Coursepoint HA: Ch 2 Collecting Subjective Data: The Interview and Health History
13. A client has presented for care with complaints of persistent lower back pain. When using the mnemonic COLDSPA, which question should the nurse use to evaluate the "P"? A) "What makes it worse?" B) "When did it start?" C) "How does it feel?" D) "How would you rate your pain?"
A) "What makes it worse?"
33. 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)
A) Active listening
29. 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." How should the nurse best follow up this client's statement? A) Briefly describe some of the potential benefits of regular exercise. B) Ask the client if he understands the risk factors for heart disease and diabetes. C) Explain to the client that he should be performing aerobic exercise for 20 to 30 minutes at least three times a week. D) Document the nursing diagnosis of Risk for Activity Intolerance related to sedentary lifestyle.
A) Briefly describe some of the potential benefits of regular exercise.
9. A nurse provides care in a rural hospital that serves a community that has few minority residents. When interviewing a client from a minority culture, the nurse has enlisted the assistance of a "culture broker." How can this individual best facilitate the client's care? A) By interpreting the client's language and culture B) By evaluating the client's culturally based health practices C) By teaching the client about health care D) By making the client feel comfortable and safe
A) By interpreting the client's language and culture
19. A nurse is creating a genogram of a client's family health history. The nurse should use which of the following symbols to denote the client's female relatives? A) Circle B) Square C) Triangle D) Rectangle
A) Circle
1. A nurse is preparing to assess a client who is new to the clinic. When beginning the collection of the client database, which of the following actions should the nurse prioritize? A) Establishing a trusting relationship B) Determining the client's strengths C) Identifying potential health problems D) Making clinical inferences
A) Establishing a trusting relationship
When entering a client's room, the nurse washes the hands and asks the client for his name. What is the nurse's next best action? A) Introduce self and explain what will be done. B) Auscultate heart, lungs, and breath sounds. C) Prepare medications in front of the client. D) Take the client's vital signs and record them.
A) Introduce self and explain what will be done
7. A nurse is eliciting a client's health history and the client asks, "Can I take the herb ginkgo biloba with my other medications?" What action would be best if the nurse is unsure of the answer? A) Promise to find out the information for the client. B) Change the subject and return to this topic later. C) Teach the client to only take prescribed medications. D) Encourage the client to ask the pharmacist or primary care provider.
A) Promise to find out the information for the client.
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.
A) Provide simple and organized information.
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
A) The client
8. The nurse is preparing to assess the mental status of a 90-year-old client who is being admitted to the hospital from a long-term care facility. Which of the following should the nurse assess first? A) The client's sensory abilities B) The client's general intelligence C) The presence of any phobias D) The client's judgment and insight
A) The client's sensory abilities
32. 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) Pre-interaction
A) Working
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.
A) maintain eye contact while asking the questions from the form.
A client's spouse answers the interview questions and will not leave the examination room. What should the nurse suspect be occurring with the client? A) physical abuse B) low self-esteem C) cognitive disorder D) mental health disorder
A) physical abuse
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? A) reliable B) puzzling C) concerning D) questionable
A) reliable
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
A) value-belief
31. 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
A, B, C
26. The nurse is completing a review of systems for a client. Which of the following information would the nurse document related to the client's musculoskeletal system? Select all that apply. A) Joint stiffness B) Rhinorrhea C) Shortness of breath D) Chest pain E) Muscle strength F) Knee swelling
A, E, F A) Joint stiffness E) Muscle strength F) Knee swelling
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?"
B) "Has this been having an effect on your ability to carry out your routines and get around your home?"
28. 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? A) "In general, it's necessary for us to gather as much information about each client as possible." B) "We want to make sure your nursing care matches your needs as closely as possible." C) "The care team needs to cross-reference your diagnostic testing with the information that I'm asking you about." D) "We don't want to make the mistake of focusing solely on the medical problem that brought you here."
B) "We want to make sure your nursing care matches your needs as closely as possible."
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
B) As many genetic relatives as the client can recall
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.
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.
20. A client has just been admitted to the postsurgical unit from postanesthetic recovery, and the nurse is in the introductory phase of the client interview. Which of the following activities should the nurse perform first? A) Collaborate with the client to identify problems. B) Explain the purpose of the interview. C) Determine the client's vital signs. D) Obtain family health history data.
B) Explain the purpose of the interview.
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.
B) Maintain a professional distance during assessment.
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? A) Transition B) Summarization C) Reassurance D) Termination
B) Summarization
4. A nurse is interviewing a 22-year-old client of the campus medical clinic. Which nonverbal behavior should the nurse adopt to best facilitate communication during this phase of assessment? A) Standing while the client is seated B) Using a moderate amount of eye contact C) Sitting across the room from the client D) Minimizing facial expressions
B) Using a moderate amount of eye contact
2. A nurse is interpreting and validating information from an older adult client who has been experiencing a functional decline. The nurse is in which phase of the interview? A) Introductory B) Working C) Summary D) Closing
B) Working
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
B) Working
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
B) be nonjudgmental
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
B) health maintenance
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
B) health maintenance
The review of systems is to be completed next while conducting a comprehensive assessment. Which type of question should the nurse use for this review? A) narrative B) yes or no C) open-ended D) summative
B) yes or no
5. A nurse is providing feedback to a colleague after observing the colleague's interview of a newly admitted client. Which of the following would the nurse identify as an example of a closed-ended question or statement? A) "Tell me about your relationship with your children?" B) "Tell me what you eat in a normal day?" C) "Are you allergic to any medications?" D) "What is your typical day like?"
C) "Are you allergic to any medications?"
16. A client's elevated body mass index (BMI) has prompted the nurse to assess the client's activity and exercise level. Which statement would indicate to the nurse that the client is getting the recommended amount of exercise? A) "I walk briskly on the treadmill once or twice a week." B) "I play basketball with a team every Friday night without fail." C) "I go to a step class for an hour three times a week." D) "I swim for at least half an hour each Saturday morning."
C) "I go to a step class for an hour three times a week."
14. A medical nurse has completed the review of systems component of the client's health history. Which assessment finding should the nurse document under the review of systems? A) "High school diploma plus 2 years of college" B) "Caregiver reliable source of information" C) "Menarche at age 13" D) "Lungs clear to auscultation bilaterally"
C) "Menarche at age 13"
3. A 71-year-old woman has been admitted to the hospital for a vaginal hysterectomy, and the nurse is collecting subjective data prior to surgery. Which statement by the nurse could be construed as judgmental? A) "How often do your adult children typically visit you?" B) "Your husband's death must have been very difficult for you." C) "You must quit smoking because it affects others, not only you." D) "How would you describe your feelings about getting older?"
C) "You must quit smoking because it affects others, not only you."
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.
C) Ask the client to repeat the statement or question.
34. 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
C) Circle with a cross
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
C) Closing the door may help to limit background noise.
The nurse is focusing an interview on a client'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?
C) Describe how you breathe for me?
24. A nurse is teaching a recent nursing graduate about the significance of verbal and nonverbal communication during client care. The new graduate demonstrates an understanding of these techniques by citing what example of verbal communication? A) Maintaining an open attitude B) Using silence appropriately C) Providing a laundry list of descriptors when needed D) Maintaining an open and encouraging facial expression
C) Providing a laundry list of descriptors when needed
22. The nurse is using the mnemonic "COLDSPA" to assess a client's complaint of lower abdominal pain. The nurse asks the client to rate the pain on a scale of 0 to 10. The nurse is assessing which aspect of the complaint? A) Character B) Onset C) Severity D) Pattern
C) Severity
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
C) Working
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
C) gastrointestinal
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.
C) knowledge of his or her own thoughts and feelings about these issues.
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
C) unable to go to the gym since having back surgery
25. The admission of a new resident to a long-term care facility has necessitated a thorough health history. Place the following focuses in the correct sequence in which the nurse should perform them, beginning with the section obtained first. A) Family health history B) Reason for seeking care C) Biographic data D) Review of body systems E) History of present concern F) Past health history
C, B, E, F, A, D C) Biographic data B) Reason for seeking care E) History of present concern F) Past health history A) Family health history D) Review of body 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?"
D) "Do you perform any sustained or continually repetitive motions with that arm?"
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?"
D) "How do you manage your stress?"
11. A nurse has admitted a client to the medical unit and is describing the purpose for obtaining a comprehensive health history. Which of the following purposes should the nurse describe? A) "This helps us to complete your health record accurately." B) "This helps us to establish a trusting interpersonal relationship." C) "This helps us to evaluate the seriousness of your risk factors for disease." D) "This helps us have an appropriate focus for the physical examination."
D) "This helps us have an appropriate focus for the physical examination."
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?"
D) "What is your routine for checking your blood sugar these days?"
10. Upon entering an exam room, the client states, "Well! I was getting ready to leave. My schedule is very busy and I don't have time to waste waiting until you have the time to see me!" Which response by the nurse would be most appropriate? A) "Our schedule is very busy also. We got to you as soon as we could." B) "No one is forcing you to be here, and you are free to leave at any time." C) "Would you like to report your complaints to someone with power?" D) "You're certainly justified in being upset, but I am ready to begin your exam now."
D) "You're certainly justified in being upset, but I am ready to begin your exam now."
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? A) Write down the information as the client is speaking. B) Key the information into the electronic medical record as the client is speaking. C) Avoid maintaining eye contact while the client is discussing spouse abuse. D) Stop documenting in order to maintain eye contact with the client.
D) Stop documenting in order to maintain eye contact with the client.
30. A nurse is obtaining subjective data from an adult client who is new to the clinic. The nurse has asked the client, "Where do you usually turn for help in a time of crisis?" What domain is this nurse assessing? A) The client's family relationships B) The client's current level of social and relational stability C) The client's critical thinking and problem-solving abilities D) The client's stress management and coping strategies
D) The client's stress management and coping strategies
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? A) To summarize the conversation B) To restate what the client has said C) To promote objectivity D) To clarify
D) To clarify
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.
D) explain the role and purpose of the nurse.
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
D) past medical history
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? A) Friends and family who are unfamiliar with medical terminology may misinterpret information B) Hospital interpreters may not always be the best choice because they are unfamiliar with the client C) Using children in the family, other relatives, or close friends as interpreters does not violate privacy laws D) Interpreters do not understand cultural health beliefs and practices, so they are unable to help bridge the gap
A) Friends and family who are unfamiliar with medical terminology may misinterpret information
21. During the interview, the client states, "Is today the 12th? My wife died 2 months ago today." Which of the following responses would be most appropriate? A) "What was the cause of your wife's death?" B) "How does that make you feel right now?" C) "You probably must be sad." D) "Are you feeling sad, depressed, angry, or upset?"
B) "How does that make you feel right now?"
17. During an assessment, the nurse determines that a client sees more than one primary care provider and has obtained prescriptions from each provider. Which method would be most appropriate to determine a client's current medication regimen? A) Ask the client to identify which medications taken every day. B) Ask the client to bring all the medications and supplements to an interview. C) Ask the caregiver whether the client is taking prescribed medications. D) Ask the client about the use of any over-the-counter medications.
B) Ask the client to bring all the medications and supplements to an interview.
15. A client has been admitted following an unexplained weight loss of 15 pounds over the past 3 months. How should the nurse best assess the subjective component of the client's nutritional status? A) Ask the client to explain MyPlate. B) Obtain a 24-hour diet recall. C) Ask about the contents of one typical meal. D) Elicit the client's favorite foods.
B) Obtain a 24-hour diet recall.
6. A client has presented to the emergency department and is having difficulty describing her vague sensation of physical discomfort and unease. How can the nurse best elicit meaningful assessment data about the nature of the client's complaint? A) Ignore the complaint for now and return to it later in the assessment. B) Provide a laundry list of descriptive words. C) Restate the question using simpler terms. D) Wait in silence until the client can determine the correct words.
B) Provide a laundry list of descriptive words.
23. The nurse is obtaining information about a client's past health history. Which client statement would best reflect this component of assessment? A) "My mom's still alive, but my dad died 10 years ago of heart failure." B) "I have a brother with leukemia and a sister with hypertension." C) "I had surgery 5 years ago to repair an inguinal hernia." D) "I have been having some pain when I urinate for the last several days."
C) "I had surgery 5 years ago to repair an inguinal hernia."
12. A clinic nurse has reviewed a new client's available health record and will now begin taking the client's health history. Which of the following questions should the nurse ask first when obtaining the health history? A) "Do you have adequate health insurance coverage?" B) "Are you generally fairly healthy?" C) "What is your major health concern at this time?" D) "Did you bring all your medications with you?"
C) "What is your major health concern at this time?"
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
C) working.
27. The nurse is completing an assessment of a 50-year-old female client who has sought care for recurrent migraines that have not responded to treatment. Following the review of systems, how should the nurse best document unremarkable results of the subjective portion of the gastrointestinal assessment? A) "Client's gastrointestinal health is within reference ranges for age." B) "Client denies GI signs and symptoms." C) "Gastrointestinal problems are absent." D) "Client denies recent constipation, diarrhea, bowel incontinence, or abdominal pain."
D) "Client denies recent constipation, diarrhea, bowel incontinence, or abdominal pain."
18. The nurse is preparing to assess an adult woman's activities related to health promotion and maintenance. Which question should the nurse ask to obtain the most objective and thorough assessment data? A) "Do you always wear your seatbelt when driving?" B) "How much beer, wine, or alcohol do you drink?" C) "Do you use condoms with each sexual encounter?" D) "Could you describe how you perform self-breast exams?"
D) "Could you describe how you perform self-breast exams?"
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?"
D) "What other symptoms occurred during the spell?"
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
D) Personal health history
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.
D) expressing interest in a neutral manner.
