N114 Chapter 2

The nurse is focusing an interview on a client's respiratory status. Which question should the nurse ask first to begin this interview? Do you currently have a cough? Do you experience any pain when you breathe? Do you have any difficulty producing sputum? Describe how you breathe for me?

D

A nurse collects data about a client's family health history. Which family member's health problems should the nurse include when documenting this information in the database? As many maternal and paternal relatives as the client can recall Illnesses that resulted in death or disablement Disease processes that are known to have a genetic link Only the members with health problems that relate to the client's gender

A

What intervention should the nurse implement to regain control of the interview process when the client, reporting abdominal pain monopolizes the conversation with unrelated information? Politely direct the interview in order to ask about the characteristics of the pain. Inform the client that pain medication can not be administered until the interview is completed. Suggest that the interview be stopped now and continued later. Share with the client that there is only a limited amount of time left to complete the interview.

A

When interacting with a client, what conveys the extent of interest, attention, acceptance, and understanding of the nurse? (Select all that apply.) Tone of voice Posture Cultural reassurance Gestures Eye contact

A,B,D,E

A nurse who may be shy in social situations may exhibit excellent therapeutic communication by what? Select all that apply. Discussing alternative treatment options Using silence Communicating nonverbally through facial expression Using touch Giving advice

B,C,D

A nurse draws a genogram to help organize and illustrate a client's family history. Which shape is a standard format of representing a deceased female relative? Square with a cross Simple circle Circle with a cross Simple square

C

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

C

A client reports having scarlet fever when in the 2nd grade. In which area of the comprehensive health history should the nurse document this information? family health history history of present illness review of symptoms past history

D

While interviewing a client for the first time, the nurse is using a standardized nursing history form. The nurse should ask the client to complete the form. ask leading questions throughout the interview. read the questions verbatim from the form. maintain eye contact while asking the questions from the form.

D

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

False

A client reports the health status of living parents, siblings, and deceased grandparents. What should the nurse do with this information? create a genogram include in the past medical history document it in a narrative note consider using it when planning care

A

A client is asked to describe "something that brings the most hope." Which functional health pattern is the nurse assessing? self-perception value-belief role-relationship Coping-stress-tolerance

B

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? compliance with treatment health maintenance screening test completion risk factors

B

A nursing instructor is talking about nonverbal communication with the nursing class. The instructor explains that facial expressions should be what? Detached Relaxed Inquisitive Happy

B

A client reports difficulty sleeping. Which question would be the most effective way for the nurse to open the interview? "When did the sleep problem begin?" "How would you rate your sleep on a scale from 1 to 10?" "Can you tell me about your sleep problem from when it started until now?" "What have you tried to help with your sleep?"

C

One technique of therapeutic communication is silence. What does silence allow the client to do? Learn to trust the nurse Change topics if he or she wants Communicate concerns nonverbally Decide how much information to disclose

D

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? role-relationship mental health self-concept family violence

D

A client who only speaks Spanish is admitted to the unit. The client's sister, who speaks English, is in the room when the English-speaking nurse starts the admission assessment. Why would it be inappropriate to use the sister as an interpreter for this client? The client may not want the sister to know their private information The client's sister may not understand medical terminology The sister may not tell the client exactly what the nurse says The sister may not be there every time the nurse needs to talk to the client

A

A nurse assesses a client who reports the onset of a severe headache. During which phase of the nursing interview should the nurse ask the client about the history of the present health concern and the reasons for seeking care? Working Closing Summary Introductory

A

A client states, "I feel worse since the nurse gave me that medication." What is the nurse's best action? Note the statement as objective data in the nurse's notes. Report the client's complaints to quality control. Record the information as subjective data. Do not document any direct client statements.

C

The nurse is beginning a health history interview with an adult client who expresses anger at the nurse. The best approach for dealing with an angry client is for the nurse to offer reasons why the client should not feel angry. refer the client to a different health care provider. allow the client to verbalize his or her feelings. provide structure during the interview.

C

The nurse should respond to a client's request to "keep what I'm about to tell you a secret" with which statement? "I'm ethically bound to keep your health information confidential." "Don't share anything with me that you don't want your health provider to know." "I have to share the information if it reveals something that could hurt you." "Confidentiality is a right you have as a client."

C

A client has a 10-year history of being treated for hypertension. Where should the nurse document this information? past medical history health maintenance review of systems health patterns

A

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

A

During an assessment the client says "I've been having bad pain in my left leg for a week." In which section should the nurse document this information? chief complaint review of systems history of present illness health patterns

A [chief complaint (statement by own patients words)]

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. Do not use facial expressions such as rolling the eyes or looking bored or disgusted Make sure that dress and appearance are professional Do not look the client in the eye Use gestures intentionally to illustrate points, especially for clients who cannot communicate verbally Laugh a lot, which puts the client at ease

A, B, D

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? History of present illness Personal health history Chief complaint Review of systems

B

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? Restatement Reflection Active listening Encouraging elaboration (facilitation)

C

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? "When was the last time you talked with a psychiatrist?" "What medication do you take for your depression?" "Have you ever had a problem with mental or emotional illness?" "Have you considered counseling for your mental problems?

C

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 set time limits with the client. allow the client time to calm down. avoid discussing sensitive issues. explain the role and purpose of the nurse.

D

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 Asking the client if they are wearing a hearing aide Introducing hand gestures whenever it is appropriate Closing the door may help to limit background noise.

D

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 To promote objectivity To restate what the client has said To summarize the conversation

A

During an interview with an adult client, the nurse can keep the interview from going off course by using open-ended questions. using closed-ended questions. rephrasing the client's statements. inferring information.

B

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? Beginning Closing Working Pre-interaction

C

A student nurse is conducting her first client interview. The student suddenly draws a blank on what to ask the client next. What is a useful interview technique for the student to use at this point? Termination Transition Reassurance Summarization

D

A way to use nonverbal communication is through silence. The purposeful use of silence during the interview allows clients to what? Provide accurate answers Talk about their feelings Rest and improve health Communicate verbal concern

A

A client with a terminal diagnosis has asked the nurse about the purpose of a durable power of attorney for health care. What explanation will best answer the client's question? Hospice and palliative care will be implemented as a part of the final health care plan. It makes health care decision making less burdensome for the client's family. A proxy is identified to make healthcare decisions when the client is no longer able to do so. It assures that the client's final health care wishes are known and implemented.

C

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?" "When did the pain start?" "You work at a computer a lot, don't you?" "I recommend that you change your posture while working at the computer."

A

A nurse is running late after a quarterly quality improvement meeting at the hospital and has just been paged from the nurses' station. A client's relative wants to talk as soon as possible about the client's care. The nurse has clinic duty this afternoon and is about to see the first client. The first appointment time slot is double-booked, and three other clients have arrived, all of whom are sitting in the waiting room. Which of the following demeanors is consistent with skilled interviewing when the nurse walks into the examination room to speak with the first client at the clinic? Calm Boredom Impatience Irritability

A

During the interview of an adult client, the nurse should provide the client with information as questions arise. read each question carefully from the history form. use leading questions for valid responses. complete the interview as quickly as possible.

A

During the review of systems a client states that at times both hands feel numb. In which category should the nurse document this information? neurologic cardiovascular musculoskeletal peripheral vascular

A

During an interview, the client begins to talk about the frequency of being abused by a spouse. What can the nurse do at this time to acknowledge the sensitivity of the information the client is providing? Key the information into the electronic medical record as the client is speaking. Stop documenting in order to maintain eye contact with the client. Avoid maintaining eye contact while the client is discussing spouse abuse. Write down the information as the client is speaking.

B

Learning about the effects of the illness does what for the nurse and the client? Gives them the opportunity to create a complete and congruent picture of the problem Gives them each a better understanding of the other Gives them the ability to communicate better Gives them the basis to establish a trusting relationship

A

A nurse is conducting a review of systems with a client and is asking about his ears. The nurse asks, "Do you have any problems with your ears or your hearing?" The client stares blankly at the nurse a moment and then says, "I'm sorry—could you repeat that?" The nurse repeats the question, to which the client replies, "No." The nurse then asks, "Do you ever experience any trouble hearing or any ringing, buzzing, or earaches?" The client responds, "No." What should the nurse record under "Ears" in the review of systems section of the client's health history? "No problems." "Denies any trouble hearing or any ringing, buzzing, or earaches." "Client denies any problems but had trouble hearing me when I asked him a question." Nothing—it should be left blank

B

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? chief complaint review of symptoms history of present illness past health history

C

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 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 Behind the examiner, so the interpreter can pick up the movements of the lips of the client and the client's nonverbal cues

C

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

B

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? Maintaining eye contact with the client at all times Explaining the reason for taking down notes Remaining standing during the interview Reading questions from the history form

B

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? Beginning Working Closing Pre-interaction

B

For a nurse to be therapeutic with clients when dealing with sensitive issues such as terminal illness or sexuality, the nurse should have experience in dealing with these types of clients. knowledge of his or her own thoughts and feelings about these issues. advanced preparation in this area. personal experiences with death, dying, and sexuality.

B

During a health history a client recalls the date when being first diagnosed with hypertension. Which term should the nurse use to categorize the quality of the client's data? concerning questionable reliable Puzzling

C

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? Touch the client lightly on the shoulder to dissipate the anger Encourage the client to use a more appropriate method to cope with feelings Remind the client that this information must be obtained to provide proper care Remain in control and allow the client to vent feelings

D

A female client tells the nurse it has been 5 years since her last pap smear examination. Where should the nurse document this information? health maintenance physical examination review of systems personal and social history

A

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. ongoing. closure. Introductory.

A

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? Some herbal supplements may interact with prescribed medications. Taking herbal supplements may be the client's mechanism for coping with stress. Abuse of herbal supplements can result in cardiac dysfunction. Taking herbal supplements is an indicator that the client is concerned with maintaining her health.

A

The nurse is planning to interview a client who is being treated for depression. When the nurse enters the examination room, the client is sitting on the table with shoulders slumped. The nurse should plan to approach this client by expressing interest in a neutral manner. providing the client with simple explanations. using a highly structured interview process. offering to hold the client's hand.

A

What occurs during the termination phase of an interview? Planning for follow-up care Addressing topics that have not yet been addressed Assessing the client's mental status Letting the client know you understood all he or she has told you

A

While interviewing an adult client about the client's stress levels and coping responses, an appropriate question by the nurse is "Is stress a problem in your life?" "How do you manage your stress?" "How often do you feel stressed?" "Do you feel stress at work?"

B

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. Head and neck: sore throat and enlarged lymph nodes 1212 South Maple St., Sylvan, VA 23236 Occupation: Brick mason Mother: Sugar L. Thompson, died 7/14/2006 from heart attack Caucasian Lamar P. Thompson

B, C, E, F

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? "How do you feel about having to seek health care?" "Are both of your parents still living?" "What diseases did you have as a child?" "What do you usually eat in a typical day?"

C

During an interview with an adult client for the first time, the nurse can clarify the client's statements by repeating verbatim what the client has said. offering a "laundry list" of descriptors. rephrasing the client's statements. inferring what the client's statements mean.

C

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? Pre-interaction Beginning Working Closing

C

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. Turn the television on for distraction. Ask the client to repeat the statement or question. Refer all questions to the client's family member in room.

C

Which type of question is asked first by the nurse in order to attain a full description of the client's symptoms and to generate and test diagnostic hypotheses? pertinent positive and negative questions to determine relevant details specific questions to secure a description of every symptom open-ended questions to encourage the client to tell his or her story yes-or-no questions to determine relevant areas of the physical examination

C

The nurse documents information about a client's activity-exercise health pattern. Which information did the nurse most likely document? misses seeing friends who used to go for walks together experiences panic attacks several times a week gained 15 lbs. over the last 6 months unable to go to the gym since having back surgery

D

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? "Do you ever find yourself SOB when you're carrying out your daily routines?" "Has your heart failure been causing you any dyspnea lately?" "Has your congestive heart failure been affecting your activities of daily living recently?" "Has this been having an effect on your ability to carry out your routines and get around your home?

D

Which of the following questions is most useful in the assessment of a client's diabetes management? "Are you still using your glucometer 4 times a day?" "You check your sugars before each meal, don't you?" "Are you staying vigilant with your blood sugar monitoring?" "What is your routine for checking your blood sugar these days?"

D