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.
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: "Although I live in the country, my neighbor takes me shopping each week. It takes about 10 minutes for us to drive to the nearest grocery store."
This statement indicates that the client has access to a grocery store within a reasonable driving distance, even though they rely on a neighbor for transportation. While this situation may present some challenges, it does not fit the definition of a food desert, which is characterized by limited access to affordable and nutritious food.
Choice B reason: "Sometimes I get food from the Salvation Army food pantry that is about a half a mile from my house."
This statement suggests that the client has access to a food pantry relatively close to their home. While relying on food pantries can indicate food insecurity, it does not necessarily mean the client lives in a food desert. Food deserts are defined by the lack of access to grocery stores that provide fresh and nutritious food.
Choice C reason: "I am able to walk to a grocery store that is 5 blocks away from my apartment."
This statement indicates that the client has convenient access to a grocery store within walking distance. This accessibility does not align with the characteristics of a food desert, where residents typically have to travel long distances to reach a grocery store.
Choice D reason: "I cannot always afford ride-share services to get to the nearest store, which is 30 minutes away from where I live."
This statement fits the definition of a food desert. The client has to travel a significant distance to reach the nearest grocery store and faces financial barriers to accessing transportation. This limited access to grocery stores that provide fresh and nutritious food is a key characteristic of food deserts.

Correct Answer is A
Explanation
Choice A: "I Will Not Know if I Am Going to Be in the Intervention or Control Group."
This statement indicates an understanding of the concept of blinding in a randomized controlled trial (RCT). In an RCT, participants are randomly assigned to either the intervention group or the control group, and they are often blinded to which group they are in to prevent bias. This helps ensure the validity and reliability of the study results.
Choice B: "The Study Will Last for 10 Years. You Will Contact Me Annually for an Interview and Blood Work."
While this statement may describe the duration and follow-up procedures of some studies, it does not specifically indicate an understanding of the key aspects of a randomized controlled trial, such as randomization and blinding. The focus here is on the logistics rather than the methodology of the RCT.
Choice C: "You'll Need to Find Other Participants Like Me but Who Do Not Have This Disease."
This statement suggests a misunderstanding of the typical participant selection process for an RCT. In many RCTs, especially those testing new treatments, participants are selected based on having the condition being studied. The comparison is usually between those receiving the intervention and those receiving a placebo or standard treatment, not between those with and without the disease.
Choice D: "The Survey Will Take an Hour to Complete and Then I'll Be Done."
This statement indicates a misunderstanding of the nature of participation in an RCT. RCTs often involve multiple assessments, follow-ups, and possibly interventions over a period of time. A single survey is unlikely to encompass the full scope of participation in an RCT.
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