An employee presents to an occupational health nurse with concerns that their hearing is worse on one side. Which of the following actions should the nurse take first to address the employee's concern?

Conduct a physical examination.

Irrigate the ear to remove any obstruction.

Advise the client on the use of ear plugs.

Refer the client to an audiologist.

Answer and Explanation

The Correct Answer is A

Choice A Reason:
Conducting a physical examination is the first step in addressing the employee's concern about hearing loss. This examination allows the nurse to assess the ear for any visible issues, such as earwax buildup, infection, or structural abnormalities. A thorough physical examination can help identify the cause of the hearing loss and determine the appropriate next steps. It is essential to rule out any immediate and easily treatable conditions before proceeding with more specialized interventions.

Choice B Reason:
Irrigating the ear to remove any obstruction, such as earwax, can be an effective treatment for hearing loss caused by cerumen impaction. However, this should only be done after a physical examination confirms that earwax is the cause of the hearing loss. Irrigation without proper assessment can potentially cause harm, especially if there is an underlying infection or perforation of the eardrum.

Choice C Reason:
Advising the client on the use of ear plugs is a preventive measure to protect hearing, particularly in noisy environments. However, this advice does not address the immediate concern of unilateral hearing loss. Ear plugs are more relevant for preventing further hearing damage rather than diagnosing or treating existing hearing issues.

Choice D Reason:
Referring the client to an audiologist is an important step if the initial physical examination does not reveal the cause of the hearing loss or if the hearing loss persists despite initial treatment. Audiologists specialize in diagnosing and treating hearing disorders and can perform comprehensive hearing tests. However, this referral should come after the nurse has conducted a preliminary assessment to rule out any obvious and treatable causes.

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Correct Answer is D

Explanation

Choice A: Develop a Team Strategy
Developing a team strategy is an important step in the CHANGE model, but it is not the first step. Before a strategy can be developed, it is essential to have a team in place. The team will collaborate to create a strategy that aligns with the community's needs and goals.

Choice B: Gather Data
Gathering data is a crucial part of the community assessment process. However, it is not the initial step in the CHANGE model. Data collection comes after the team has been assembled and a strategy has been developed. The team needs to be in place to determine what data is needed and how it will be collected.

Choice C: Build the Community Action Plan
Building the community action plan is a later step in the CHANGE model. This step involves using the data collected to develop a plan that addresses the community's health needs. The action plan is created after the team has been assembled, a strategy has been developed, and data has been gathered.

Choice D: Assemble the Team
This is the correct first step in the CHANGE model. Assembling the team involves bringing together a diverse group of stakeholders who will work collaboratively to assess the community and develop an action plan. The team typically includes representatives from various sectors of the community, such as health care, education, business, and local government.

A. The client reports there are bike paths or running trails in their community. B. The client reports contaminants in their drinking water at home. C. The client reports that there is limited public parking on their street. D. The client reports a lack of community centers in their neighborhood.

Correct Answer is B

Explanation

Choice A Reason:
The client reports there are bike paths or running trails in their community. This statement indicates a positive aspect of the built environment. The presence of bike paths and running trails promotes physical activity and overall well-being. It does not suggest any faults in the built environment.

Choice B Reason:
The client reports contaminants in their drinking water at home. This statement clearly indicates a faulty built environment. Contaminated drinking water poses significant health risks and reflects poor infrastructure or inadequate maintenance of water supply systems. Ensuring access to clean and safe drinking water is a fundamental aspect of a healthy built environment.

Choice C Reason:
The client reports that there is limited public parking on their street. While limited public parking can be an inconvenience, it does not directly indicate a faulty built environment. Parking availability is more related to urban planning and transportation policies rather than the overall quality of the built environment.

Choice D Reason:
The client reports a lack of community centers in their neighborhood. Although the absence of community centers can affect social interactions and community engagement, it does not necessarily indicate a faulty built environment. It highlights a gap in community resources but does not directly impact the safety or health of the environment.

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An employee presents to an occupational health nurse with concerns that their hearing is worse on one side. Which of the following actions should the nurse take first to address the employee's concern?

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