An older adult with hearing loss repeatedly asks the nurse to repeat discharge instructions. Which action should the nurse take?
1Speak from the doorway in a louder voice while the client reads the paperwork
2Raise the pitch of each word and repeat the instructions without pausing
3Ask a family member to answer questions while the client watches the conversation
4Face the client in a quiet, well-lit area and speak clearly without shouting✓ Correct answer
Explanation
Facing the client preserves visual speech cues, and reducing background noise improves the signal the client needs to hear. Clear speech without shouting supports understanding; the nurse should then verify comprehension directly with the client.
Quick answer Move to a quiet, well-lit area, face the client, and speak clearly without shouting. This combines auditory and visual cues and keeps communication directed to the client.
Why this is correct Hearing loss makes speech harder to distinguish, especially when background noise competes with the speaker. Facing the client supports lip and facial cues, while clear speech at an appropriate volume improves understanding without the distortion that shouting can create.
Easy analogy or mental picture Communication is like tuning a radio: lowering background noise and facing the listener strengthen the useful signal. The image does not assume every person reads lips or has the same hearing pattern, so the nurse must ask what method works best.
Memory hook For hearing loss, improve the signal: face the client, reduce noise, speak clearly, and confirm understanding.
NCLEX decision rule When teaching a client with hearing loss, optimize the environment and communicate directly before relying on louder speech or a family intermediary. Add writing or assistive technology based on the client's preference and response.
Why the other choices are wrong Speaking from a distance removes visual cues, and raising pitch or shouting can reduce clarity. Directing questions to family excludes the capable client and does not verify the client's own understanding.
References
[1]
NCSBN: 2026 NCLEX-RN Test PlanNational Council of State Boards of Nursing
[2]
NIDCD: Tips for Improving CommunicationNational Institute on Deafness and Other Communication Disorders