In performing a voice test to assess hearing, which action would the nurse perform?

The whispered voice test is a bedside screening tool used to detect high-frequency hearing loss. It requires the clinician to stand outside the patient's visual field to prevent the use of compensatory lip-reading. Effective testing relies on tragus occlusion of the non-tested ear to ensure the stimulus is only processed by the targeted auditory pathway. It assesses functional hearing in clinical settings. A. Shield the lips so that the sound is muffled: While the nurse should avoid being seen to prevent lip-reading, the goal is not to muffle the sound but to deliver a clear, whispered stimulus. The nurse should stand behind or to the side of the patient rather than just covering their mouth. B. Whisper a set of random numbers and letters, and then ask the patient to repeat them: This is the correct technique for the whispered voice test. Using a combination of three random numbers and letters (e.g., 5-B-6) provides a standardized way to check auditory acuity. A passing score is repeating at least three out of six possible digits/letters. C. Stand approximately 4 feet away to ensure that the patient can really hear at this distance: The standard distance for the whispered voice test is 2 feet (approximately 0.6 meters) behind the patient. Standing 4 feet away is too far for a whispered stimulus and may result in a false-positive screen for hearing impairment. D. Ask the patient to place a finger in his/her ear to occlude outside noise: During the test, the nurse should have the patient occlude the ear not being tested. This is usually done by having the patient place a finger on the tragus and rapidly pushing it in and out to create "masking" noise. This ensures only the tested ear hears the whisper.