A client has been receiving intravenous antibiotics (ototoxic) for several weeks. Which prevention strategy would be best for the nurse to recommend for this client?

Formal hearing test.

Rubbing fingers test.

Tuning fork test.

Whisper hearing test.

Answer and Explanation

The Correct Answer is A

Choice A reason:
A formal hearing test, or audiometry, is the most comprehensive method for assessing hearing loss, which can be a side effect of ototoxic medications. These tests can detect both conductive and sensorineural hearing loss, providing a detailed profile of hearing function across different frequencies. For clients receiving ototoxic antibiotics, regular monitoring through formal hearing tests is recommended to detect any early signs of hearing impairment and to implement timely interventions.
Choice B reason:
The rubbing fingers test is a rudimentary hearing screening method where the examiner rubs their fingers together near the patient's ear, asking them to indicate when they hear the sound. While this test can be used as a quick check for hearing loss, it is not as sensitive or specific as formal audiometry and may not detect early or mild hearing loss caused by ototoxic drugs.
Choice C reason:
Tuning fork tests, such as the Weber and Rinne tests, are used to differentiate between conductive and sensorineural hearing loss. These tests can be useful in a clinical setting to provide immediate information about the type of hearing loss; however, they are not as comprehensive as formal hearing tests and may not be sufficient for monitoring ototoxicity.
Choice D reason:
The whisper hearing test involves the examiner whispering words or numbers and asking the patient to repeat them. This test can be useful for detecting significant hearing loss but may not be sensitive enough to detect the early stages of ototoxicity. Moreover, the test's accuracy can be affected by the examiner's voice level and the testing environment.

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Correct Answer is B

Explanation

Choice a reason:
Educational Prevention is not a recognized level of prevention in healthcare. While education is a key component in all levels of prevention, it is not a standalone category. Education is typically included in primary prevention as it involves informing the public about health practices to prevent the onset of disease.

Choice b reason:
Tertiary Prevention is the level of prevention that aims to manage and treat an existing disease to prevent further complications or deterioration. In the case of immobile stroke patients, tertiary prevention would involve measures to prevent skin breakdown and other complications associated with immobility and the stroke's long-term effects.

Choice c reason:
Secondary Prevention involves early detection and prompt intervention to prevent the progression of a disease. For stroke patients, secondary prevention might include monitoring for signs of skin breakdown so that early treatment can be initiated. However, the scenario described focuses on managing an existing condition rather than early detection.

Choice d reason:
Primary Prevention aims to prevent the disease or injury before it occurs. This would involve strategies to prevent strokes in the first place, such as controlling high blood pressure or encouraging healthy lifestyle changes. It does not directly relate to the prevention of skin breakdown in patients who have already had a stroke.

A. Begin above the right clavicle and percuss each section, comparing the right chest with the left chest. B. Begin at the sternal notch and percuss all areas on the left chest, then all areas on the right chest. C. Begin at the sternal notch and percuss all areas on the right chest, then all areas on the left chest. D. Begin above the left clavicle and percuss all areas on the left chest, then reverse the process and assess the right chest, moving upward from the liver.

Correct Answer is A

Explanation

Choice A Reason:
This approach is recommended as it allows for a systematic comparison between the two sides of the chest. Percussion should start at the apices of the lungs, which are located just above the clavicles, and proceed downwards. This method ensures that any differences in percussion note, which could indicate underlying pathology, are identified by direct comparison.

Choice B Reason:
While this approach also involves a systematic assessment, it does not allow for immediate comparison between the two sides of the chest. It is important to compare corresponding areas on each side as you go to detect any asymmetry or changes in resonance.

Choice C Reason:
This method, similar to choice B, does not facilitate immediate side-to-side comparison during the assessment. Immediate comparison is crucial for identifying subtle differences that may indicate conditions such as pleural effusion or pneumothorax.

Choice D Reason:
Starting the percussion above the left clavicle and moving to the right chest after completing the left side does not allow for direct comparison of symmetrical chest areas. Additionally, assessing the right chest moving upward from the liver is not a standard practice, as the liver dullness can interfere with the percussion of the lower right lung fields.

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A client has been receiving intravenous antibiotics (ototoxic) for several weeks. Which prevention strategy would be best for the nurse to recommend for this client?

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Naxlex Comprehensive Predictor Exams

A nurse educator is presenting at a continuing education seminar for nurses. As part of his presentation, he is emphasizing the prevention of skin breakdown in immobile patients who have suffered from a stroke. The level of prevention being discussed by the nurse educator is:

Correct Answer is B

Explanation

The nurse is preparing to percuss a client's anterior chest area. Which approach will the nurse use for this assessment?

Correct Answer is A

Explanation

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