Prep U Ch.2

The principle of confidentiality is of paramount importance in the nurse-patient relationship. When should you inform the patient of with whom his or her information will be shared? A) When the patient asks B) At the beginning of the interview C) At the end of the interview D) Whenever it seems appropriate

At the beginning of the interview Ref: (ch.2 pg.13)

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? A) Allow the client to speak uninterrupted for the duration of the appointment B) 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 C) Set the time limit at the beginning of the interview and stick with it, no matter what occurs in the course of the interview D) 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 Ref: (ch.2 pg.18)

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? A) Bring all medications and preparations used to the hospital B) Bring all discharge instructions from previous hospitalizations to the hospital C) Have the health care provider fax a copy of all current medications to the care area D) Provide the name and telephone number of the pharmacy that fills the prescriptions

Bring all medications and preparations used to the hospital Ref: (ch.2 pg.13)

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? A) Simple circle B) Simple square C) Circle with a cross D) Square with a cross

Circle with a cross Ref: (ch.2 pg.23)

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

Describe how you breathe for me? Ref: (ch.2 pg.12-13)

The nurse is preparing to interview a newly admitted client. What should be done prior to hearing the client's story? A) review the attributes of a symptom B) establish the agenda for the interview C) review the client's issues in a chronologic order D) ask specific questions about the reason for admission

Establish the agenda for the interview Explanation: Prior to hearing the client's story during the working phase of the interview, the nurse should establish the agenda for the interview. Attributes of a symptom are examined during the working phase. Reviewing the client's issues in chronologic order is completed during the working phase. Asking questions about the reason for admission is the first action completed during the working phase of the interview. Ref: (ch.2 pg.13)

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 A) Providing the client with simple explanations B) Offering to hold the client's hand C) Using a highly structured interview process D) Expressing interest in a neutral manner

Expressing interest in a neutral manner Ref: (ch.2 pg. 19)

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

Facilitating the patient's fullest communication Ref: (ch.2 pg.14-16)

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? A) Self-concept B) Mental health C) Family violence D) Role-relationship

Family violence Explanation: The family violence portion of the comprehensive health history focuses on personal safety. Self-concept and role-relationship are health patterns. The mental health portion of the comprehensive health history focuses on emotional and mental health. Ref: (ch.2 pg.29)

A client reports experiencing chest pain after eating. Which category within the review of systems should the nurse document this information? A) Neurologic B) Cardiovascular C) Gastrointestinal D) Musculoskeletal

Gastrointestinal Explanation: Because the client reports "chest pain" after eating, this information is most appropriate for the gastrointestinal system. This pain should not be documented under neurologic or musculoskeletal system. If the chest pain was not associated with eating, then it would be appropriate to document it under cardiovascular. Ref: (ch.2 pg.23-24)

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

Gives them the opportunity to create a complete and congruent picture of the problem Explanation: Learning about the effects of the illness gives the nurse and the patient the opportunity to create a complete and congruent picture of the problem. Ref: (ch.2 pg.14)

For a nurse to be therapeutic with clients when dealing with sensitive issues such as terminal illness or sexuality, the nurse should have A) Advanced preparation in this area B) Experience in dealing with these types of clients C) Knowledge of his or her own thoughts and feelings about these issues D) Personal experiences with death, dying, and sexuality

Knowledge of his or her own thoughts and feelings about these issues Explanation: Be aware of your own thoughts and feelings regarding dying, spirituality, and sexuality; then recognize that these factors may affect the client's health and may need to be discussed with someone. Ref: (ch.2 pg.19)

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

Lamar P. Thompson Caucasian Occupation: Brick mason 1212 South Maple St., Sylvan, VA 23236 Ref: (ch.2 pg. 18-19)

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

Maintain a professional distance during assessment Ref: (ch.2 pg.14)

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

Maintain eye contact while asking the questions from the form Ref: (ch.2 pg.13)

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

Provide accurate answers Ref: (ch.2 pg.15)

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? A) Provide simple and organized information B) Approach the client in an in-control manner C) Refer the client to a spiritual guide D) Mirror the client's feelings

Provide simple and organized information Ref: (ch.2 pg. 19)

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

Remain in control and allow the client to vent feelings Ref: (ch.2 pg.19)

An elderly client with Parkinson's disease and his wife, who appears to be much younger than he, are being interviewed by the nurse to update the client's health history. The nurse also has the client's electronic health record on her tablet computer. Earlier in the day, the nurse had spoken with the client's primary care physician, who had relayed some concerns to the nurse regarding the progression of the client's disease. Which source of biographic information should the nurse view as primary? A) The client B) The client's wife C) The physician D) The client's medical record

The client Ref: (ch.2 pg.18-19)

While interviewing a patient, the nurse asks, "What happens when you have low blood glucose?" This type of response to the patient is used for what purpose? A) To summarize the conversation B) To restate what the patient has said C) To promote objectivity D) To clarify

To clarify Explanation: Another way to clarify is to ask, "What happens when you get low blood sugar?" Such questions prompt patients to identify other symptoms or give more information so that you can better understand the situation. Ref: (ch.2 pg.16)

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

Unable to go to the gym since having back surgery Ref: (ch.2 pg.25)

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

Value-belief Ref: (ch.2 pg.25)

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

create a genogram Ref: (ch.2 pg.23)

The nurse is reviewing the medical record before meeting a new client. In which phase of the interview process is the nurse working? A) working B) termination C) introduction D) pre-interview

pre-interview Ref: (ch.2 pg.13)

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

False Ref: (ch.2 pg.14)

A female client tells the nurse it has been 5 years since her last pap smear examination. Where should the nurse document this information? A) Physical examination B) Health maintenance C) Personal and social history D) Review of systems

Health maintenance Ref: (ch.2 pg. 18-24)

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

Make sure that dress and appearance are professional Use gestures intentionally to illustrate points, especially for clients who cannot communicate verbally Do not use facial expressions such as rolling the eyes or looking bored or disgusted Ref: (ch.2 pg.14-15)

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

Past medical history Explanation: An adult medical illness is documented as part of the past medical history. Health patterns identify the client's personal/social history and daily living routines that may influence health and illness. The review of systems focuses on the presence or absence of common symptoms related to each major body system. Health maintenance is a part of the past medical history and identifies actions taken to improve or maintain health. Ref: (ch.2 pg.21)

What is the best action by a nurse when a client has difficulty describing the chief complaint? A) Restate the question using simple terms B) Wait in silence until the client can find the correct words C) Ignore the complaint & return to it at a later time in the interview D) Provide the client with a laundry list of words to choose from

Provide the client with a laundry list of words Ref: (ch.2 pg.16)

What is an appropriate action by a nurse when providing care for an 18-year-old with respiratory problems caused by excessive smoking? A) Keep a stern expression to communicate the severity of the issue B) Ask the client why he started smoking at a young age C) Remind the client that excessive smoking could cause cancer D) Suggest methods and provide resources to assist with smoking cessation

Suggest methods and provide resources to assist with smoking cessation Ref: (ch.2 pg.15)

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

"What diseases did you have as a child?" Ref: (ch.2 pg.21-22)

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? A) Change the subject to put the client at ease B) Turn the television on for distraction C) Ask the client to repeat the statement or question D) Refer all questions to the client's family member in room

Ask the client to repeat the statement or question Explanation:The nurse should ask clients to repeat questions or statements if the nurse is unable to understand what the client said. The nurse can also paraphrase client responses to verify understanding. Ref: (ch.2 pg. 17)

Nurses weave the individualization of the client interview through all aspects of the encounter. The nurse should avoid assuming that clients follow cultural beliefs. In place of making this assumption, what should a nurse do? A) Assess the degree to which the client perceives the cultural beliefs B) Assess how acculturated the client is C) Know the mores of the culture D) Know his or her own cultural beliefs

Assess the degree to which the client perceives the cultural beliefs Ref: (ch.2 pg.28)

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? A) chief complaint B) past health history C) review of symptoms D) history of present illness

History of present illness Explanation: The history of present illness describes how each symptom developed. It includes the client's thoughts and feelings about the illness, relevant parts of the review of systems, and medications, allergies, and lifestyle habits that impact the present illness. The history of present illness includes any attempts at self-treatment for the problem. The chief complaint is the reason for the person seeking care. The past history lists childhood illnesses, adult illnesses with dates, health maintenance practices, and risk factors. The review of systems is where the presence or absence of common symptoms related to each major body system are reviewed and documented. Ref: (ch.2 pg. 21)

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

"How do you manage your stress?" Ref: (ch.2 pg.29)

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

"What is your routine for checking your blood sugar these days?" Ref: (ch.2 pg.28)

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? A) Active listening B) Restatement C) Reflection D) Encouraging elaboration (facilitation)

Active Listening Ref: (ch.2 pg. 15)

During the introduction phase of the interview, the patient begins to talk nonstop about health problems, family issues, and fears related to illness. What can the nurse do to control the interview process? A) Glance at the clock at the wall B) Tap the pen on the paper while the patient talks C) Leave the interview and contact security D) Courteously interrupt the patient to clarify some information

Courteously interrupt the patient to clarify some information Ref: (ch.2 pg.13-14)

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? A) yes-or-no questions to determine relevant areas of the physical examination B) specific questions to secure a description of every symptom C) pertinent positive and negative questions to determine relevant details D) open-ended questions to encourage the client to tell his or her story

Open-ended questions to encourage the client to tell his or her story Ref: (ch.2 pg. 16)

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

Provide the client with information as questions arise Ref: (ch.2 pg.16-17)

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 A) Introductory B) Ongoing C) Working D) Closure

Working Explanation: During the working phase, the nurse elicits the client's comments about major biographic data, reasons for seeking care, history of present health concern, past health history, family history, review of body systems for current health problems, lifestyle and health practices, and developmental level. The nurse then listens, observes cues, and uses critical thinking skills to interpret and validate information received from the client. The nurse and client collaborate to identify the client's problems and goals. Ref: (ch.2 pg.13-14)

The nurse is preparing to interview a client with a history of sexual abuse. What technique should the nurse use when conducting this interview? A) avoid eye contact B) be nonjudgmental C) ask direct questions D) skip the sexual history

be nonjudgmental Ref: (ch.2 pg.19)

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

Neurologic Explanation: Because the client states numbness of the hands, this information should be included under the neurologic system. Even though the symptom affects the hands, it should not be documented under musculoskeletal. This symptom is not a cardiovascular problem. Peripheral vascular is not a category within the review of systems.

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? A) "I recommend that you change your posture while working at the computer." B) "You work at a computer a lot, don't you?" C) "When did the pain start?" D) "Do you perform any sustained or continually repetitive motions with that arm?"

"Do you perform any sustained or continually repetitive motions with that arm?" Ref: (ch.2 pg.16)

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

"Has this been having an effect on your ability to carry out your routines and get around your home?" Ref: (ch.2 pg.16)

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

Explaining the reasons for taking down notes Ref: (ch.2 pg.1)

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

Tone of voice Posture Gestures Eye contact Ref: (ch.2 pg. 14-15)

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? A) Introductory B) Working C) Summary D) Closing

Working Ref: (ch.2 pg.13-14)

A nurse is collecting data on a client's chief complaint, which is a spell of numbness and tingling on her left side. Which of the following questions would be best for eliciting information related to associated factors? A) "How bad was the tingling and numbness?" B) "How long did the spell last?" C) "Where did the numbness and tingling occur?" D) "What other symptoms occurred during the spell?"

"What other symptoms occurred during the spell?" Ref: (ch.2 pg.13-14)

"How many steps can you climb before you get short of breath?" is an example of what kind of question? A) A question that offers multiple choices for answers B) A question that is qualitative in focus C) A question that elicits a graded response D) A question that demands an imprecise response

A question that elicits a graded response Ref: (ch.2 pg.16)

A nurse collects data about a client's family health history. Which family members' health problems should the nurse include when documenting this information in the database? A) Only the members with health problems that relate to the client's gender B) As many genetic relatives as the client can recall C) Those with diseases that are known to have a genetic link D) Those with illnesses that resulted in death or disablement

As many genetic relatives as the client can recall Ref: (ch.2 pg.23)

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

Closing the door may help to limit background noise Ref: (ch.2 pg.16-17)

The nurse learns that a client is unable to sleep because of high anxiety. On which category of health patterns should the nurse focus? A) sleep-rest B) activity-exercise C) coping-stress-tolerance D) self-perception/self-concept

Coping-stress-tolerance Explanation: The client's inability to sleep is being caused by anxiety which would be addressed within the coping-stress-tolerance category of the health pattern review. The client's anxiety is causing an issue within the category of sleep-rest. The client's anxiety would not be addressed within the activity-exercise or self-perception/self-concept categories within the health pattern review. Ref: (ch.2 pg.29)

A nurse is admitting a new client. The client is lying in bed. Where should the nurse be positioned? A) Seated in a chair at eye level with the client B) Sitting on the side of the bed, looking down at the client C) Leaning on the nightstand at eye level with the client D) Standing beside the bed, looking down at the client

Seated in a chair at eye level with the client Ref: (ch.2 pg.13)

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

"Can you tell me about your problem from when it started until now?" Ref: (ch.2 pg.15)

During an interview with an adult client, the nurse can keep the interview from going off course by A) Using open-ended questions B) Rephrasing the client's statements C) Inferring information D) Using closed-ended questions

Using closed-ended questions Explanation: Use closed-ended questions to obtain facts and to focus on specific information. Closed-ended questions are useful in keeping the interview on course. Ref: (ch.2 pg. 15)

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? A) It makes health care decision making less burdensome for the client's family. B) A proxy is identified to make healthcare decisions when the client is no longer able to do so. C) It assures that the client's final health care wishes are known and implemented. D) Hospice and palliative care will be implemented as a part of the final health care plan.

A proxy is identified to make healthcare decisions when the client is no longer able to do so

During a client interview, the nurse uses nonverbal expressions appropriately when the nurse A) avoids excessive eye contact with the client. B) remains expressionless throughout the interview. C) uses touch in a friendly manner to establish rapport. D) displays mental distancing during the interview.

Avoids excessive eye contact with the client Explanation: Avoid extremes in eye contact. Some clients feel very uncomfortable with too much eye contact; others believe that you are hiding something from them if you do not look them in the eye. Therefore, it is best to use a moderate amount of eye contact. Ref: (ch.2 pg.15)

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 A) Allow the client to verbalize his or her feelings B) Offer reasons why the client should not feel angry C) Provide structure during the interview D) Refer the client to a different health care provider

Allow the client to verbalize his or her feelings Ref: (ch.2 pg. 19)

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? A) health patterns B) chief complaint C) review of systems D) history of present illness

Chief complaint Explanation: The chief complaint is the reason for the person seeking care. Health patterns focuses on the client's social history. The review of systems is where the presence or absence of common symptoms related to each major body system are reviewed and documented. The history of present illness describes how each symptom developed. It includes the client's thoughts and feelings about the illness, relevant parts of the review of systems, and medications, allergies, and lifestyle habits that impact the present illness. Ref: (ch.2 pg.19-21)

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

Next to the client, so the examiner can maintain eye contact and observe the nonverbal cues of the client Explanation: 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. Ref: (ch.2 pg.14)

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? A) History of present illness B) Review of systems C) Chief complaint D) Personal health history

Personal health history Ref: (ch.2 pg.21-22)

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

"Have you ever had a problem with mental or emotional illness?" Explanation: The nurse should begin by asking a non-threatening open-ended question such as "have you ever had a problem with mental or emotional illness?" Asking specifically about medication for depression assumes the client has a history of depression. Asking about talking with a psychiatrist or counseling may cause the client to become defensive. Ref: (ch.2 pg. 21-22)

During one of your clinical placements you encounter a patient who becomes silent during the nursing interview. What would be appropriate for you to do? (Mark all that apply.) A) Appear attentive B) Give brief encouragement to the patient C) Change the subject you are asking about D) Ask your question again E) Watch the patient closely for nonverbal cues

-Give brief encouragement to the patient -Watch the patient closely for nonverbal cues -Appear attentive Explanation: The period of silence usually feels much longer to the nurse than it does to the patient. The nurse should appear attentive and give brief encouragement to continue when appropriate. During periods of silence, watch the patient closely for nonverbal cues, such as difficulty controlling emotions. Repetition may make the patient more uncomfortable and further hinder communication. The nurse should implement the other listed techniques before changing the subject. Ref: (ch.2 pg.14-15)

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? A) Only the members with health problems that relate to the client's gender B) As many maternal and paternal relatives as the client can recall C) Disease processes that are known to have a genetic link D) Illnesses that resulted in death or disablement

As many maternal and paternal relatives as the client can recall Ref: (ch.2 pg.23)

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 A) allow the client time to calm down B) avoid discussing sensitive issues C) set time limits with the client D) explain the role and purpose of the nurse

Explain the role and purpose of the nurse Ref: (ch.2 pg.19)

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? A) History of present illness B) Review of systems C) Chief complaint D) Personal health history

Personal health history Explanation: The chief complaint is the abdominal pain. Any associated symptoms would be a part of the history of present illness. The information provided by the client about a past illness would be part of the personal health history. Review of systems provides specific questions about past illnesses that might still be impacting the client. Ref: (ch.2 pg. 21-22)

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

Planning for follow-up care Explanation: The main activity that takes place during the termination phase is planning for follow-up and closing the interview Ref: (ch.2 pg.13)

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

Rephrasing the client's statements Explanation: Rephrasing information the client has provided is an effective way to communicate during the interview. This technique helps you to clarify information the client has stated; it also enables you and the client to reflect on what was said. Ref: (ch.2 pg.16-17)

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

Summarization Ref: (ch.2 pg.14)

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? A) The sister may not tell the client exactly what the nurse says B) The client's sister may not understand medical terminology C) The sister may not be there every time the nurse needs to talk to the client D) The client may not want the sister to know their private information

The client may not want the sister to know their private information Explanation: Using children in the family, other relatives, or close friends as interpreters violates privacy laws, because clients may not want to share personal information with others. HIPAA guidelines address privacy issues such as this scenario. Even when the client gives permission for the family member to be present, an official interpreter should be present per facility policy. The other options could be true in some situations, but the priority answer addresses privacy, both the client's right to privacy, and the facility's handling of private information. Ref: (ch.2 pg.17)

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 A) Use very basic lay terminology B) Have a family member present during the interview C) Use standard medical terminology D) Show the client pictures of different symptoms, such as the "faces of pain chart."

Use very basic lay terminology Explanation: If the client appears to have a limited vocabulary, the nurse may need to ask questions in several different ways and use very basic lay terminology. Ref: (ch.2 pg.23)

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? A) Working B) Beginning C) Closing D) Preinteraction

Working Ref: (ch.2 pg.13-14)

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? A) Pre-interaction B) Beginning C) Working D) Closing

Working Ref: (ch.2 pg.16)

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? A) risk factors B) health maintenance C) screening test completion D) compliance with treatment

health maintenance Ref: (ch.2 pg.21-22)

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? A) adult daughter controlling the interview B) unable to recall exact date of last surgery C) last surgery date validated by adult daughter D) confused regarding dates of surgical procedures

last surgery date validated by adult daughter Ref: (ch.2 pg.17)