A client of the Islamic faith refuses to eat a hot dog on his tray because he is afraid that it may contain pork products. Which of the following is the best response by the Practical Nurse (PN)?

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: Counteract shyness in the client is not the major effect of maintaining eye contact for 2 to 6 seconds during communication. Eye contact is a nonverbal cue that involves looking at the other person’s eyes or face while communicating. It can have different meanings and effects depending on the culture, context, and relationship of the communicators. Maintaining eye contact for 2 to 6 seconds can help to establish rapport, show interest, or convey sincerity, but it may not necessarily counteract shyness in the client. In fact, some clients may feel uncomfortable, intimidated, or threatened by too much eye contact, especially if they are shy, anxious, or from a different cultural background. Therefore, this choice is incorrect.

Choice B reason: Keep the Practical Nurse’s atention on the conversation is not the major effect of maintaining eye contact for 2 to 6 seconds during communication. Eye contact is a nonverbal cue that involves looking at the other person’s eyes or face while communicating. It can have different meanings and effects depending on the culture, context, and relationship of the communicators. Maintaining eye contact for 2 to 6 seconds can help to keep the

Practical Nurse’s atention on the conversation, but it is not the main purpose or outcome of doing so. The main purpose or outcome of maintaining eye contact is to communicate with the other person effectively and respectfully, not to focus on oneself or one’s own behavior. Therefore, this choice is incorrect.

Choice C reason: Assess if the client is involved in the conversation is not the major effect of maintaining eye contact for 2 to 6 seconds during communication. Eye contact is a nonverbal cue that involves looking at the other person’s eyes or face while communicating. It can have different meanings and effects depending on the culture, context, and relationship of the communicators. Maintaining eye contact for 2 to 6 seconds can help to assess if the client is involved in the conversation, but it is not the only or most reliable way of doing so. The Practical Nurse should also pay atention to other verbal and nonverbal cues from the client, such as their tone of voice, facial expressions, body language, or feedback. Therefore, this choice is incorrect.

Choice D reason: Indicate continuous focused atention is the major effect of maintaining eye contact for 2 to 6 seconds during communication. Eye contact is a nonverbal cue that involves looking at the other person’s eyes or face while communicating. It can have different meanings and effects depending on the culture, context, and relationship of the communicators. Maintaining eye contact for 2 to 6 seconds can indicate continuous focused atention, which means that the Practical Nurse is listening actively, understanding empathetically, and responding appropriately to the client’s message. It can also show respect, interest, or sincerity to the client, and enhance rapport and trust between them. Therefore, this choice is correct.