Health Assessment - Chap 3- The Interview

The nurse is assessing a patient who has an unsteady gait and lacks coordination. The nurse finds that the patient abuses alcohol. What should be the first question asked by the nurse to the patient during the interview? 1 "When did you take your last drink?" 2 "Did anyone ask you to quit drinking?" 3 "With whom did you have your last drink?" 4 "Have you injured anyone because of your drinking?"

1 "When did you take your last drink?" While interviewing a patient with a history of substance abuse, the nurse should first assess the withdrawal patterns of the patient. The time of the last drink and the amount of alcohol consumed in the last drink helps in assessing the withdrawal patterns of the patient. Inquiring whether anyone had asked the patient to quit drinking or with whom the patient had the last drink does not help the nurse in assessing the withdrawal patterns of the patient. Asking whether the patient had injured anyone helps in assessing the behavior of the patient. However, this question should not be asked first because the top priority is to assess withdrawal symptoms.

Which child is in the stage of presymbolic language development? 1 2-year-old child 2 3-year-old child 3 4-year-old child 4 5-year-old child

1 2-year-old child According to Piaget's theory of cognitive development, the child younger than the age of 2 years is in the sensorimotor stage. The child at this age communicates largely nonverbally; therefore, the 2-year-old child may be in the stage of presymbolic language development. The child older than this age may communicate verbally and, therefore, has symbolic language development. Therefore, the 3-year-old, 4-year-old, and 5-year-old children have symbolic language development and may be able to use more vocabulary and grammar.

The nurse is assessing an immigrant patient with the help of an interpreter. What actions should the nurse take to conduct an effective interview? Select all that apply. 1 Ensure that the interpreter is not related to the patient. 2 Instruct the interpreter to explain medical jargon to the patient. 3 Ask the interpreter to complete the interview in a limited time period. 4 Have the interpreter avoid discussing the purpose of the investigation. 5 Request the interpreter to provide a verbatim account of the conversation.

1 Ensure that the interpreter is not related to the patient. 2 Instruct the interpreter to explain medical jargon to the patient. 5 Request the interpreter to provide a verbatim account of the conversation. A relative of the patient should not be used as an interpreter, because this may result in a breach of patient confidentiality. Thus, the nurse must ensure that the interpreter is not related to the patient. The patient may not understand medical jargon; therefore, the nurse should ask the interpreter to explain the medical jargon to the patient. The nurse must also ensure that the interpreter provides a verbatim account of the conversation with the patient. This would help the nurse plan the patient treatment effectively. The interview conducted by an interpreter may take longer to complete. Therefore, the nurse should not limit the duration of the interview. The nurse should ensure that the interpreter is well aware of the purpose of the investigation so that he or she can explain it to the patient.

What are the advantages of using trained interpreters in patient interviews? Select all that apply. 1 Improved primary care 2 Increased admission rates 3 Increased patient satisfaction 4 Maintain patient confidentiality 5 Improved overall health outcomes

1 Improved primary care 3 Increased patient satisfaction 4 Maintain patient confidentiality 5 Improved overall health outcomes Trained interpreters can understand medical jargon, which helps them in asking proper questions and gathering accurate information from the patients. Trained interpreters help the nurse in learning about the problems of the patient, which leads to the improvement of primary care. The violation of confidentiality occurs when using a relative or close friend of the patient as an interpreter, because such a person may share information with others. Therefore, the interpreter is trained to maintain the confidentiality of the patient. Improvement of primary care results in increased patient satisfaction. The overall health outcomes improve due to effective communication. Unnecessary admissions to the hospital are prevented due to effective communication and assessment. This lowers, not increases, admission rates.

The charge nurse is observing a new nurse who is interviewing a psychotic patient with a history of violent behavior. The charge nurse would be most concerned if the nurse takes which action? 1 The nurse talks to the patient in a soft voice. 2 The nurse closes the door of the interview room. 3 The nurse stands between the door and the patient. 4 The nurse faces the patient at all times.

2 The nurse closes the door of the interview room. The nurse should take proper measures when interviewing psychotic patients, because they are prone to aggressive and violent outbursts. The nurse should leave the door of the examination room open, rather than closing it, so that others are able to see them and so the nurse can leave easily if the patient gets out of control. Talking to a violent patient in a soft voice may help calm the patient. The patient may harm the nurse if the nurse's back is turned; therefore, the nurse should always face the patient. Also, the nurse should stand between the door and the patient, which helps the nurse escape the room if necessary.

A patient with a hearing impairment prefers lip reading while communicating. Which actions by the nurse would be helpful in making communication during this interview effective? Select all that apply. 1 The nurse speaks loudly. 2 The nurse faces the patient. 3 The nurse uses hand gestures. 4 The nurse emphasizes the lip movements. 5 The nurse ensures good lighting in the room.

2 The nurse faces the patient. 3 The nurse uses hand gestures. 5 The nurse ensures good lighting in the room. While talking to a patient with a hearing impairment, the nurse should face the patient in such a way that the patient can see the nurse clearly. The nurse should use hand gestures while speaking. This would help the patient gain a clear understanding of what the nurse is trying to convey. The nurse should ensure good lighting in the room for the patient to see the nurse's face and hand gestures clearly. The patient is reading the nurse's lips, so the nurse does not need to speak loudly. Lip movements may distort the words, and this strategy would make the communication ineffective.

A nurse is preparing for a patient interview. What tasks does the nurse complete before the interview begins? Select all that apply. 1 Ensure direct, bright light in the room. 2 Turn off the television and radio in the room. 3 Ask the patient to change into a hospital gown. 4 Ask the accompanying family member to step out. 5 Request other staff not to interrupt the discussion

2 Turn off the television and radio in the room. 4 Ask the accompanying family member to step out. 5 Request other staff not to interrupt the discussion The nurse should ensure that the physical settings are optimal for a patient interview. The television and radio in the room should be turned off to prevent distractions. Asking the accompanying family members to step out during an interview helps provide privacy for the patient. Other staff members should be informed in advance about the interview so that they do not interrupt the discussion. The room should be well lit, but should not have direct or bright light, because it can cause squinting. A hospital gown may make the patient feel exposed and uncomfortable.

What is a positive nonverbal behavior of an interviewer? 1 Bland expression 2 High-pitched tone 3 Equal-status seating 4 Slouching in the chair

3 Equal-status seating Equal-status seating is a type of sitting in which the nurse sits at the same level as the patient while facing him or her. This behavior indicates that the nurse is not assuming superiority, which encourages the patient to interact freely with the nurse. Speaking in a high-pitched tone may indicate the patient that the nurse is being disrespectful. Therefore, the nurse should speak slowly to the patient in a soft voice. Slouching in the chair may give an impression that the interviewer is not active and is thus not interested in learning about the patient. Similarly, having a bland expression also indicates that the nurse is not interested in the interview.

Which characteristic of linguistic development is likely to be observed in an 18-month-old child according to Piaget's stages of cognitive development? 1 Use of pronouns 2 Use of passive tense 3 Use of short sentences 4 Use of complex grammar

3 Use of short sentences Children within the age group of 0-2 years are in the sensorimotor stage of cognitive development. An 18-month-old child has developed the vocabulary to speak short sentences. A 3- to 6-year-old child, who is in the preoperational stage, is able to use pronouns in sentences. The 7- to 11-year-old child, who is in the concrete operation stage, develops logical thinking. A 7-year-old child is able to use passive tense, and a 10-year-old child can use complex grammar.

A nurse educator is teaching a group of nursing students about interview techniques. What information should the nurse educator include regarding the seating of the patient and the interviewer? 1 The interviewer should stand in front of the patient. 2 The interviewer should sit facing the patient across a desk. 3 The interviewer should sit at a distance of 3 feet from the patient. 4 The interviewer should have equal-status seating with the patient.

4 The interviewer should have equal-status seating with the patient. During an interview, the patient and the interviewer should have equal-status seating. This allows them to be seated comfortably at eye level. Equal-status seating allows the patient to face the nurse or look straight ahead from time to time. Standing over the patient may indicate hurriedness or superiority, and should be avoided. Sitting across the desk creates a barrier and interferes with effective communication. Sitting at a distance of 3 feet may indicate encroaching on the personal space of the patient. The distance between the interviewer and the patient should be 4 to 5 feet.