A patient roughly asks the nurse to bring him some ice cream. An assertive response by the nurse is:

Choice A reason: Maslow’s hierarchy of needs is a framework for prioritizing human needs, but it is not an organized approach for performing a physical examination. A physical examination should be systematic and comprehensive, not based on subjective preferences or assumptions. Therefore, this choice is incorrect.

Choice B reason: A head-to-toe assessment is an organized approach for performing a physical examination that covers all the major body systems and regions. It allows the nurse to identify any abnormalities or changes in the client’s health status and to document the findings in a consistent manner. Therefore, this choice is correct.

Choice C reason: Subjective data collection is the process of obtaining information from the client about their symptoms, feelings, beliefs, and preferences. It is an important part of the nursing assessment, but it is not an organized approach for performing a physical examination. A physical examination requires objective data collection, which involves observing, measuring, and testing the client’s physical signs. Therefore, this choice is incorrect.

Choice D reason: Review of systems is an organized approach for performing a physical examination that focuses on each body system separately and asks specific questions related to its function and problems. It helps the nurse to elicit relevant information from the client and to detect any abnormalities or deviations from normal. Therefore, this choice is correct.

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.