The client has been diagnosed with pneumonia and has a Stage II pressure ulcer.

Which of the following nursing diagnoses will be of the greatest initial importance when planning care?
A) Potential for infection related to impaired skin integrity
B) Pain related to destruction of tissue
C) Knowledge deficit related to care of skin disorder
D) Risk for infection related to impaired skin integrity

AaaA · **Reply #1 on:** Jul 11, 2018

Answer to Question 1

2,3,4
Rationale: A Rinne test is not appropriate at this time because it is a diagnostic test that evaluates air and bone conduction.

Answer to Question 2

B