chapter 2

A nurse is interviewing a man complaining of a pain in his shoulder. The nurse asks him where exactly the pain is, and he points to a spot on the lateral, posterior upper arm. The nurse has seen similar cases in other clients and recognizes that is likely from prolonged work at a computer, particularly using a mouse. Which of the following is the most effective use of inferring that the nurse might implement in this situation? "I recommend that you change your posture while working at the computer." "You work at a computer a lot, don't you?" "When did the pain start?" "Do you perform any sustained or continually repetitive motions with that arm?"

"Do you perform any sustained or continually repetitive motions with that arm?"

Which of the following questions is most useful in the assessment of a client's diabetes management? "You check your sugars before each meal, don't you?" "Are you still using your glucometer 4 times a day?" "Are you staying vigilant with your blood sugar monitoring?" "What is your routine for checking your blood sugar these days?"

"What is your routine for checking your blood sugar these days?"

A nurse is collecting data on a client's chief complaint, which is a spell of numbness and tingling on her left side. Which of the following questions would be best for eliciting information related to associated factors? "How bad was the tingling and numbness?" "How long did the spell last?" "Where did the numbness and tingling occur?" "What other symptoms occurred during the spell?"

"What other symptoms occurred during the spell?"

A client with a terminal diagnosis has asked the nurse about the purpose of a durable power of attorney for health care. What explanation will best answer the client's question? It makes health care decision making less burdensome for the client's family. A proxy is identified to make healthcare decisions when the client is no longer able to do so. It assures that the client's final health care wishes are known and implemented. Hospice and palliative care will be implemented as a part of the final health care plan

A proxy is identified to make healthcare decisions when the client is no longer able to do so.

"How many steps can you climb before you get short of breath?" is an example of what kind of question? A question that offers multiple choices for answers A question that is qualitative in focus A question that elicits a graded response A question that demands an imprecise response

A question that elicits a graded response

A nurse is interviewing an adult client who had a miscarriage 3 weeks ago. The woman is crying and is having difficulty talking. The nurse moves closer and places a hand on the woman's hand. What type of communication is this? Active listening Restatement Reflection Encouraging elaboration (facilitation)

Active listening

A nurse is discussing with an older female patient the factors that affect sleep. What fact does the nurse teach her? Drinking a cup of regular tea at night induces sleep. Using alcohol moderately promotes a deep sleep. Aging decreases the amount of REM sleep a person experiences. Exercising decreases REM and NREM sleep

Aging decreases the amount of REM sleep a person experiences.

During one of your clinical placements you encounter a client who becomes silent during the nursing interview. What would be appropriate for you to do? (Mark all that apply.) Appear attentive Give brief encouragement to the client Change the subject you are asking about Ask your question again Watch the client closely for nonverbal cues

Appear attentive Give brief encouragement to the client Watch the client closely for nonverbal cues

A nurse collects data about a client's family health history. Which family member's health problems should the nurse include when documenting this information in the database? Only the members with health problems that relate to the client's gender As many maternal and paternal relatives as the client can recall Disease processes that are known to have a genetic link Illnesses that resulted in death or disablement

As many maternal and paternal relatives as the client can recall

During an interview with a client with a language barrier, what action does the nurse take first to assure mutual understanding? Request that a trained interpreter be available during the interview. The interview should consist of short and simple sentences. Ask the client to repeat back in his or her own words what was asked. Allow extra time to develop the nurse-client relationship.

Ask the client to repeat back in his or her own words what was asked.

Nurses weave the individualization of the client interview through all aspects of the encounter. The nurse should avoid assuming that clients follow cultural beliefs. In place of making this assumption, what should a nurse do? Assess the degree to which the client perceives the cultural beliefs Assess how acculturated the client is Know the mores of the culture Know his or her own cultural beliefs

Assess the degree to which the client perceives the cultural beliefs

A nurse is running late after a quarterly quality improvement meeting at the hospital and has just been paged from the nurses' station. A client's relative wants to talk as soon as possible about the client's care. The nurse has clinic duty this afternoon and is about to see the first client. The first appointment time slot is double-booked, and three other clients have arrived, all of whom are sitting in the waiting room. Which of the following demeanors is consistent with skilled interviewing when the nurse walks into the examination room to speak with the first client at the clinic? Irritability Impatience Boredom Calm

Calm

A nurse draws a genogram to help organize and illustrate a client's family history. Which shape is a standard format of representing a deceased female relative? Simple circle Simple square Circle with a cross Square with a cross

Circle with a cross

The nurse is focusing an interview on a client's respiratory status. Which question should the nurse ask first to begin this interview? Do you currently have a cough? Do you have any difficulty producing sputum? Describe how you breathe for me? Do you experience any pain when you breathe?

Describe how you breathe for me?

How would the nursing instructor explain the goal of guided questioning to his or her students? Providing the most plausible answer to the client Facilitating the client's fullest communication Developing a basis for accurate health promotion activities Creating an opportunity for the early generation of a plan

Facilitating the client's fullest communication

Learning about the effects of the illness does what for the nurse and the client? Gives them the basis to establish a trusting relationship Gives them each a better understanding of the other Gives them the ability to communicate better Gives them the opportunity to create a complete and congruent picture of the problem

Gives them the opportunity to create a complete and congruent picture of the problem

A client will require an extended period of intense physical therapy after having a compound fracture of the femur surgically repaired. What question should the nurse ask when assessing the client's perception of the injury and recovery plan? (Select all that apply.) "How does experiencing such a trauma make you feel?" "What did the pain feel like when you broke your femur?" "How do you plan to support yourself financially while you recover?" "What frustrations are you experiencing since your accident?" "What do you expect from the physical therapy you will have?"

How does experiencing such a trauma make you feel?" "How do you plan to support yourself financially while you recover?" "What frustrations are you experiencing since your accident?" "What do you expect from the physical therapy you will have?"

A 59-year-old patient tells the nurse that he has ulcerative colitis. He has been having "black stools" for the last 24 hours. How would the nurse best document his reason for seeking care? J.M. is a 59-year-old man seeking treatment for ulcerative colitis. J.M. came into the clinic complaining of having black stools for the past 24 hours. J.M. is a 59-year-old man who states that he has ulcerative colitis and wants it checked. J.M. is a 59-year-old man who states that he has been having "black stools" for the past 24 hours.

J.M. is a 59-year-old man who states that he has been having "black stools" for the past 24 hours.

Which action should a nurse implement when assessing a nonnative client to facilitate collection of subjective data? Speak to the client using local slang. Maintain a professional distance during assessment. Avoid any eye contact with the client. Ask one of the client's children to interpret.

Maintain a professional distance during assessment.

When using an interpreter to facilitate an interview, where should the interpreter be positioned? Behind the examiner, so the interpreter can pick up the movements of the lips of the client and the client's nonverbal cues Next to the client, so the examiner can maintain eye contact and observe the nonverbal cues of the client Between the examiner and the client, so all parties can make the necessary observations In a corner of the room, so as to provide minimal distraction to the interview

Next to the client, so the examiner can maintain eye contact and observe the nonverbal cues of the client

A client scheduled for surgery tells the nurse that he is very anxious about the surgery. What is an appropriate action by the nurse when interacting with this client? Provide simple and organized information. Approach the client in an in-control manner. Refer the client to a spiritual guide. Mirror the client's feelings.

Provide simple and organized information.

A nursing instructor is talking about nonverbal communication with the nursing class. The instructor explains that facial expressions should be what? Happy Inquisitive Relaxed Detached

Relaxed

A client is admitted to the health care facility with new onset of abdominal pain. The client becomes angry with the nurse when questions about personal information are asked. How should the nurse proceed with the interview? Remind the client that this information must be obtained to provide proper care Touch the client lightly on the shoulder to dissipate the anger Remain in control and allow the client to vent feelings Encourage the client to use a more appropriate method to cope with feelings

Remain in control and allow the client to vent feelings

At the end of the examination, the examiner should: Complete documentation before leaving the examination room Have findings confirmed by another provider Compare objective and subjective data for discrepancies Review the findings with the patient

Review the findings with the patient

During an interview, the client begins to talk about the frequency of being abused by a spouse. What can the nurse do at this time to acknowledge the sensitivity of the information the client is providing? Write down the information as the client is speaking. Key the information into the electronic medical record as the client is speaking. Avoid maintaining eye contact while the client is discussing spouse abuse. Stop documenting in order to maintain eye contact with the client.

Stop documenting in order to maintain eye contact with the client.

What is an appropriate action by a nurse when providing care for an 18-year-old with respiratory problems caused by excessive smoking? Keep a stern expression to communicate the severity of the issue Ask the client why he started smoking at a young age Remind the client that excessive smoking could cause cancer Suggest methods and provide resources to assist with smoking cessation

Suggest methods and provide resources to assist with smoking cessation

A nurse has completed assessment of a client and is now validating the information gathered and reviewing goals with the client. Which phase of the interview process is this? Introductory Summary Analysis Working

Summary

A client who only speaks Spanish is admitted to the unit. The client's sister, who speaks English, is in the room when the English-speaking nurse starts the admission assessment. Why would it be inappropriate to use the sister as an interpreter for this client? The sister may not tell the client exactly what the nurse says The client's sister may not understand medical terminology The sister may not be there every time the nurse needs to talk to the client The client may not want the sister to know their private information

The client may not want the sister to know their private information

While interviewing a client, the nurse asks, "What happens when you have low blood glucose?" This type of response to the client is used for what purpose? To summarize the conversation To restate what the client has said To promote objectivity To clarify

To clarify

A nurse who may be shy in social situations may exhibit excellent therapeutic communication by what? Select all that apply. Using silence Giving advice Using touch Discussing alternative treatment options Communicating nonverbally through facial expression

Using silence Using touch Communicating nonverbally through facial expression

A nurse is collecting data on a client's chief complaint, which is a spell of numbness and tingling on her left side. Which of the following questions would be best for eliciting information related to associated factors? "How bad was the tingling and numbness?" "How long did the spell last?" "Where did the numbness and tingling occur?" "What other symptoms occurred during the spell?"

What other symptoms occurred during the spell?

A nurse assesses a client who reports the onset of a severe headache. During which phase of the nursing interview should the nurse ask the client about the history of the present health concern and the reasons for seeking care? Introductory Working Summary Closing

Working

During the client interview, the nurse asks specific questions such as "What were you doing when the pain started?" or "Was the pain relieved when you rested?" In what phase of the interview is the nurse involved? Working Beginning Closing Pre-interaction

Working

A client reports the health status of living parents, siblings, and deceased grandparents. What should the nurse do with this information? create a genogram document it in a narrative note include in the past medical history consider using it when planning care

create a genogram

The nurse is preparing to interview a newly admitted client. What should be done prior to hearing the client's story? review the attributes of a symptom establish the agenda for the interview review the client's issues in a chronologic order ask specific questions about the reason for admission

establish the agenda for the interview

The nurse is preparing to interview an adult client for the first time. The nurse observes that the client appears very anxious. The nurse should allow the client time to calm down. avoid discussing sensitive issues. set time limits with the client. explain the role and purpose of the nurse.

explain the role and purpose of the nurse.

The nurse asks a client "is there any time when you feel unsafe?" On which part of the comprehensive health history is the nurse focusing with this question? self-concept mental health family violence role-relationship

family violence

A client is unable to recall the last time an immunization was received. Which part of the client's health should the nurse realize is being the most impacted by this practice? risk factors health maintenance screening test completion compliance with treatment

health maintenance

A client with abdominal pain says that the last time it the pain occurred, over-the-counter laxatives helped. In which part of the assessment should the nurse document this information? chief complaint past health history review of symptoms history of present illness

history of present illness

During a client interview, the nurse asks questions about the client's past health history. The primary purpose of asking about past health problems is to determine whether genetic conditions are present. summarize the family's health problems. evaluate how the client's current symptoms affect his or her lifestyle. identify risk factors to the client and the client's significant other, if any.

identify risk factors to the client and the client's significant other, if any.

For a nurse to be therapeutic with clients when dealing with sensitive issues such as terminal illness or sexuality, the nurse should have advanced preparation in this area. experience in dealing with these types of clients. knowledge of his or her own thoughts and feelings about these issues. personal experiences with death, dying, and sexuality.

knowledge of his or her own thoughts and feelings about these issues.

During the review of systems a client states that at times both hands feel numb. In which category should the nurse document this information? neurologic cardiovascular musculoskeletal peripheral vascular

neurologic

A client has a 10-year history of being treated for hypertension. Where should the nurse document this information? health patterns review of systems health maintenance past medical history

past medical history

During an interview with an adult client for the first time, the nurse can clarify the client's statements by offering a "laundry list" of descriptors. rephrasing the client's statements. repeating verbatim what the client has said. inferring what the client's statements mean.

rephrasing the client's statements.

During an interview between a nurse and a client, the nurse and the client collaborate to identify problems and goals. This occurs during the phase of the interview termed introductory. ongoing. working. closure.

working.