An older adult client, reporting a significant loss of hearing ...

[nelaaney]

An older adult client, reporting a significant loss of hearing after being involved in an explosion, asks when hearing will return. Which response by the nurse is most appropriate?
 
  A) Surgery will help restore the hearing you have lost.
  B) The most common cause of hearing impairments is exposure to loud noises.
  C) Loud noises can cause immediate, permanent loss of hearing.
  D) Hearing loss attributed to loud noises is normally reversible.

Question 2

The nurse suspects that a client has a hearing disorder; however, the client denies not being able to hear. Which initial action by the nurse to assess the client's hearing is appropriate?
 
  A) Use an otoscope to visualize the inner ear.
  B) Schedule a Weber and Rinne test.
  C) Confront the client with the suspicion.
  D) Observe the client's interaction with family.

[vkodali]

Answer to Question 1

Answer: C

The loss of hearing attributed to loud noises can have an immediate onset. The loss can be profound and permanent. Even though approximately one-third of hearing impairments are associated with loud noises, it does not explain the client's sudden immediate hearing loss. Promising that surgery will restore the client's hearing is inappropriate and may not be correct.

Answer to Question 2

Answer: D

The most telling of these options would be to observe the client's interactions with family. The nurse should assess for frequent requests to repeat, inattention to conversation, turning one ear to the conversation, and lip-reading. The Weber and Rinne test and use of an otoscope may be a part of an assessment but will not yield as much information as simple observation. The client has already denied having a hearing problem, so confronting the client with the nurse's suspicion will probably only alienate the client from the nurse.

[nelaaney]

Excellent

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