Chapter 2: Collecting Subjective Data: The Interview & Health Hx

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? a. Encouraging elaboration (facilitation) b. Active listening c. Restatement d. Reflection

Active listening **[Rational: Active listening is the ability to focus on the client and their perspectives. It requires the nurse to constantly decode messages including thoughts, words, opinions, and emotions. For example, if a client is sad, it is appropriate for a nurse to place a hand over the client's and to show a facial expression of compassion. The purpose of restatement is to have the client elaborate on what was originally stated by the client. Reflection uses summarizing by the nurse to find the true meaning of a client's words. Encouraging elaboration encourages the client to explain or go into more detail in the client's responses. p15]

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 on this question? a. self-concept b. family violence c. role-relationship d. mental health

b. family violence **[Rational: The family violence portion of the comprehensive health history focuses on personal safety. Self-concept & role-relationship are health patterns. The mental health portion of the comprehensive health history focuses on emotional and mental health. p29]

What are the nursing goals for the introductory phase of the nurse-patient interview? ck all that apply a.Establishing a trusting, respectful rapport w/pt. b. Agreeing upon the agenda for the interview. c. Inviting the patient to tell their story. d.Reviewing the patient's records.

a.Establishing a trusting, respectful rapport w/pt. b. Agreeing upon the agenda for the interview. **[During the introduction phase of the nurse-patient interview, the nursing focus is on putting the patient at ease & establishing trust. Actions that the nurse will take during this phase of the interview process include greeting the pt, establishing rapport, establishing the agenda for the interview. Inviting the patient's story & responding to emotional cues are actions within the working phase while reviewing the patient's records in done in the pre-interview phase. p13]

An elderly female client is accompanied by her daughter on a visit to the health care facility. The nurse observes that the client is doing quite well, except for the use of a hearing aid. How can the nurse best facilitate the interview process with this client? a.Speak slowly & clearly, using straightforward language b.Ask the client's daughter to be present during the interview c.Direct the questions to the daughter to enhance communication

a.Speak slowly & clearly, using straightforward language **[Rational: The nurse should speak slowly and clearly, using straightforward language, keeping the language as simple as possible for easy understanding. The nurse need not ask the client's daughter to be present during the interview, as the client is quite able except for the use of a hearing aid. The nurse should establish and maintain trust, privacy, and partnership w/ older client for effectively collecting data & sharing concerns. The nurse should not occupy a position close to the client and speak softly, as the client has hearing loss; in such cases, the nurse should face the client at all times and speak loudly. pp16-17]

The nurse is preparing to interview a client with a documented history of mental illness. Which question should the nurse use to begin this interview? a."Have you ever had a problem with mental or emotional illness?" b. "Have you considered counseling for your mental problems? c."When was the last time you talked with a psychiatrist?"

a. **[Rational:The nurse should begin by asking a non-threatening open-ended question such as "have you ever had a problem with mental or emotional illness?" Asking specifically about medication for depression assumes the client has a history of depression. Asking about talking w/a psychiatrist or counseling may cause the client to become defensive. pp21-22]

The nurse is performing a follow-up assessment and interview of a 72-year-old woman with a history of congestive heart failure. The nurse asks the client, "Have you been experiencing any activity intolerance since I last saw you?" What would be a more appropriate way for the nurse to elicit this information? a. "Has this been having an effect on your ability to carry out your routines and get around your home?" b. Do you ever find yourself SOB when you're carrying out your daily routines?" c. "Has your heart failure been causing you any dyspnea lately?"

a. "Has this been having an effect on your ability to carry out your routines and get around your home?" **[Rational: When initiating an interview, it is important to use language that is understandable and appropriate to the client. "Dyspnea," "SOB," and "activities of daily living" are potentially unclear to a client and reflect clinical language rather than clear communication p16]

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

a. Facilitating the pt's fullest communication [The main goal of guided questioning is to facilitate the patient's fullest communication. The early generation of a plan is not a paramount goal and it is incorrect to suggest particular answers to the patient. pp14-16]

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 a.working b.closure c. going d. introductory

a. working **[During the working phase, the nurse elicits the client's comments about major biographic data, reasons for seeking care, history of present health concern, past health history, family history, review of body systems for current health problems, lifestyle and health practices, and developmental level. The nurse then listens, observes cues, and uses critical thinking skills to interpret and validate information received from the client. The nurse and client collaborate to identify the client's problems and goals. pp13-14]

A nurse is discussing with a client the client's personal health history. Which of the following would be an appropriate question to ask at this time? a. "Are both of your parents still living?" b. "What do you usually eat in a typical day?" c. "How do you feel about having to seek health care?" d. "What diseases did you have as a child?"

d. "What diseases did you have as a child?" **[Information covered in the personal health history section includes questions about birth, growth, development, childhood diseases, immunizations, allergies, medication use, previous health problems, hospitalizations, surgeries, pregnancies, births, previous accidents, injuries, pain experiences, and emotional or psychiatric problems. The question, "How do you feel about having to seek health care?" would be asked during the reason for seeking health care section of the interview. The question regarding the status of the client's parents would be posed in the family health history section. The question regarding what the client usually eats in a typical day would be included in the lifestyle and health practices profile section. pp21-22]