A nurse is caring for a client who has presbycusis. Which of the following actions should the nurse take?
Sit by the client's side and speak very slowly.
Speak directly to the client, a little more slowly, in a normal, clear voice.
Prepare to remove the blockage in the ear.
Raise your voice and speak loudly and into the client's good ear.
The Correct Answer is B
Choice A reason: Speaking very slowly distorts speech, worsening comprehension in presbycusis, an age-related high-frequency hearing loss. Facing the client aids lip-reading, but excessive slowness disrupts natural cadence, reducing clarity for those with sensorineural deficits typically seen here.
Choice B reason: Speaking directly, slightly slower, in a clear voice enhances understanding in presbycusis. Facing the client supports visual cues, while normal volume avoids distortion, addressing high-frequency loss effectively without assuming blockage or overcompensating unnecessarily for this condition.
Choice C reason: Presbycusis is sensorineural, not conductive from blockages like cerumen. Preparing to remove nonexistent wax misdiagnoses this age-related cochlear degeneration, wasting time and missing the communication adjustments needed for effective care in this scenario entirely.
Choice D reason: Raising the voice distorts sound, worsening presbycusis comprehension, as shouting amplifies lower frequencies, not the lost high ones. Assuming a “good ear” ignores bilateral degeneration, making this less effective than clear, direct speech for communication here.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: Cerebral stagger isn’t a standard term; cerebral damage might cause spasticity, not wide-based ataxia. This lacks specificity for cerebellar signs like staggering, misaligning with the broad, unsteady gait tied to coordination loss in this client fully.
Choice B reason: Scissors gait, from cerebral palsy, shows stiff, crossed legs, not wide-based staggering. This spastic pattern contrasts with the unsteady, broad stance of cerebellar dysfunction, excluding it as the correct description for this presentation entirely here.
Choice C reason: Parkinsonian gait is shuffling with small steps and rigidity, not wide-based or staggering. This contrasts with the unsteady, broad stance of cerebellar ataxia, making it an incorrect match for the client’s observed walking pattern fully here.
Choice D reason: Cerebellar ataxia causes a wide-based, staggering gait due to coordination loss from cerebellar damage. This matches the client’s unsteady walk, reflecting impaired balance and motor control, accurately describing the observed gait pattern comprehensively here.
Correct Answer is D
Explanation
Choice A reason: Impaired judgment suggests frontal lobe pathology, like dementia, not normal aging. Age-related changes slow processing, not executive function, making this a disease sign, not a typical neurological shift in an 81-year-old fully here.
Choice B reason: Loss of remote memory indicates Alzheimer’s, not normal aging. Aging may slow recall, but long-term memory typically persists, excluding this as an expected age-related change in this neurological assessment entirely and accurately here.
Choice C reason: Intention tremors signal cerebellar disease, like Parkinson’s, not aging. Normal aging may reduce fine motor speed, but not cause action tremors, distinguishing this as pathological, not a standard age-related finding fully here.
Choice D reason: Reduced distal sensation, from nerve conduction slowing, is a common age-related change. Aging thins myelin, impairing peripheral nerves, making this the expected finding in an 81-year-old’s neurological exam accurately and comprehensively here.
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