NU 273 PrepU Collecting Subjective Data: The Interview and Health History

A client reports difficulty sleeping. Which question would be the most effective way for the nurse to open the interview? "What have you tried to help with your sleep?" "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?" "When did the sleep problem begin?"

"Can you tell me about your sleep problem from when it started until now?" In order to open the interview, the nurse should start with an open-ended question and then identify missing data. Asking when the sleep problem began is assessing for the onset of the problem. Asking the client to rate the sleep problem from 1 to 10 is part of assessing characteristic symptoms. Asking the client what has been tried to help with the sleep is assessing for treatments.

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

"Do you perform any sustained or continually repetitive motions with that arm?" Inferring information from what the client tells you and what you observe in the client's behavior may elicit more data or verify existing data. Be careful not to lead the client to answers that are not true. The question, "Do you perform any sustained or continually repetitive motions with that arm?" is open enough to not lead the client to an expected answer but narrow enough for the nurse to help elicit more information from the client about probable causes of his pain. Recommending that the client change his posture while working at the computer is premature, as the nurse has not confirmed that the computer work is the culprit. Likewise, "You work at a computer a lot, don't you?" is a leading question, as it encourages the client to answer in the affirmative. The question, "When did the pain start?" is a close-ended question; it will elicit more information from the client but is not an example of inferring.

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 this been having an effect on your ability to carry out your routines and get around your home?" "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?" When initiating an interview, it is important to use language that is understandable and appropriate to the client. "Dyspnea," "SOB," and "activities of daily living" are potentially unclear to a client and reflect clinical language rather than clear communication.

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

"Have you ever had a problem with mental or emotional illness?" 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?" Even though the nurse has information about this topic in the documentation, asking the question opens a dialogue with the client in which the client can share as feels comfortable. The question may elicit important information about the client's prior experiences seeking care for mental illness, for example. 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.

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

"How do you manage your stress?"

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 do you usually eat in a typical day?" "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 diseases did you have as a child?" Information covered in the personal health history section includes questions about birth, growth, development, childhood diseases, immunizations, allergies, medication use, previous health problems, hospitalizations, surgeries, pregnancies, births, previous accidents, injuries, pain experiences, and emotional or psychiatric problems. The question, "How do you feel about having to seek health care?" would be asked during the reason for seeking health care section of the interview. The question regarding the status of the client's parents would be posed in the family health history section. The question regarding what the client usually eats in a typical day would be included in the lifestyle and health practices profile section.

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? "Where did the numbness and tingling occur?" "How long did the spell last?" "What other symptoms occurred during the spell?" "How bad was the tingling and numbness?"

"What other symptoms occurred during the spell?" Examples of questions related to associated factors include the following: "What other symptoms occur with it? How does it affect you? What do you think caused it to start? Do you have any other problems that seem related to it? How does it affect your life and daily activities?" The question, "How bad was the tingling and numbness?" relates to severity. The question, "How long did the spell last?" relates to duration. The question, "Where did the numbness and tingling occur?" relates to location.

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? Encouraging elaboration (facilitation) Restatement Reflection Active listening

Active listening Active listening is the ability to focus on the client and their perspectives. It requires the nurse to constantly decode messages including thoughts, words, opinions, and emotions. For example, if a client is sad, it is appropriate for a nurse to place a hand over the client's and to show a facial expression of compassion. The purpose of restatement is to have the client elaborate on what was originally stated by the client. Reflection uses summarizing by the nurse to find the true meaning of a client's words. Encouraging elaboration encourages the client to explain or go into more detail in the client's responses.

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

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.

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? Simple circle Circle with a cross Square with a cross Simple square

Circle with a crossThe standard format of representing a deceased female relative in a genogram is using a circle with a cross. A simple circle indicates a living female relative. A simple square indicates a living male relative. A square with a cross indicates a deceased male relative.

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

Courteously interrupt the client to clarify some information.

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 have any difficulty producing sputum? Do you currently have a cough? Do you experience any pain when you breathe? Describe how you breathe for me?

Describe how you breathe for me? During an interview, questions should proceed from general to specific. The question that is the most general is "describe your breathing." This provides the client with an opportunity to discuss the current breathing pattern with the nurse. The other questions are specific and will elicit a yes-no response.

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 Use gestures intentionally to illustrate points, especially for clients who cannot communicate verbally

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

Facilitating the client's fullest communication The main goal of guided questioning is to facilitate the client's fullest communication. The early generation of a plan is not a paramount goal and it is incorrect to suggest particular answers to the client.

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 True

False Recruiting family members or friends to serve as interpreters can be hazardous—confidentiality and cultural norms may be violated, meanings may be distorted, and transmitted information may be incomplete. Untrained interpreters may try to speed up the interview by telescoping lengthy replies into a few words, losing much of what may be significant detail.

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? Hospital interpreters may not always be the best choice because they are unfamiliar with the client Friends and family who are unfamiliar with medical terminology may misinterpret information Interpreters do not understand cultural health beliefs and practices, so they are unable to help bridge the gap Using children in the family, other relatives, or close friends as interpreters does not violate privacy laws

Friends and family who are unfamiliar with medical terminology may misinterpret Friends and family who are unfamiliar with medical terminology may misinterpret information. When possible, a trained medical interpreter is preferred. Using children or other relatives violates the client's privacy. It does not matter if the hospital interpreter knows the client; the interpreter can still accurately interpret for the health care provider. Interpreters generally understand cultural beliefs and practices, so they can help to bridge the gap between cultures.

Learning about the effects of the illness does what for the nurse and the client? Gives them the ability to communicate better 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 basis to establish a trusting relationship

Gives them the opportunity to create a complete and congruent picture of the problem

A nurse assesses a client with regard to nutritional habits, use of substances, education, and work and stress levels. The nurse recognizes this as what type of information? Personal health history History of present health concern Family health history Lifestyle and health practices profile

Lifestyle and health practices profile By assessing the client with regard to nutritional habits, use of substances, education, and work and stress levels, the nurse expects to obtain a lifestyle and health practices profile. To determine the history of present health concerns, the nurse should ask questions relating to the onset, duration, and treatments, if any have been conducted on the client, for the present health concern. The questions related to personal health history assist the nurse in identifying risk factors that stem from previous health problems. Family health history helps the nurse to identify potential risk factors for the client.

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

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.

During a health history interview, a nurse asks a client about childhood illnesses, past surgeries, and allergies. The nurse knows that this information will be charted in what section of the initial comprehensive assessment database? Biographic Personal health history Family health history Review of systems

Personal health history Information about a client's birth, childhood illnesses, immunization status, adult illnesses, surgeries, accidents, prolonged pain or pain patterns, and allergies are part of the personal health history. Biographic data include name, address, phone number, gender, date of birth, place of birth, race, educational level, occupation, and support systems. Family health history includes age of parents (living or deceased), parent illnesses, grandparent illnesses, and children illness or handicaps. Review of systems includes asking the client specific questions to draw out current health problems or problems from the past that may still be affecting the client's health.

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

Personal health history 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.

A client reports chest pain that occurs with exercise but subsides with rest. The nurse recognizes this as what type of data? Subjective Reflective Introspective Objective

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.

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

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.

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

Relaxed Facial expressions should be relaxed, caring, and interested. Facial expressions that are happy, inquisitive, or detached can interfere with the therapeutic communication process.

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. Abuse of herbal supplements can result in cardiac dysfunction. Some herbal supplements may interact with prescribed medications. 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.

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? Write down the information as the client is speaking. 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.

Stop documenting in order to maintain eye contact with the client. Whenever the client is talking about sensitive or disturbing information, the nurse should stop documenting or move away from the keyboard and maintain eye contact with the client. The nurse should not write down the information as the client is speaking and should not continue keying the information into the electronic medical record while the client is speaking. Avoiding eye contact minimizes the importance of the information that the client is providing and should not be done.

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? Transition Summarization Reassurance Termination

Summarization Summarization can be used at different points in the interview to structure the visit, especially at times of transition. This technique also allows the nurse to organize his or her clinical reasoning and to convey it to the client, making the relationship more collaborative. It is also a useful technique for learners when they draw a blank on what to ask the client next.

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? The client's wife The client's medical record The client The physician

The client Biographic data usually include information that identifies the client, such as name, address, phone number, gender, and who provided the information—the client or significant others. The client is considered the primary source and all others (including the client's medical record) are secondary sources. In some cases, the client's immediate family or caregiver may be a more accurate source of information than the client. An example would be an older adult client's wife who has kept the client's medical records for years or the legal guardian of a mentally compromised client. In any event, validation of the information by a secondary source may be helpful.

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

The client may not want the sister to know their private information 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.

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

To clarify Another way to clarify is to ask, "What happens when you get low blood sugar?" Such questions prompt clients to identify other symptoms or give more information so that you can better understand the situation.

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

To clarify Another way to clarify is to ask, "What happens when you get low blood sugar?" Such questions prompt clients to identify other symptoms or give more information so that you can better understand the situation.

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? Closing Working Beginning Pre-interaction

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.

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 allow the client to verbalize his or her feelings. provide structure during the interview. offer reasons why the client should not feel angry. refer the client to a different health care provide

allow the client to verbalize his or her feelings. When interacting with an angry client approach this client in a calm, reassuring, in-control manner. Allow him to ventilate feelings.

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

coping-stress-tolerance 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.

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

explain the role and purpose of the nurse. When interacting with an anxious client provide the client with simple, organized information in a structured format and explain who you are, along with your role and purpose.

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 using a highly structured interview process. providing the client with simple explanations. offering to hold the client's hand. expressing interest in a neutral manner.

expressing interest in a neutral manner.

The nurse is completing a comprehensive assessment with a newly admitted client. In which area should the nurse document the client's list of immunizations? health patterns health maintenance past medical history review of systems

health maintenance Health maintenance is a part of the past medical history and identifies actions taken to improve or maintain health. Immunizations would be documented under health maintenance. 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. The past history lists childhood illnesses, adult illnesses with dates, health maintenance practices, and risk factors.

A client plays doubles tennis every Saturday and golfs on Wednesday afternoons. In which part of the comprehensive health history is this information utilized? health maintenance history of present illness health patterns review of systems

health patterns Activity-exercise is a category within the health patterns section of the comprehensive health history. Physical activity is not a part of the review of systems. Health maintenance focuses on immunizations, safety and risk factors. The client's activity is not a part of the history of present illness.

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

last surgery date validated by adult daughter The client's memory was cloudy but the adult daughter was able to provide the exact date based upon a life event that can be validated. This interaction does not indicate that the adult daughter is controlling the interview. The client was unable to recall the exact date of the surgery but with the daughter's help, the date was provided. The exact information about the surgical date and the person who provided the information should be documented. The client may have been confused, but that is not what needs to be documented.

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. read the questions verbatim from the form. maintain eye contact while asking the questions from the form. ask leading questions throughout the interview.

maintain eye contact while asking the questions from the form. Establish eye contact when the client is speaking to you but look down at your notes from time to time.

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

neurologic 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.

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? specific questions to secure a description of every symptom pertinent positive and negative questions to determine relevant details 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

open-ended questions to encourage the client to tell his or her storyUsing the visualization of "the cone," the process begins with open-ended questions to hear "the story of the symptom," ideally in the client's own words. Specific questions are then used to get the features of every symptom. Yes-or-no questions, also referred to as pertinent positives and negatives, are used to retrieve information from the review of systems assessment.

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

past medical history 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.

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

provide the client with information as questions arise. Another important thing to do throughout the interview is to provide the client with information as questions and concerns arise. Make sure that you answer every question as thoroughly as you can. If you do not know the answer, explain that you will find out for the client. The more clients know about their own health, the more likely they are to become equal participants in caring for their health.

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 gained 15 lbs. over the last 6 months experiences panic attacks several times a week unable to go to the gym since having back surgery

unable to go to the gym since having back surgery

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. show the client pictures of different symptoms, such as the "faces pain chart." use standard medical terminology. have a family member present during the interview.

use very basic lay terminology.

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

value-belief The value-belief health pattern describes patterns of values, beliefs or goals that guide choices or decisions. The self-perception-self-concept pattern describes body image, feeling state, self-esteem, personal identity, and social identity. The role-relationship pattern describes patterns of role interactions and relationships including family functioning and problems, and work and neighborhood environment. The coping-stress-tolerance pattern describes general coping pattern and its effectiveness in terms of stress tolerance.

What are the nursing goals for the introductory phase of the nurse-client interview? (Select all that apply.) Agreeing upon the agenda for the interview. Responding therapeutically to the client's emotional cues. Inviting the client to tell their story. Establishing a trusting, respectful rapport with the client. Reviewing the client's records.

• Establishing a trusting, respectful rapport with the patient.• Agreeing upon the agenda for the interview.Explanation: During the introduction phase of the nurse-patient interview, the nursing focus is on putting the patient at ease and establishing trust. Actions that the nurse will take during this phase of the interview process include greeting the patient, establishing rapport, and establishing the agenda for the interview. Inviting the patient's story and responding to emotional cues are actions within the working phase while reviewing the patient's records in done in the pre-interview phase