During an auditory screening of third graders, the school nurse identifies a hearing deficit for one of the students. When the parents ask the nurse about the findings, the nurse should respond:
1. "Hearing acuity is not fully developed in your child. Let's recheck next year."
2. "I'd like to recheck at the clinic. Then we may have to have your child seen by an auditory specialist."
3. "It was too noisy when we were testing, so I wouldn't be concerned if I were you."
4. "Your child will probably need a hearing aid."
Correct Answer: 2
Rationale 1: The follow up for these findings should not be postponed.
Rationale 2: Auditory perception is fully developed in school-age children, who are able to identify fine differences in voices, both in sound and pitch. Rechecking the results with a possible referral would be appropriate at this level.
Rationale 3: Auditory testing should be done in a quiet environment or none of the testing is accurate.
Rationale 4: The child's hearing test could be affected by a number of physiological variables (recent respiratory illness or excess cerumen in the ears), and telling the parents their child needs a hearing aid is both premature and not within the nurse's realm of practice.
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