The nurse is performing a voice test to assess hearing. Which of the following describes the accurate procedure for performing this test?
A. Stand 4 feet away from the client to ensure that the client can hear at this distance.
B. Whisper a statement and ask the client to repeat it.
C. Whisper a statement with the examiners back facing the client.
D. Whisper a statement while the client blocks both ears.
Correct Answer: B. Whisper a statement and ask the client to repeat it.
The examiner stands 1-2 feet away from the client and asks the client to block one external ear canal. The nurse whispers a statement and asks the client to repeat it. Each ear is tested separately. Before the examination, one must first ask the patient if they are in any pain. The patient should also be asked whether they have any ear-related symptoms (specifically discharge, pain, hearing loss) – and which they think is their better hearing ear.
Option A: The patient should be sat on a chair suited to their habitus and comfort. The chair should ideally be in the center of the room, as part of the examination requires the examiner to stand behind the patient.
Option C: Explain to the patient that they will be required to repeat words or phrases they hear back to the examiner. To eliminate the possibility of lip-reading, stand behind the patient, and say a test word to be repeated back. The examiner then stands to the side of the test ear (conventionally the better hearing ear) and gently presses on the tragus of the non-test ear to mask it.
Option D: The examiner then speaks several test words at arm’s length and then half arm’s length. At each distance, the test words are spoken at three volumes: whispered, conversational, and loud.
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