Prep U Chapter 2
personal health history
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?
past medical history
A client has a 10-year history of being treated for hypertension. Where should the nurse document this information?
explain the purpose of the interview
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?
health maintence
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?
create a genogram
A client reports the health status of living parents, siblings, and deceased grandparents. What should the nurse do with this information?
provide simple and organized information
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?
Record the information as subjective data
A client states, "I feel worse since the nurse gave me that medication." What is the nurse's best action?
The client may not want the sister to know their private information
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?
intimate partner violence
A client's spouse answers the interview questions and will not leave the examination room. What should the nurse suspect may be occurring with the client?
"What is your major health concern at this time
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?
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?
develop a plan of care for the client
A nurse completes an initial assessment and discusses findings with the client. What is the next best action of the nurse?
circle with a cross
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?
summary
A nurse has completed assessment of a client and is now validating the information gathered and reviewing goals with the client. Which phase of the interview process is this?
what other symptoms occurred during the spell?
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?
"Denies any trouble hearing or any ringing, buzzing, or earaches."
A nurse is conducting a review of systems with a client and is asking about his ears. The nurse asks, "Do you have any problems with your ears or your hearing?" The client stares blankly at the nurse a moment and then says, "I'm sorry—could you repeat that?" The nurse repeats the question, to which the client replies, "No." The nurse then asks, "Do you ever experience any trouble hearing or any ringing, buzzing, or earaches?" The client responds, "No." What should the nurse record under "Ears" in the review of systems section of the client's health history?
what diseases did you have as a child
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?
"Do you perform any sustained or continually repetitive motions with that arm?"
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?
active listening
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?
"Do you live alone or with someone?"
A nurse is performing an admission assessment on a new client to the unit. What would be the best way to phrase a question about the client's marital status?
Where do you feel the pain?" "Where does the pain travel?" "What other symptoms do you have with the pain?" "What makes the pain less or worse?"
After a client describes abdominal pain to the nurse, which questions can the nurse use to help the client provide more information about the pain? (Select all that apply.)
the client
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?
identify risk factors to the client and the client's significant other, if an
During a client interview, the nurse asks questions about the client's past health history. The primary purpose of asking about past health problems is to
reliable
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?
"It helps the nurse organize data on the client's family history."
During a health history, the nurse recommends using a genogram. The client asks the nurse to explain the purpose of a genogram. How should the nurse respond?
Stop documenting in order to maintain eye contact with the client
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?
working
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?
working
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?
Courteously interrupt the client to clarify some information.
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?
knowledge of his or her own thoughts and feelings about these issues.
For a nurse to be therapeutic with clients when dealing with sensitive issues such as terminal illness or sexuality, the nurse should have
Make sure that dress and appearance are professional Do not use facial expressions such as rolling the eyes or looking bored or disgusted Use gestures intentionally to illustrate points, especially for clients who cannot communicate verbally
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.
family violence
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?
unable to go to the gym since having back surgery
The nurse documents information about a client's activity-exercise health pattern. Which information did the nurse most likely document?
indicate acceptance of the clients cultural difference
The nurse has interviewed a Hispanic client with limited English skills for the first time. The nurse observes that the client is reluctant to reveal personal information and believes in a hot-cold syndrome of disease causation. The nurse should
allow the client to verbalize his or her feelings
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
ask the client to repeat the statement or question
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?
works in the service industry
The nurse is caring for a client in the health care provider's office. In reviewing the client's chart, the nurse recognizes the need for providing the client with additional education related to COVID-19 when noting which of the following about the client?
use very basic lay terminology
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
"Have you ever had a problem with mental or emotional illness?"
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?
knock and announce self before entering room
The nurse is reviewing a new client's chart prior to the initial interview. The chart reveals the client has a visual impairment. What actions should the nurse take to ensure a successful interview?
pre interview
The nurse is reviewing the medical record before meeting a new client. In which phase of the interview process is the nurse working
coping-stress=tolerance
The nurse learns that a client is unable to sleep because of high anxiety. On which category of health patterns should the nurse focus?
at the beginning of the interview
The principle of confidentiality is of paramount importance in the nurse-client relationship. When should you inform the client of with whom his or her information will be shared?
false
When interviewing, the nurse should logically move from specific to open-ended questions.
open-ended questions to allow full freedom of response
Which type of question is asked first by the nurse in order to attain a full description of the client's symptoms?
to clarify
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?
how do you manage your stress
While interviewing an adult client about the client's stress levels and coping responses, an appropriate question by the nurse is
