问题 单项选择题

患者女,50岁,工人,高中文化,有听力障碍。护士在病室与其沟通时,不妥的方式是()

A、核实信息

B、倾听时身体位置与患者同高

C、用手势和表情加强信息传递

D、提高讲话声音与其交流

E、可适当使用文字交流

答案

参考答案:D

解析:

我们总以为耳聋的人小声听不见,要声音大些才好,而且是越大越好。其实不然。很多聋人怕吵,甚至非常怕吵。   我们的听觉是有限度的。就像把水结冰时的温度定为 0 摄氏度一样,听力学家把正常年轻人刚刚能听到的几种不同频率的声音人为地定为0dBHL(听力零级)。0dBHL大小的声音正常人勉强能听到。安静环境下的交谈声大约 65dBHL 左右,听起来柔和适宜。如果在耳边大声喊叫,我们都会反感,因为声音过大了。更大的声音我们会感觉受不了。一般说来,我们的忍受极限不会超过120dB(SPL)。   从刚能听到的OdBHL算起,到最大极限120dB都是我们能听的范围,术语上称为“听觉动态范围”。如果存在听力损失(耳聋),刚刚能听到的声音就不会是OdBHL,而可能是30dB、60dB、70dBHL甚至更多。假设一个聋人的平均听力损失 (PTA)6OdBHL (这意味着60dBHL是他刚刚能听到的声音,感觉上相当于正常的听阀:OdBHL),又假设他也有12OdB的听觉动态范围,则该聋人似乎能忍受180dBHL左右的声音。实际上,不仅没有人能忍受,自然界中也根本不存在如此巨大的声音。第二条假设是完全错误的。   尽管小声听不见,绝大部分聋人,特别是感音神经性聋患者对过大声音的忍受能力并不比正常听力者好,甚至更差。漫说120dB,就是110dB、100dB他们也往往听得“震耳欲聋”。这是因为他们的听觉动态范围不同程度地变窄了,有时甚至会窄到不足5dB。也就是说,减小5dB听不见,加大5dB又受不了。因此,许多聋人比正常听力者还怕吵。   耳聋后怕吵,术语称为“重振”(复响)。重振是伴随听力损失而来的一种病理反应,专家们将其定义为:“随声强增加,响度感觉较正常人异常快速增长的现象。”重振的本质是内耳内、外毛细胞协作失调。在给患者解释重振现象时,我们可作如下比喻:说话的声音加大一倍,正常人的听感觉也加大了一倍:说话的声音加大十倍、一百倍,正常人的听感觉会相应地加大十倍、一百倍。有重振的聋人不是这样。我们说话的声音加大一倍,他们的听感觉往往会加大十倍、二十倍甚至五十倍、一百倍。听感觉(响度)的过度增长就叫做重振。   重振现象的存在,是导致耳聋又怕吵的根本原因。

阅读理解

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Basic Photography

This is an eight-hour course for beginners who want to learn how to use a 35mm camera. The teacher will cover such areas as kinds of film, light, and lenses(镜头). Bring your own 35mm camera to the class.

Course Charge: $150

Jan. 10, 12, 17, 19, Tues. & Thurs. 6-8p.m.

Marianne Adams is a professional photographer whose photographs appear in many magazines.

Understanding Computers

This twelve-hour course is for people who do not know very much about computers, but who need to learn about them. You will learn what computers are, what they can and can’t do, and how to use them.

Course Charge: $75

Equipment Charge: $10

Jan. 7, 14, 21, 28, Sat. 9-12 a.m.

Joseph Saimders is a professor of computer science at New Urban University. He has over twelve years of experience in the computer field.

Stop Smoking

Do you want to stop smoking? Have you already tried to stop and failed? Now it is the time to stop smoking using the latest methods. You can stop smoking, and this twelve-hour course will help you do it.

Course Charge: $30

Jan. 4, 11, 18, 25 Mon. 4-7 p.m.

Dr.John Goode is a practicing psychologist(心理学家)who has helped hundreds of people stop smoking.

Typing

This course on weekdays is for those who want to type as well as those who want to improve their typing. You are tested in the first class and practice at one of eight different skill levels. This allows you to learn at your own speed. Each program lasts 20 hours. Bring your own paper.

Course Charge: $125

Materials Charge: $25                      

Two hours each evening for two weeks.

This course is taught by a number of business education teachers who have successfully taught typing courses before.

小题1:The shortest course is _________.

A.Basic Photography

B.Understanding Computers

C.Stop Smoking

D.Typing小题2:A course which can do something good for your health will cost________.

A.$50

B.$30

C.$10

D.$125小题3:There are typing courses___________.

A.on Saturdays and Sundays

B.from Monday to Friday

C.from Monday to Saturday

D.on each day in the week

单项选择题