To assess for the presence of egophony, which instruction should the nurse give the client who has a lung abscess?

A. Whisper "one, two, three" in sequence during auscultation of the thorax. This maneuver assesses whispered pectoriloquy, not egophony. Whispered pectoriloquy is used to detect areas of lung consolidation, where whispered sounds become abnormally clear. B. Repeat the number "99" during a systematic auscultation of the thorax. This technique is used to assess bronchophony, where lung consolidation causes increased transmission of vocal sounds, making "99" sound louder and clearer than normal. C. Repeat vocalizing the letter "E" while the thorax is auscultated. Egophony is assessed by having the client say "E" repeatedly while the nurse auscultates the lungs. In areas of lung consolidation, such as with a lung abscess or pneumonia, the sound changes to a nasal "A" instead of "E" (E-to-A change), indicating abnormal lung tissue. D. Breathe in and out while all lobes of both lungs are auscultated. Normal breathing sounds are important for assessing lung function but do not specifically test for egophony, which requires vocalization.