The advanced practice registered nurse (APRN) is performing the Weber test on an 80 year-old patient with known cochlear nerve damage. The APRN expects what findings?

A. Sound will lateralize to the patient's ears equally is incorrect because in unilateral sensorineural hearing loss, such as cochlear nerve damage, sound is not heard equally in both ears during the Weber test. Lateralization occurs toward the ear with better cochlear function. B. Sound will lateralize to the patient's unaffected ear is correct because the Weber test detects unilateral hearing loss. In sensorineural hearing loss (cochlear nerve damage), sound is perceived louder in the unaffected ear. This happens because the affected cochlear nerve cannot transmit vibrations effectively, so the brain perceives sound predominantly from the normal, unaffected side. C. Sound will lateralize to the patient's affected ear is incorrect because this occurs in conductive hearing loss, not sensorineural hearing loss. In conductive loss, the affected ear may actually perceive sound louder because background ambient noise is reduced, making the tuning fork vibration seem more prominent. D. The patient will not hear the tuning fork at all is incorrect because sensorineural hearing loss typically affects one ear; the patient can still hear sound in the unaffected ear. Total inability to hear the tuning fork would suggest bilateral profound hearing loss, which is not specified here.