Advanced Health Assessment and Diagnostic Reasoning 3rd edition Rhoads

Advanced Health Assessment and Diagnostic Reasoning 3rd edition Rhoads...4. In an interview, the nurse may find it necessary to take notes to aid hiWhich statement is trueregarding note-taking? a. Note-taking may impede the nurses observation of the patients nonverbal b. Note-taking allows the patient to continue at his or her own pace as the nurecords what is said. c. Note-taking allows the nurse to shift attention away from the patient, resuin an increased comfort level. d. Note-taking allows the nurse to break eye contact with the patient, which mincrease his or her level of comfort. ANS: A The use of history forms and note-taking may be unavoidable. However, the nthat note-taking during the interview has disadvantages. It breaks eye contthe attention away from the patient, which diminishes his or her sense of imay also interrupt the patients narrative flow, and it impedes the observatpatients nonverbal behavior. 5. The nurse asks, I would like to ask you some questions about your healthactivities so that we can better plan your stay here. This question is founphase of the interview process. a. Summary b. Closing c. Body d. Opening or introduction ANS: D When gathering a complete history, the nurse should give the reason for theopening or introduction phase of the interview, not during or at the end of6. A woman has just entered the emergency department after being battered bnurse needs to get some information from her to begin treatment. What is thopening phase of the interview with this patient? a. Hello, Nancy, my name is Mrs. C. b. Hello, Mrs. H., my name is Mrs. C. It sure is cold today! c. Mrs. H., my name is Mrs. C. How are you? d. Mrs. H., my name is Mrs. C. Ill need to ask you a few questions about whANS: D Address the person by using his or her surname. The nurse should introduce give the reason for the interview. Friendly small talk is not needed to bui7. During an interview, the nurse states, You mentioned having shortness ofmore about that. Which verbal skill is used with this statement? a. Reflection b. Facilitation c. Direct question d. Open-ended question ANS: D The open-ended question asks for narrative information. It states the topiconly in general terms. The nurse should use it to begin the interview, to iof questions, and whenever the person introduces a new topic. 8. A patient has finished giving the nurse information about the reason he reviewing the data, the nurse finds that some information about past hospitAt this point, which statement by the nurse would be most appropriate to gaa. Mr. Y., at your age, surely you have been hospitalized before! b. Mr. Y., I just need permission to get your medical records from County Mc. Mr. Y., you mentioned that you have been hospitalized on several occasions.Would you tell me more about that? d. Mr. Y., I just need to get some additional information about your past hospWhen was the last time you were admitted for chest pain? ANS: D The nurse should use direct questions after the persons opening narrative tor she left out. The nurse also should use direct questions when specific fwhen asking about past health problems or during the review of systems. 9. In using verbal responses to assist the patients narrative, some responsframe of reference and some focus on the health care providers l response that focuses on the health care providers perspective woulda. Empathy. b. Reflection. c. Facilitation. d. Confrontation. ANS: D When the health care provider uses the response of confrontation, the framefrom the patients perspective to the perspective of the health care provideprovider starts to express his or her own thoughts and feelings. Empathy, rfacilitation responses focus on the patients frame of reference. 10. When taking a history from a newly admitted patient, the nurse notices and expectantly looks at the nurse. What would be the nurses best response a. Be silent, and allow him to continue when he is ready. b. Smile at him and say, Dont worry about all of this. Im sure we can find outyoure having these pains. c. Lean back in the chair and ask, You are looking at me kind of funny; theishere d. Stand up and say, I can see that this interview is uncomfortable for you. We can continue it another time. ANS: A Silent attentiveness communicates that the person has time to think and to she wishes to say without an interruption from the nurse. Health professioninterrupt this thinking silence. The other responses are not conducive to i 11. A woman is discussing the problems she is having with her 2-year-old sowont go to sleep at night, and during the day he has several fits. I get soThe nurses best verbal response would be: a. Go on, Im listening. b. Fits? Tell me what you mean by this. c. Yes, it can be upsetting when a child has a fit. d. Dont be upset when he has a fit; every 2 year old has fits. ANS: B The nurse should use clarification when the persons word choice is ambiguou(e.g., Tell me what you mean by fits.). Clarification is also used to summaor to simplify the words to make them clearer; the nurse should then ask ifright track. 12. A 17-year-old single mother is describing how difficult it is to raise herself. During the course of the interview she states, I cant believe my bthis by myself! What a terrible thing to do to me! Which of these responsesempathy? a. You feel alone. b. You cant believe he left you alone? c. It must be so hard to face this all alone. d. I would be angry, too; raising a child alone is no picnic. ANS: C An empathetic response recognizes the feeling and puts it into words. It naallows its expression, and strengthens rapport. Other empathetic responses hard for you, I understand, or simply placing your hand on the persons ns words or agreeing with the person is not an empathetic response. 13. A man has been admitted to the observation unit for observation after blarge cut on his forehead. As the nurse works through the interview, one ofquestions has to do with alcohol, tobacco, and drug use. When the nurse askuse, he states, I quit smoking after my wife died 7 years ago. However, thepack of cigarettes in his shirt pocket. Using confrontation, the nurse coula. Mr. K., I know that you are lying. b. Mr. K., come on, tell me how much you smoke. c. Mr. K., I didnt realize your wife had died. It must be difficult for youPlease tell me more about that. d. Mr. K., you have said that you dont smoke, but I see that you have an open cigarettes in your pocket. ANS: D In the case of confrontation, a certain action, feeling, or statement has bnurse now focuses the patients attention on it. The nurse should give honesis seen or felt. Confrontation may focus on a discrepancy, or the nurse maywhen parts of the story are inconsistent. The other statements are not appr14. The nurse has used interpretation regarding a patients statement or acttechnique, it would be best for the nurse to: a. Apologize, because using interpretation can be demeaning for the patient b. Allow time for the patient to confirm or correct the inference. c. Continue with the interview as though nothing has happened. d. Immediately restate the nurses conclusion on the basis of the patients nANS: B Interpretation is not based on direct observation as is confrontation, but inference or conclusion. The nurse risks making the wrong inference. If thipatient will correct it. However, even if the inference is correct, interprfurther discussion of the topic. 15. During an interview, a woman says, I have decided that I can no longer live with their fathers violence, but I just cant seem to leave him. Using best response would be: a. You are going to leave him? b. If you are afraid for your children, then why cant you leave? c. It sounds as if you might be afraid of how your husband will respond. d. It sounds as though you have made your decision. I think it is a good onANS: C This statement is not based on ones inference or conclusion. It links eventor implies cause. Interpretation also ascribes feelings and helps the persoown feelings in relation to the verbal message. The other statements do not16. A pregnant woman states, I just know labor will be so painful that I woknow it sounds awful, but I really dread going into labor. The nurse respondont worry about labor so much. I have been through it, and although it is medications are available to decrease the pain. Which statement istrue regaThe nurses reply was a: a. Therapeutic response. By sharing something personal, the nurse gives hopb. Nontherapeutic response. By providing false reassurance, the nurse actuallydiscussion of the womans fears. c. Therapeutic response. By providing information about the medications availagiving information to the woman. d. Nontherapeutic response. The nurse is essentially giving the message to that labor cannot be tolerated without medication. ANS: B By providing false assurance or reassurance, this courage builder relieves and gives the nurse the false sense of having provided comfort. However, foproviding false assurance or reassurance actually closes off communication,anxiety, and effectively denies any further talk of it. 17. During a visit to the clinic, a patient states, The doctor just told mesmoking. He doesnt understand how hard Ive tried. I just dont know the bestshould I do? The nurses most appropriate response in this case would be: a. Id quit if I were you. The doctor really knows what he is talking about.b. Would you like some information about the different ways a person can quc. Stopping your dependence on cigarettes can be very difficult. I understad. Why are you confused? Didn 't the doctor give you the information about the smoking cessation program we offer? ANS: B Clarification should be used when the persons word choice is ambiguous or cClarification is also used to summarize the persons words or to simplify thclearer; the nurse should then ask if he or she is on the right track. The unwanted advice or do not offer a helpful response. 18. As the nurse enters a patients room, the nurse finds her crying. The pajust found out that the lump in her breast is cancer and says, Im so afraidnurses most therapeutic response would be to say in a gentle manner: a. Youre afraid you might lose your breast? b. No, Im not sure what you are talking about. c. Ill wait here until you get yourself under control, and then we can talkd. I can see that you are very upset. Perhaps we should discuss this later.ANS: A Reflection echoes the patients words, repeating part of what the person hascan also help express the feelings behind a persons words. 19. A nurse is taking complete health histories on all of the patients atteworkshop. On the history form, one of the written questions asks, You dont drugs, do you? This question is an example of: a. Talking too much. b. Using confrontation. c. Using biased or leading questions. d. Using blunt language to deal with distasteful topics. ANS: C