What nursing intervention is best to improve communication with a hearingimpaired client?

Correct Answer: D

Rationale: In the context of improving communication with a hearing-impaired client, option D, "Speak slowly and clearly while facing the client," is the best nursing intervention. This approach enhances communication by allowing the client to lip-read and observe facial expressions, aiding in understanding. Speaking slowly and clearly helps the client to catch more words and reduces the chances of miscommunication. Option A, talking in a regular voice in the good ear, is not the best choice as it may still pose challenges for the client to fully grasp the conversation. Option B, talking loudly in the impaired ear, can be uncomfortable and ineffective as it may distort sound and not necessarily improve comprehension. Option C, writing down the message, although useful in some situations, may not always be feasible or practical, especially in spontaneous interactions where immediate communication is needed. In an educational context, understanding the most effective interventions for communicating with hearing-impaired clients is crucial for healthcare professionals, especially nurses. By selecting the appropriate communication strategies, nurses can ensure effective patient-centered care, promote understanding, and build trust with clients who have hearing impairments. This knowledge enhances the overall quality of care provided and supports the principles of patient advocacy and effective communication in healthcare settings.

Correct Answer: D

Rationale: In the context of systemic sclerosis (Scleroderma) with Raynaud's phenomenon, the correct assessment finding the nurse would anticipate is D) Cold and purple nailbeds. Raynaud's phenomenon is characterized by vasospasm of small arteries in response to cold or stress, leading to reduced blood flow to the extremities. This can result in the fingers or toes turning white, then blue/purple, and finally red as circulation improves. Cold and purple nailbeds are indicative of this vascular dysfunction associated with Raynaud's. Option A) Excessive heartburn is not typically associated with Raynaud's phenomenon or systemic sclerosis. Heartburn may be more commonly linked to gastroesophageal reflux disease (GERD) in these patients. Option B) Cyanosis of the lips is a sign of inadequate oxygenation and is not a specific finding related to Raynaud's phenomenon. Cyanosis may occur in conditions such as respiratory distress or heart failure. Option C) Excess wrinkled skin is not a typical assessment finding associated with Raynaud's phenomenon or systemic sclerosis. Skin changes in systemic sclerosis often include skin thickening, tightness, and loss of skin elasticity rather than excess wrinkling. In an educational context, it is crucial for nurses to understand the manifestations of systemic sclerosis and its complications like Raynaud's phenomenon. Recognizing the signs and symptoms of Raynaud's can help nurses provide appropriate care, educate patients on symptom management, and collaborate with the healthcare team to optimize treatment strategies for these complex conditions.

Correct Answer: C

Rationale: In the context of treating rheumatoid arthritis with medications, the expected outcome of decreased pain (option C) is the most appropriate choice among the given options. This is because medications used for rheumatoid arthritis primarily aim to reduce inflammation, which in turn helps alleviate pain associated with the condition. Option A, increased quality of life, is a broad outcome that can result from decreased pain and improved mobility, but it is not as specific to the direct effect of medications on pain relief. Option B, increased range of motion, is also a potential outcome of treatment, but it is more closely related to physical therapy and exercise rather than medication alone. Option D, cure the disease, is incorrect because currently, there is no known cure for rheumatoid arthritis. Medications can help manage symptoms, slow down disease progression, and improve quality of life, but they do not eliminate the disease entirely. In an educational context, understanding the expected outcomes of medication treatment for rheumatoid arthritis is crucial for healthcare professionals to effectively communicate with patients about treatment goals and manage expectations. It also underscores the importance of a multidimensional approach to care that includes medication management, physical therapy, lifestyle modifications, and patient education.

Correct Answer: B

Rationale: In this scenario, the correct term the nurse would use when documenting a wound covered by black and necrotic tissue is "B) Eschar." Eschar refers to the black, hard crust or scab that forms over a wound when dead skin tissue accumulates. This term specifically describes the necrotic tissue covering the wound, indicating a specific characteristic of the wound that needs to be documented accurately. Option A) Tunnelling refers to narrow passageways extending from the wound into the surrounding tissue, which is not the primary characteristic being described in this case. Option C) Blanching refers to the whitening of the skin when pressure is applied, typically seen in pressure injuries, which is not relevant to the scenario. Option D) Cellulitis is a bacterial infection of the skin and underlying tissues, which is not the same as the necrotic tissue covering the wound. Educationally, understanding wound characteristics and appropriate documentation is crucial in nursing practice to communicate effectively with other healthcare team members, track wound healing progress, and determine appropriate treatment interventions. Proper terminology usage ensures clear and accurate communication in the healthcare setting, promoting patient safety and quality care delivery.

Correct Answer: C

Rationale: In this scenario, option C, purulent drainage, is the correct answer indicating a possible infection in a client with AIDS. Purulent drainage is a sign of infection as it represents the presence of pus, which is a result of the body's immune response to an infection. In clients with AIDS, who have compromised immune systems, any signs of infection should be taken seriously and addressed promptly. Option A, respirations at 22 breaths per minute, is a normal respiratory rate and does not specifically indicate infection. Option B, client ambulating 20 feet, is a measure of mobility and does not directly relate to the presence of infection. Option D, oxygen saturation at 97% on room air, is within normal range and does not necessarily point towards infection. Educationally, it is crucial for healthcare providers to be able to recognize signs of infection in clients with AIDS due to their increased susceptibility to infections. Understanding these signs can assist in early detection and prompt treatment, which is vital in managing the health of clients with compromised immune systems.