CoursePoint Chapter 2: The Health and History Interview

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

False

What occurs during the termination phase of an interview?

Planning for follow-up care

A nurse is interviewing a client with a different cultural background. Which nonverbal behavior should the nurse adopt to best facilitate communication during this phase of assessment?

Using a moderate amount of eye contact

During an interview, the nurse remains silent and nods the head periodically while the client is talking. The therapeutic communication technique the nurse is using would be:

continuers

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

During an interview with an adult client for the first time, the nurse can clarify the client's statements by

rephrasing the client's statements

During an interview, how can the nurse best assist the client as the client tells their story?

Avoid interrupting the client.

Which is an example of subjective data from a primary source?

The client states, "My chest hurts and my left arm feels numb."

The nurse performs a comprehensive assessment on a new client. What is the next action of the nurse?

Validate problems and determine client's goals.

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?

Active listening

While completing a history of present illness the nurse asks the client about risk factors. In which way should the nurse use this information?

Analyze as a contributing factor to the current problem

How would the nursing instructor explain the goal of guided questioning to his or her students?

Facilitating the client's fullest communication

The nurse would document driving with car seatbelt fastened, bicycling with properly-fitted helmet, and installing a smoke detector in a vacation home in the client's health history under which of the following?

personal and social history

A client has come to the physician's office several times in the last month with a black eye, bruises, and lacerations on the lower extremities. The client always explains having fallen and tripped. The nurse suspects abuse. The next step should be to:

report the findings to a supervisor

The nurse is admitting a new client to the unit. While reviewing old records of the client, the nurse knows that the data being gathered are what kind of data?

secondary

While the nurse is assessing a client's gastrointestinal system, the nurse's findings are unremarkable and the client denies any complications. How would the nurse best document the subjective portion of the assessment?

"Client denies recent constipation, diarrhea, bowel incontinence, or abdominal pain." Correct response:

During the nurse's assessment of the client's exercise and activity habits, the client laughs and then states, "Unless you're including channel surfing, I don't really do much of anything." What would the nurse do next?

Briefly describe some of the potential benefits of regular exercise.

The nurse is assessing the seven attributes of a client's symptom using the mnemonic OLD CART. In which section of the comprehensive health history will the nurse document this information?

History of present illness

When using an interpreter to facilitate an interview, where should the interpreter be positioned?

Next to the client, so the examiner can maintain eye contact and observe the nonverbal cues of the client

Which of the following describes how the health history interview differs from a social conversation?

The interview focuses on the client's needs to improve health and well-being.

A client reports difficulty sleeping. Which question would be the most effective way for the nurse to open the interview?

"Can you tell me about your sleep problem from when it started until now?"

The nurse is focusing an interview on a client's respiratory status. Which question should the nurse ask first to begin this interview?

Describe how you breathe for me?

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

A question that elicits a graded response

A nurse 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?

Explaining the reason for taking down notes

A client is admitted to the health care facility with new onset of abdominal pain. The client becomes angry with the nurse when questions about personal information are asked. How should the nurse proceed with the interview?

Remain in control and allow the client to vent feelings

During the working phase of an interview the nurse encourages the client to continue and expand on the health issues. What technique is the nurse using?

active listening

An adult client is brought to the ED after falling 12 feet from a ladder. The client has an obvious deformity to his left lower leg. What kind of assessment is the nurse going to perform?

emergency

A client reports a weight loss and fatigue during the review of systems. In which area should the nurse document this information?

general

A client with acute onset of shoulder pain is answering questions during a health history. The nurse is utilizing a mnemonic specific to the attributes of a symptom. The nurse first asks about the onset of symptoms followed by

location duration characteristic symptoms associated manifestations relieving/exacerbating factors treatment

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?

personal health history

The client is being interviewed upon arrival in the Emergency Department. When collecting subjective data from the client, the nurse is obtaining what other type of data from the client?

primary

Jason, a 41-year-old electrician, presents to the clinic for evaluation of shortness of breath, which occurs with exertion and improves with rest. The shortness of breath has been occurring for several months. Initially, it happened only a few times a day with strenuous exertion; however, it has started to occur with minimal exertion and is happening more than 12 times a day. The shortness of breath lasts for fewer than 5 minutes at a time. The client has no cough, chest pressure, chest pain, swelling in his feet, palpitations, orthopnea, or paroxysmal nocturnal dyspnea. Which of the following symptom attributes was not addressed in this description?

severity

A 60-year-old woman with a bunion will undergo surgery later today. The client tells the nurse in the surgical daycare admitting department, "I'm sure I've been asked these questions before. Can't we just focus on my foot and not all these other topics?" How should the nurse best explain the rationale for obtaining a health history?

"We want to make sure your nursing care matches your needs as closely as possible."

During the interview, the client informs the nurse that their abdominal pain has caused them to be fearful. The client worries that they may have ulcers or cancer. The nurse is aware that rephrasing is an excellent way to clarify subjective information. Which is the best response from the nurse?

"You are thinking that you may have a serious illness?"

The nursing instructor is teaching about the different types of health histories. Students show an understanding of what a comprehensive health history involves when identifying the following as examples: (Select all that apply.)

-Annual Physical Examination -Sports Participation Screening -Hospital Admission

The nurse is conducting an initial interview with a client. During the introductory phase, it is essential that the nurse perform which of the following actions? Select all that apply.

-Build rapport. -Provide a comfortable environment. -Explain the purpose of the interview. -Ensure confidentiality.

During the comprehensive health assessment, the nurse asks several questions relating to the client's family history of illnesses, such as diabetes and cancer. Why does the nurse do this? Select all that apply.

-To help identify those diseases for which the client may be at risk -To provide counseling and health teaching in high-risk areas -To identify genetic family trends for which the client is at risk

A nurse in a clinic is preparing to meet with a new, 35-year-old male client. Complete the following sentence by choosing from the lists of options. Prior to meeting the new client, the nurse should first ___________ and then ______.

-review the client's medical record -explain the purpose of the interview speak to family members

When the nurse asks the client with abdominal pain about what medications are currently being taken, which medications must be documented in the health history? Select all that apply.

-vitamin D -birth control pills -echinacea

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

-when does the pain occur? -what makes the pain better or worse? -how would you describe the pain? -could you show me where the pain is exactly?

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?

Courteously interrupt the client to clarify some information.

A nurse completes an initial assessment and discusses findings with the client. What is the next best action of the nurse?

Develop a plan of care with the client.

A unit of packed red blood cells has been prescribed for a client. Just prior to administering the unit of blood, the client states, "I remember the last time I had a blood transfusion, I had problems." What is the best action of the nurse?

Obtain a focused health history.

During a health history, a client states "I want to know why my feet are swelling" whereas the primary diagnosis is arthritis. What should the nurse do with the client's statement?

write it as the chief complaint