Chapter 2

The nurse is caring for a client exhibiting slurred speech after suffering from a cerebrovascular accident. The nurse is unable to completely understand the client. What is the nurse's best action? Change the subject to put the client at ease. Ask the client to repeat the statement or question. Refer all questions to the client's family member in room. Turn the television on for distraction.

Ask the client to repeat the statement or question. The nurse should ask clients to repeat questions or statments if the nurse is unable to understand what the client said. The nurse can also paraphrase client responses to verify understanding.

When conducting the health assessment, the nurse interacts with the client in a caring manner. How would the nurse demonstrate caring to the client? Select all that apply. Showing respect to the client Dressing in a relaxed and casual manner Valuing the client unconditionally Being nonjudgmental Being sympathetic

Being nonjudgmental Showing respect to the client Valuing the client unconditionally Caring encompasses the nurse's empathy for and connection with the client. The nurse shows warmth, caring, interest, and respect and values the client unconditionally and nonjudgmentally. Being sympathetic and dressing in a relaxed and casual manner are nontherapeutic and would not show caring.

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? Allow impatience to show so that the client picks up on nonverbal cues that the appointment needs to end. 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. Allow the client to speak uninterrupted for the duration of the appointment. Set the time limit at the beginning of the interview and stick with it, no matter what occurs in the course of the interview.

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. The nurse can also say, "I want to make sure I take good care of this problem because it is very important. We may need to talk about the others at the next appointment. Is that OK with you?" This is a helpful technique that can help the nurse to change the subject, but at the same time, validate the client's concerns; this can provide more structure to the interview.

What intervention would be most helpful when conducting an interview with a client who has stated, "I'm a little hard of hearing"? Using pre-written cards that state the interview questions Introducing hand gestures whenever it is appropriate Closing the door may help to limit background noise. Asking the client if they are wearing a hearing aide

Closing the door may help to limit background noise. Closing the door may help to limit background noise, making it easier for the client to hear. Not all clients with minimal hearing loss wear hearing aids. Pre-written questions and hand gestures are interventions reserved for those diagnosed with severe hearing limitations.

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

Maintain a professional distance during assessment. When assessing a nonnative client, the nurse should maintain a professional distance during assessment; the size of personal space affects one's comfortable interpersonal distance. The nurse should not speak to the client using local slang; if the client finds it difficult to learn the proper language, slang would be much more difficult to understand. The nurse need not avoid any eye contact with the client, but should maintain eye contact with the client as required, without giving the client reason to think that the nurse is being rude. Asking one of the client's children to interpret during the interview may actually impair the assessment process. In addition, health care institutions often have specific policies regarding interpreters that you must be aware of prior to using an interpreter.

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

Next to the client, so the examiner can maintain eye contact and observe the nonverbal cues of the client A priority is for the examiner is to have a good view of the client and to avoid having to look back and forth between client and interpreter. The nurse should remember to use short simple phrases while speaking directly to the client and ask the client to repeat back what he or she understands.

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? Approach the client in an in-control manner. Mirror the client's feelings. Provide simple and organized information. Refer the client to a spiritual guide.

Provide simple and organized information. The nurse should provide simple and organized information to reassure the client about the procedure and its expected outcomes. The nurse approaches the aggressive, not anxious, client in an in-control manner. The nurse refers the dying client or client with spiritual concerns to a spiritual guide. The nurse should avoid expressing anxiety or becoming anxious like the client, as it would make the client more anxious.

In interviewing a client about substance use, a nurse asks her whether she takes any herbal supplements. Which of the following is the best rationale for asking this question? Taking herbal supplements is an indicator that the client is concerned with maintaining her health. Some herbal supplements may interact with prescribed medications. Abuse of herbal supplements can result in cardiac dysfunction. Taking herbal supplements may be the client's mechanism for coping with stress.

Some herbal supplements may interact with prescribed medications. Because many people use vitamins or a variety of herbal supplements, it is important to ask which ones and how often. These supplements and prescription medications may interact (e.g., garlic decreases coagulation and interacts with warfarin [Coumadin]). There is no indication that using herbal supplements can result in cardiac dysfunction. Taking herbal supplements may be an indicator of concern for one's health and a mechanism for coping with stress, but neither of these is as good a rationale as the one regarding interactions with prescribed medications.

The experienced nurse understands that active listening is the key element when interviewing a patient. True False

True Underlying all the techniques is the habit of active listening. Active listening is the process of paying close attention to what the patient is communicating, being aware of the patient's emotional state, and using verbal and nonverbal skills to encourage the speaker to continue and expand

During the interview process, the nurse uses both open-ended and closed-ended questions. During what phase of the interview process does the nurse use these specific types of questions? Working Pre-interaction Closing Beginning

working During the working phase, the nurse collects data by asking specific questions. Two types of questions are closed-ended and open-ended questions. Each type has a purpose; the nurse chooses which type will help solicit the appropriate information. Pre-interaction, beginning, and closing are all phases in the interview process. The pre-interaction phase is prior to meeting the client, when the nurse collects data from the medical record. The information gathered from the medical record is used to conduct the client interview. The beginning phase is when introductions are exchanged, privacy is ensured, and actions are made by the nurse to relax the client. The closing phase is when a review of the interview is conducting, summarizing areas of concerns or importance, allowing the client to ask any closing questions.

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? Preinteraction Working Beginning Closing

working During the working phase, the nurse collects data by asking specific questions. Two types of questions are closed-ended and open-ended. Each type has a purpose; the nurse chooses which type will help solicit the appropriate information. The pre-interaction phase is prior to meeting with the client. The nurse review the client's medical records to collect important data. The beginning phase is the phase when introductions are exchanged and the purpose of the interaction is explained to the client. The closing phase is a time for summarizing information shared with the client and assessing any learning deficits.