Chapter 2: Collecting Subjective Data Prep U

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A nurse is performing an admission assessment on a new client to the unit. What would be the best way to phrase a question about the client's marital status?

"Do you live alone or with someone?"

The nurse should respond to a client's request to "keep what I'm about to tell you a secret" with which statement?

"I have to share the information if it reveals something that could hurt you."

Which statement by the nurse demonstrates an understanding of the termination phase of the interviewing process?

"Let me stress the importance of being medication adherent."

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?"

The nurse performs a focused assessment on a client who is reporting joint pain. To gather a better understanding of the client's pain, the nurse uses COLDSPA. Which question(s) should the nurse ask the client to determine the origin of the pain? Select all that apply.

-"When does the pain occur?" -"What makes the pain better or worse?" -"How would you describe the pain?" -"Could you show me where the pain is exactly?"

When interacting with a client, what conveys the extent of interest, attention, acceptance, and understanding of the nurse? Select all that apply.

-Eye contact -Gestures -Posture -Tone of voice

A nurse who may be shy in social situations may exhibit excellent therapeutic communication by what? Select all that apply.

-Using silence -Using touch -Communicating nonverbally through facial expression

"How many steps can you climb before you get short of breath?" is an example of what kind of question?

A question that elicits a graded response

A nurse collects data about a client's family history. Which family members' health problems should the nurse include when documenting this information in the database?

As many genetic relatives as the client can recall

The nurse is conducting a review of systems on a new client. The client denies any signs, symptoms, or diseases. What is the best action of the nurse?

Ask the client a series of specific questions

During a health history interview the client states, "I have been short of breath." What is the priority action of the nurse?

Ask the client if they currently feel short of breath.

During an assessment, the nurse determines that a client sees more than one primary care provider and has obtained prescriptions from each provider. Which method would be most appropriate to determine a client's current medication regimen?

Ask the client to bring all the medications and supplements to an interview.

The nurse is preparing to conduct an interview with a hospitalized client. What nursing intervention can best ensure a confidential and comfortable environment for the client?

Asking permission to draw the client's privacy curtain

One technique of therapeutic communication is silence. What does silence allow the client to do?

Decide how much information to disclose

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

False

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

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

What is the best action by a nurse when a client has difficulty describing the chief complaint?

Provide the client with a laundry list of words to choose from

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?

Remain in control and allow the client to vent feelings

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

Summary

The nurse is interviewing a 78-year-old client for the first time. The nurse should first

assess the client's hearing acuity

A client is being admitted for elective surgery. What should the nurse instruct the client to do to ensure that the medication history is complete?

bring all medications and preparations used to the hospital

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 is interviewing a client in the clinic for the first time. When the client tells the nurse he smokes "about two packs of cigarettes a day," the nurse should

encourage the client to quit smoking.

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

explain the role and purpose of the nurse

A client with abdominal pain says that the last time the pain occurred, over-the-counter laxatives helped. In which part of the assessment should the nurse document this information?

history of present illness

For a nurse to be therapeutic with clients when dealing with sensitive issues such as terminal illness or sexuality, the nurse should have

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

During the review of systems a client stats that at times both hands feel numb. In which category should the nurse document this information?

neurologic

During the interview of an adult client, the nurse should

provide the client with information as questions arise

A client is experiencing a relapse of a urinary tract infection. Which additional information should the nurse collect when discussing this client's present health problem?

sexual history

The nurse is interviewing a client in the clinic for the first time. The client appears to have a very limited vocabulary. The nurse should plan to

use very basic lay terminology.

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

using closed-ended questions

A client has been admitted following an unexplained weight loss of 15 pounds over the past 3 months. How should the nurse best assess the subjective component of the client's nutritional status?

Obtain a 24-hour diet recall

A client plays doubles tennis ever Saturday and golfs on Wednesday afternoons. In which part of the comprehensive health history is this information utilized?

health patterns


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