A nurse is assessing a client for conductive hearing loss. When using the Rinne test, which of the following results should the nurse identify as an indication that the client has conductive hearing loss of the left ear?
Sound is lateralizing to the right ear.
Sound is lateralizing to the left ear.
Air conduction is greater than bone conduction in the left ear.
Air conduction is less than bone conduction in the left ear.
The Correct Answer is D
Choice A rationale
Sound lateralizing to the right ear during the Rinne test does not indicate conductive hearing loss in the left ear. This result suggests that the right ear may have better hearing or that there is an issue with the left ear, but it does not specifically diagnose conductive hearing loss.
Choice B rationale
Sound lateralizing to the left ear during the Rinne test indicates that the left ear is perceiving the sound better, which could be due to conductive hearing loss in the left ear. However, this option does not provide a definitive result for conductive hearing loss.
Choice C rationale
Air conduction being greater than bone conduction in the left ear is a normal finding and does not indicate conductive hearing loss. In conductive hearing loss, bone conduction is typically better than air conduction.
Choice D rationale
Air conduction being less than bone conduction in the left ear is indicative of conductive hearing loss. This result means that the sound is being conducted through the bones of the skull more effectively than through the air, which is a hallmark of conductive hearing loss.
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Correct Answer is D
Explanation
Choice A rationale
Asking the client if she would prefer a liquid diet does not promote independence in eating. It may limit the client’s dietary options and does not address the need for the client to learn how to eat independently with bilateral eye patches.
Choice B rationale
Assigning an assistive personnel to feed the client does not promote independence. It makes the client reliant on others for feeding, which does not help in developing self-feeding skills.
Choice C rationale
Explaining to the client that her tray is here and placing her hands on it is a step towards promoting independence. However, it does not provide enough information for the client to locate and identify the food items on the tray independently.
Choice D rationale
Describing to the client the location of the food on the tray promotes independence by enabling the client to use her sense of touch and memory to locate and consume the food items without assistance.
Correct Answer is C
Explanation
Choice A rationale
Pitting edema of the hands and fingers is not a typical finding in clients with systemic lupus erythematosus (SLE). Edema can occur in SLE, but it is more commonly associated with renal involvement and not specifically pitting edema of the hands and fingers.
Choice B rationale
Subcutaneous nodules on the ulnar side of the arm are more commonly associated with rheumatoid arthritis rather than SLE. SLE does not typically present with subcutaneous nodules.
Choice C rationale
A dry, red rash across the bridge of the nose and on the cheeks, known as a “butterfly rash,” is a classic sign of SLE. This rash is caused by inflammation of the small blood vessels in the skin and is often exacerbated by sun exposure.
Choice D rationale
A grey-colored, non-purpuric papular rash is not characteristic of SLE. The typical rash in SLE is the butterfly rash, which is dry, red, and raised.