Ch 3 Interviewing & Communication PrepU

Which action should a nurse implement when assessing a nonnative client to facilitate collection of subjective data?

Maintain a professional distance during assessment.

Nonverbal communication is a very important aspect in nurse-client relationships. What can the nurse do to help gain trust in clients? Select all that apply.

Make sure that dress and appearance are professional Do not use facial expressions such as rolling the eyes or looking bored or disgusted Use gestures intentionally to illustrate points, especially for clients who cannot communicate verbally

When using an interpreter to facilitate an interview, where should the interpreter be positioned?

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

The nurse is interviewing an elderly woman in the ambulatory setting and trying to get more information about her urinary symptoms. Which of the following techniques is not a component of guided questioning?

Reassure the client that the urinary symptoms are most often treated successfully.

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 clarify

The nurse performs a comprehensive assessment on a new client. What is the next action of the nurse?

Validate problems and determine client's goals.

A client reports the health status of living parents, siblings, and deceased grandparents. What should the nurse do with this information?

create a genogram

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?

family violence

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?

history of present illness

A nurse in a community clinic is attempting to collect a health history on a 26-year-old female new client who appears anxious.

introduce oneself, ask simple, concise questions, decrease environmental stimuli, explain the nurse's role

An older client cannot recall the date of a surgical procedure but the adult daughter interjects with the exact date because it occurred a week before her wedding. How should the nurse document this information?

last surgery date validated by adult daughter

A client has a 10-year history of being treated for hypertension. Where should the nurse document this information?

past medical history

The nurse is preparing to complete a comprehensive assessment of a newly admitted client. Why is the nurse completing this type of assessment?

provides a baseline for future assessments

During an interview with an adult client, the nurse can keep the interview from going off course by

using closed-ended questions.

A client is asked to describe "something that brings the most hope." Which functional health pattern is the nurse assessing?

value-belief

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?

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

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?

"Has this been having an effect on your ability to carry out your routines and get around your home?"

A client states, "My wife died two months ago today." Which of the following responses would be most appropriate?

"How does that make you feel?"

The nurse is obtaining information about a client's past health history. Which client statement would best reflect this component of assessment?

"I had surgery 5 years ago to repair an inguinal hernia."

A nurse knocks and enters a client room, makes introductions to the client and visitors, and explains to the client that she would like to conduct an interview so a plan of care can be completed. Which statement by the nurse would be most appropriate?

"Mrs. Smith, I would like to conduct an interview with you but I see you have visitors. I will come back in about 30 minutes so you can visit before you and I sit privately to talk."

A 60-year-old woman with a bunion will undergo surgery later today. The client tells the nurse in the surgical daycare admitting department, "I'm sure I've been asked these questions before. Can't we just focus on my foot and not all these other topics?" How should the nurse best explain the rationale for obtaining a health history?

"We want to make sure your nursing care matches your needs as closely as possible."

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?

"What diseases did you have as a child?"

Which of the following questions would be most important for the nurse to ask first when obtaining the health history?

"What is your major health concern at this time?"

Which of the following questions is most useful in the assessment of a client's diabetes management?

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

On a very busy day in the health care provider's office, Mrs. Donelan, age 81 years, comes for her usual visit to check her blood pressure. She has been on a low-dose diuretic for many years and denies any side effects. Today, her blood pressure is 118/78, which is well controlled. The client mentions that it is hard not having her husband Bill around anymore. What would the nurse do next?

Ask why Bill is not there.

A nurse has completed gathering some basic data about a client and then reflects on personal feelings about the client. The nurse does this primarily to accomplish which of the following?

Avoid biases and judgments

A pediatric nurse, working in a community health clinic, is about to start an interview with a school aged child. What is the most appropriate way to address this child and the accompanying adults?

Call the child by their first name and ask the parents how they prefer to be addressed

A client asks "Can I take the herb ginkgo biloba with my other medications?" What action would be best if the nurse is unsure of the answer?

Explain that you will find out the information for the client.

A nurse is collecting subjective data from a client as part of the assessment process. Which behavior is most appropriate for the nurse to display in this situation?

Explaining the reason for taking down notes

When interviewing a client with a language barrier, it is best to use a family member to help interpret so the client has a level of comfort with the process.

False

When interviewing, the nurse should logically move from specific to open-ended questions.

False

When caring for a client, what aspect is important in conducting a conversation?

Keep the conversation at the knowledge level of the client

The nurse uses the mnemonic OLD CART when assessing a client's symptoms. Which letter represents the area of the symptom and if it radiates?

L

A nurse is gathering biographic data from a new client who is visiting the office for the first time. Which of the following pieces of data would likely be included in the biographic section of the client's health history? Select all that apply.

Lamar P. Thompson 1212 South Maple St., Sylvan, VA 23236 Caucasian Occupation: Brick mason

A client admitted to the health care facility for new onset of abdominal pain expresses to the nurse that she was treated for gastroesophageal reflux disease in the past. In which section of the comprehensive health assessment should the nurse document this information?

Personal health history

A nurse is admitting a new client. The client is lying in bed. Where should the nurse be positioned?

Seated in a chair at eye level with the client

An older client arrives for an appointment in the community clinic. Which approach should the nurse use when communicating with this client? Select all that apply.

Speak clearly Avoid jargon Show respect use simple terms

A nurse is obtaining subjective data from an adult client who is new to the clinic. The nurse has asked the client, "Where do you usually turn for help in a time of crisis?" What domain is this nurse assessing?

The client's stress management and coping strategies

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

Working

While interviewing an adult client about the client's stress levels and coping responses, an appropriate question by the nurse is

"How do you manage your stress?"

A graduate nurse working on a medical-surgical unit is admitting a client who does not speak English. No interpreters are available. The client's spouse is present and speaks English. What should the nurse remember about the use of interpreters when communicating with clients?

Friends and family who are unfamiliar with medical terminology may misinterpret information

When interviewing a client who does not speak English, the nurse enlists the assistance of a "culture broker," based on the understanding of what as this person's primary function?

to interpret the language and culture

A client reports experiencing chest pain after eating. Which category within the review of systems should the nurse document this information?

gastrointestinal

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?

health maintenance

An initial review of the client's chart and brief interview reveals the following: ● Labs: Albumin 1.5 g/dL (3.5-5.0 g/dL), AST 185 U/L, ALT 200 U/L ● Client states: "I've gained so much weight in the last month." ● Client states: "My stomach feels distended." ● Client states: "I drink about 1 bottle of wine every day." ● Client's weight is 150 lb. (68 kg) ● 4+ pitting edema lower extremities Which subjective finding will the nurse document? Select all that apply.

report of weight gain report of abdominal distention

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?

"Have you ever had a problem with mental or emotional illness?"

Mrs. T. comes for her regular visit to the clinic. Her regular provider is on vacation, but the client did not want to wait. The nurse has heard about this client many times from colleagues and is aware that she is very talkative. Which of the following is a helpful technique to improve the quality of the interview for both provider and client?

Briefly summarize what the client says in the first 5 minutes and then try to have her focus on one aspect of what she discussed.

A nurse is preparing to assess a client who is new to the clinic. When beginning the collection of the client's data, which of the following actions should the nurse prioritize?

Establishing a trusting relationship