A nurse is admitting a client who has a partial hearing loss. Which of the following is the priority action by the nurse?
Rephrase statements the client does not hear.
Determine if the client uses hearing aids.
Speak using his usual tone of voice and directly in front of the client.
Use hand gestures to communicate.
The Correct Answer is B
Choice A rationale
Rephrasing statements the client does not hear is helpful but not the priority action. The priority is to determine if the client uses hearing aids to ensure they can hear instructions and communication effectively.
Choice B rationale
Determining if the client uses hearing aids is the priority action. Ensuring the client has and uses their hearing aids can significantly improve communication and care.
Choice C rationale
Speaking using the usual tone of voice and directly in front of the client is important but secondary to ensuring the client has their hearing aids.
Choice D rationale
Using hand gestures to communicate can be helpful but is not the priority action. The primary focus should be on ensuring the client has their hearing aids for optimal hearing.
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Correct Answer is ["A","C","D"]
Explanation
Choice A rationale
A family history of breast cancer is a significant risk factor because genetic mutations, such as BRCA1 and BRCA2, can be inherited and increase the likelihood of developing breast cancer.
Choice B rationale
Multiparity (having multiple pregnancies) is generally considered to reduce the risk of breast cancer. This is because pregnancy and breastfeeding lower the number of menstrual cycles a woman has, reducing her lifetime exposure to estrogen.
Choice C rationale
Exposure of the chest to high-dose radiation, especially during childhood or young adulthood, increases the risk of breast cancer. Radiation can cause mutations in breast cells, leading to cancer.
Choice D rationale
Previous cancer of the breast, uterus, or ovaries increases the risk of developing breast cancer. This is due to shared risk factors and the possibility of metastasis or recurrence.
Correct Answer is C
Explanation
Choice A rationale
Auscultating for wheezing is important but not the first action. The priority is to administer epinephrine to counteract the severe allergic reaction.
Choice B rationale
Assessing the client’s level of consciousness is important but not the first action. Administering epinephrine takes precedence to stabilize the client’s condition.
Choice C rationale
Administering epinephrine is the first action. It is crucial to counteract the severe allergic reaction and prevent further complications.
Choice D rationale
Monitoring for hypotension is important but not the first action. Administering epinephrine is the priority to stabilize the client’s condition.