NR509 Midterm Exam || with 100% Accurate Solutions.
Focused Assessment correct answers -Addresses focused concerns or symptoms
-Used for established clients during routine or urgent care visits
-Health history and physical exams are focused on the problem
-Includes:
• brief history of the present illness
• only the system related to the problem in the review of systems
Comprehensive Assessment correct answers -Used for new clients
-Provides personalized information about the client
-Strengthens the clinician-client relationship
-Provides a baseline for future assessments
-Provides an opportunity for health promotion education and counseling
-Includes:
• extended history of the present illness
• at least two areas of past medical history, family history, and social history
• at least 10 systems in the review of systems
Subjective data correct answers includes symptoms that the client describes such as a sore throat,
headache, or pain. It also includes the client's feelings, perceptions, and concerns
Information obtained from the client during any part of the health history
Examples of Subjective Data:
-Lower back pain
-Fatigue
-Stomach cramps
-Immunization history
Objective data correct answers includes the physical examination findings or signs observed
All physical examinations, laboratory information, and test data
Examples of Objective Data:
-Heart rate
-Blood pressure
-Lung sounds
-Wound appearance
-Ambulation description
-Weight
Clinical Encounter Sequence (detailed) correct answers Initiate Encounter
-Review the clinical record
-Ensure the client is comfortable
-Clarify the goals/agenda for the encounter; balance provider and client goals
-Establish rapport
-Identify the client's preferred title, name, and gender pronouns
-Use "people first" language (i.e., a person with hearing loss, a person who uses a wheelchair)
,Gather Information
-ID the client's chief complaint or reason for seeking care
-Invite the client's story using an open-ended approach
-Gather information about the client's perspective of the illness using the mnemonic FIFE
-Conduct the health history interview
-Gather information about past medical history, medications and allergies, family history,
personal and social history, and ROS
Perform the Physical Exam
-Conduct the exam based on the information obtained from the health history
-Maintain client's comfort and privacy throughout the exam
Explain and Plan
-Assess and respond to the client's needs for information
-Negotiate and make decisions together
-Utilize teach-back to ensure the client understands the plan
Close the Encounter
-Leave time for the client to ask questions
-Summarize the plans for future evaluation, treatments, and follow up
The general sequence of a clinical encounter is to: correct answers -initiate the encounter
-gather information
-perform a physical exam
-develop a shared plan
-close the encounter
FIFE mnemonic correct answers Feelings
Ideas
Function
Expectations
-A mnemonic for the patient's perspective on the illness
• The patient's Feelings, including fears or concerns, about the problem
• The patient's Ideas about the nature and the cause of the problem
• The effect of the problem on the patient's life and Function
• The patient's Expectations of the disease, of the clinician, or of health care, often based on prior
personal or family experiences
Basic interviewing techniques correct answers -active listening
-empathy
-guided questioning
-validating
-empowerment
-partnering
-transitioning
,-reassuring
-summarizing
-nonverbal communication
active listening correct answers closely attending to what the client is communicating,
connecting to the client's emotional state, and using verbal and nonverbal skills to encourage the
client to expand on their feelings and concerns.
empathy correct answers identifying with the client and feeling their pain as one's own, then
responding to them in a supportive manner.
guided questioning correct answers -Guided questions help to elicit more information, while still
showing a continued interest in the client's feelings and story.
-Some techniques of guided questioning include moving from open-ended to more focused
questions; clarifying what the client means; encouraging with continuers such as "go on"; using a
series of questions one at a time; and using questions that require a graded response (i.e., how
many stairs can you climb before feeling short of breath?).
validating correct answers affirming the legitimacy of the client's emotional experience.
-Examples: "That must have been a difficult experience. It's very common to feel the way you
are feeling."
empowerment correct answers Empowering clients to ask questions and express their concerns
increases the chances that they will adopt your advice, make lifestyle changes, or take
medications as prescribed.
partnering correct answers involves expressing commitment to an ongoing relationship with the
clients to build rapport
transitioning correct answers Transitions can be used to inform the client that the direction of the
interview is changing.
reassuring correct answers Reassurance is an appropriate way to help the client feel that
problems have been fully understood and are being addressed.
summarizing correct answers Giving a summary of the client's story during the interview helps
to communicate that they have been carefully listening.
nonverbal communication correct answers includes eye contact, facial expression, posture, head
position, and movement such as shaking or nodding, interpersonal distance, and placement of the
arms or legs (i.e., crossed, neutral, or open).
Managing Challenging Situations: Silent Clients correct answers -Clients may be quiet to collect
thoughts, remember details, or decide if they trust the provider
-Become comfortable with periods of silence
, -Acknowledge that the client is quiet and ask what they are thinking about or if something has
upset them
Managing Challenging Situations: Talkative Clients correct answers -Talkative clients should be
allowed to talk for several minutes at the beginning of the interview
-Focus on what seems to be most important to the client
-Offer a summary of the main concerns and suggest a focus on one problem or ask the client to
identify their priority concern for the day
Managing Challenging Situations: Clients with Altered Cognition correct answers -Clients with
conditions such as dementia or mental health illness may not be able to provide their history
-Obtain information from family members or caregivers
-Some clients may be able to provide a history, but cannot make their own health decisions
Managing Challenging Situations: Angry Clients correct answers -Clients may direct anger
toward the provider even if their anger is related to being ill, suffering a loss, or feeling
overwhelmed and not in control
-Acknowledge clients' anger and frustration, but avoid reinforcing criticism of other providers or
the clinical setting
-Alert security staff for clients who are overly disruptive or out of control
-Remain calm and avoid being confrontational
Comprehensive health history correct answers Chief Complaint
History of Present Illness
Past Medical History
Medications and Allergies
Family History
Personal and Social History
Review of Systems
History of present illness correct answers use OLDCARTS
Past medical history correct answers -Childhood Illnesses: Inquire about childhood illnesses such
as measles, chickenpox, or scarlet fever and chronic childhood illnesses such as diabetes or
asthma.
-Adult Illnesses: Inquire about illnesses such as diabetes, hypertension, or asthma and
hospitalizations.
-Surgical: Document dates, indications, and types of surgical procedures.
-Obstetric/Gynecologic: Document number of pregnancies (gravida), number of deliveries (para-
term, preterm, abortions, and living children), menstrual history, methods of contraception, and
sexual function.
-Psychiatric: Document diagnoses, hospitalizations, treatments, and the time frame.
-Health Maintenance: Document immunizations and screening tests such as pap smears,
mammograms, or colonoscopies. Include the results and dates of screening tests.
Focused Assessment correct answers -Addresses focused concerns or symptoms
-Used for established clients during routine or urgent care visits
-Health history and physical exams are focused on the problem
-Includes:
• brief history of the present illness
• only the system related to the problem in the review of systems
Comprehensive Assessment correct answers -Used for new clients
-Provides personalized information about the client
-Strengthens the clinician-client relationship
-Provides a baseline for future assessments
-Provides an opportunity for health promotion education and counseling
-Includes:
• extended history of the present illness
• at least two areas of past medical history, family history, and social history
• at least 10 systems in the review of systems
Subjective data correct answers includes symptoms that the client describes such as a sore throat,
headache, or pain. It also includes the client's feelings, perceptions, and concerns
Information obtained from the client during any part of the health history
Examples of Subjective Data:
-Lower back pain
-Fatigue
-Stomach cramps
-Immunization history
Objective data correct answers includes the physical examination findings or signs observed
All physical examinations, laboratory information, and test data
Examples of Objective Data:
-Heart rate
-Blood pressure
-Lung sounds
-Wound appearance
-Ambulation description
-Weight
Clinical Encounter Sequence (detailed) correct answers Initiate Encounter
-Review the clinical record
-Ensure the client is comfortable
-Clarify the goals/agenda for the encounter; balance provider and client goals
-Establish rapport
-Identify the client's preferred title, name, and gender pronouns
-Use "people first" language (i.e., a person with hearing loss, a person who uses a wheelchair)
,Gather Information
-ID the client's chief complaint or reason for seeking care
-Invite the client's story using an open-ended approach
-Gather information about the client's perspective of the illness using the mnemonic FIFE
-Conduct the health history interview
-Gather information about past medical history, medications and allergies, family history,
personal and social history, and ROS
Perform the Physical Exam
-Conduct the exam based on the information obtained from the health history
-Maintain client's comfort and privacy throughout the exam
Explain and Plan
-Assess and respond to the client's needs for information
-Negotiate and make decisions together
-Utilize teach-back to ensure the client understands the plan
Close the Encounter
-Leave time for the client to ask questions
-Summarize the plans for future evaluation, treatments, and follow up
The general sequence of a clinical encounter is to: correct answers -initiate the encounter
-gather information
-perform a physical exam
-develop a shared plan
-close the encounter
FIFE mnemonic correct answers Feelings
Ideas
Function
Expectations
-A mnemonic for the patient's perspective on the illness
• The patient's Feelings, including fears or concerns, about the problem
• The patient's Ideas about the nature and the cause of the problem
• The effect of the problem on the patient's life and Function
• The patient's Expectations of the disease, of the clinician, or of health care, often based on prior
personal or family experiences
Basic interviewing techniques correct answers -active listening
-empathy
-guided questioning
-validating
-empowerment
-partnering
-transitioning
,-reassuring
-summarizing
-nonverbal communication
active listening correct answers closely attending to what the client is communicating,
connecting to the client's emotional state, and using verbal and nonverbal skills to encourage the
client to expand on their feelings and concerns.
empathy correct answers identifying with the client and feeling their pain as one's own, then
responding to them in a supportive manner.
guided questioning correct answers -Guided questions help to elicit more information, while still
showing a continued interest in the client's feelings and story.
-Some techniques of guided questioning include moving from open-ended to more focused
questions; clarifying what the client means; encouraging with continuers such as "go on"; using a
series of questions one at a time; and using questions that require a graded response (i.e., how
many stairs can you climb before feeling short of breath?).
validating correct answers affirming the legitimacy of the client's emotional experience.
-Examples: "That must have been a difficult experience. It's very common to feel the way you
are feeling."
empowerment correct answers Empowering clients to ask questions and express their concerns
increases the chances that they will adopt your advice, make lifestyle changes, or take
medications as prescribed.
partnering correct answers involves expressing commitment to an ongoing relationship with the
clients to build rapport
transitioning correct answers Transitions can be used to inform the client that the direction of the
interview is changing.
reassuring correct answers Reassurance is an appropriate way to help the client feel that
problems have been fully understood and are being addressed.
summarizing correct answers Giving a summary of the client's story during the interview helps
to communicate that they have been carefully listening.
nonverbal communication correct answers includes eye contact, facial expression, posture, head
position, and movement such as shaking or nodding, interpersonal distance, and placement of the
arms or legs (i.e., crossed, neutral, or open).
Managing Challenging Situations: Silent Clients correct answers -Clients may be quiet to collect
thoughts, remember details, or decide if they trust the provider
-Become comfortable with periods of silence
, -Acknowledge that the client is quiet and ask what they are thinking about or if something has
upset them
Managing Challenging Situations: Talkative Clients correct answers -Talkative clients should be
allowed to talk for several minutes at the beginning of the interview
-Focus on what seems to be most important to the client
-Offer a summary of the main concerns and suggest a focus on one problem or ask the client to
identify their priority concern for the day
Managing Challenging Situations: Clients with Altered Cognition correct answers -Clients with
conditions such as dementia or mental health illness may not be able to provide their history
-Obtain information from family members or caregivers
-Some clients may be able to provide a history, but cannot make their own health decisions
Managing Challenging Situations: Angry Clients correct answers -Clients may direct anger
toward the provider even if their anger is related to being ill, suffering a loss, or feeling
overwhelmed and not in control
-Acknowledge clients' anger and frustration, but avoid reinforcing criticism of other providers or
the clinical setting
-Alert security staff for clients who are overly disruptive or out of control
-Remain calm and avoid being confrontational
Comprehensive health history correct answers Chief Complaint
History of Present Illness
Past Medical History
Medications and Allergies
Family History
Personal and Social History
Review of Systems
History of present illness correct answers use OLDCARTS
Past medical history correct answers -Childhood Illnesses: Inquire about childhood illnesses such
as measles, chickenpox, or scarlet fever and chronic childhood illnesses such as diabetes or
asthma.
-Adult Illnesses: Inquire about illnesses such as diabetes, hypertension, or asthma and
hospitalizations.
-Surgical: Document dates, indications, and types of surgical procedures.
-Obstetric/Gynecologic: Document number of pregnancies (gravida), number of deliveries (para-
term, preterm, abortions, and living children), menstrual history, methods of contraception, and
sexual function.
-Psychiatric: Document diagnoses, hospitalizations, treatments, and the time frame.
-Health Maintenance: Document immunizations and screening tests such as pap smears,
mammograms, or colonoscopies. Include the results and dates of screening tests.
