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The client is undergoing a tuning fork test to assess for hearing conduction. The nurse performs a Rinne test. How will this test be performed?

Have the client close their eyes, lightly rub fingers together 12 inches away from the ear, and have the client identify which side the sound is heard.

First, place the tuning fork on the mastoid process behind the ear. When the client states the sound is no longer heard, place the tuning fork beside the ear.

Strike the tuning fork and place it in the center of the skull.

Stand three feet away and have the client repeat back what you have whispered.

Answer and Explanation

The Correct Answer is B

In the Rinne test, the nurse first places a tuning fork on the mastoid process behind the ear, and when the client states that the sound is no longer heard, the tuning fork is placed beside the ear. This test is done to compare bone conduction with air conduction. When sound is no longer heard via bone conduction, the sound will still be heard via air conduction.

Choice A is incorrect because it describes the Weber test, not the Rinne test.

Choice C is incorrect because it is not a standard hearing test.

Choice D is incorrect because it describes the Whisper test, which is also used to test for hearing loss.

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Correct Answer is B

Explanation

. A biopsy is a procedure in which a sample of tissue is removed from the suspicious area and examined under a microscope to determine if the lump is cancerous or benign. An ultrasound uses sound waves to create an image of the breast tissue and is often used to evaluate the lump further. A clinical breast exam is a physical examination of the breast by a healthcare provider. Magnetic resonance imaging (MRI) may be used to obtain additional information about the lump, but it is not the primary diagnostic test.

A. Client states a piercing feeling. B. Physician maintains aseptic procedure. C. Client states pressure relief in the head. D. Cerebrospinal fluid is cloudy in nature.

Correct Answer is D

Explanation

Cerebrospinal fluid is cloudy in nature. Cloudy cerebrospinal fluid is a sign of infection or inflammation in the central nervous system, and lumbar puncture can be used to obtain cerebrospinal fluid for diagnostic purposes. The nurse should report this finding immediately to the physician for further evaluation and management.

Choice A, client states a piercing feeling, is incorrect because a piercing feeling is common during the procedure due to the insertion of the needle into the subarachnoid space.

Choice B, physician maintains aseptic procedure, is incorrect because maintaining aseptic technique during the procedure is standard protocol to prevent infection.

Choice C, client states a pressure relief in the head, is incorrect because this is not a concerning finding during the procedure.

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The client is undergoing a tuning fork test to assess for hearing conduction. The nurse performs a Rinne test. How will this test be performed?

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Naxlex Comprehensive Predictor Exams

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Correct Answer is B

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Correct Answer is D

Explanation

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