Question 1

Which of the following are statements the client makes about how he or she feels?

Accepted Answer

Subjective data refers to information provided by the client about how he or she feels or experiences something. Objective data refers to measurable or observable information such as vital signs or lab results. Cultural data refers to information about the client's cultural background or beliefs. Signs refer to observable indications of a health problem, such as a rash or swelling.

Question 2

When asking questions about the client's marital status, the nurse is gathering information about which of the following?

Accepted Answer

Asking about the client's marital status gives the nurse information about the client's psychosocial history, including their family life and support system.

Question 3

Which of the following should a nurse do to add depth to the original data of the client?

Accepted Answer

Asking for more detailed information about one body system allows the nurse to gather more specific and in-depth data related to the client's health, thereby adding depth to the original data.

Question 4

Which of the following should the nurse do during the interview?

Accepted Answer

It is important for the nurse to give the client ample time to answer each question and maintain eye contact to establish a trusting and therapeutic relationship. Giving suggestions for answers and setting time limits can cause the client to feel pressured or uncomfortable. Giving a self-help guide is not appropriate during an interview, as the nurse should be actively engaged and present to provide support and answer any questions or concerns the client may have.

Question 5

A client is complaining of nausea and pain. This type of data can be described as which of the following?

Accepted Answer

Nausea and pain are symptoms that the client is experiencing and are subjective in nature because they are based on the client's individual perception and report of their own experiences. This type of data cannot be observed or measured objectively by a healthcare provider.

Question 6

Which assessment technique involves a systematic observation of the client?

Accepted Answer

Inspection involves a systematic observation of the client, which makes it the most appropriate choice for this question. Auscultation involves listening to body sounds (e.g. heart sounds) with a stethoscope, palpation involves using touch to feel for abnormalities (e.g. a lump or tenderness), and percussion involves tapping the body to assess underlying structures (e.g. to assess for fluid in the lungs).

Question 7

Which of the following are components of the client interview?

Accepted Answer

The components of the client interview include active listening, open-ended questions, empathetic responses, and frequent eye contact. The use of medical terminology and closed-ended questions may be necessary in certain situations, but they are not necessarily components of a standard client interview. Time limits on question answers may also vary based on the purpose and context of the interview.

Question 8

Establishment of rapport is part of which area of the nursing process?

Accepted Answer

The answer of Establishment of rapport is part of which...

Question 9

A client diagnosed with asthma has audible wheezes. Which assessment technique is used when the nurse listens with a stethoscope for abnormal lung sounds?

Accepted Answer

Auscultation is the assessment technique used when the nurse listens with a stethoscope for abnormal lung sounds such as wheezes. Inspection is visual examination, palpation is examining with touch or pressure, and percussion is tapping the patient's body to elicit sounds that can indicate abnormalities in underlying tissue.

Question 10

Which portion of the interview determines how well the client can perform activities of daily living (ADLs)?

Accepted Answer

The functional assessment portion of the interview focuses specifically on the client's ability to perform ADLs, such as bathing, dressing, and meal preparation.

Question 11

Which of the following should a nurse do when giving a client a physical examination?

Accepted Answer

A nurse should avoid showing surprise or concern at any of the findings during the examination, as this could cause unnecessary anxiety or worry for the client. It is not appropriate to inform the client's family members and friends about the findings without the client's permission, as this violates their right to confidentiality. It is also not appropriate to avoid any conversation with the client during the examination, as communication is important for building rapport and ensuring the client's comfort. Finally, avoiding eye contact with the client while discussing the findings of the examination could be interpreted as disinterest or insensitivity.

Question 12

The primary purpose of the interview is gathering information about which of the following?

Accepted Answer

The primary purpose of the interview is to identify the chief complaint, which is the reason for the patient seeking medical attention. While healthcare providers may also gather information about past health history, family history, and cultural history during the interview, the primary focus should be on the immediate health concern.

Question 13

When the nurse asks for more detailed information about one body system, he or she is using which of the following?

Accepted Answer

Focused assessment involves gathering detailed information about a specific body system or area of concern. The nurse would use this when they need more information about a particular complaint or issue reported by the patient. Chief complaint refers to the main reason the patient is seeking medical attention. Functional assessment focuses on the patient's ability to perform activities of daily living, while past health history involves gathering information about the patient's medical history, including previous illnesses and treatments.

Question 14

The nurse identifies jaundice in an assigned client. Which assessment technique is the nurse using?

Accepted Answer

Jaundice is identified through inspection, as it can be seen in the yellowing of the skin or white of the eyes. Palpation, auscultation, and percussion are not effective assessment techniques for identifying jaundice.

Question 15

The nurse is completing a physical examination on a client complaining of abdominal pain. Which of the following are facts obtained during the physical examination?

Accepted Answer

Objective data are measurable or observable facts obtained during a physical examination, such as the presence of tenderness, swelling, or abnormal bowel sounds. Symptoms, complaints, and subjective data are all related to the client's perception and are not directly observable by the nurse during the physical examination.

Question 16

Which of the following is important to do at the end of an interview with the client?

Accepted Answer

Summarizing the information obtained with the client is important at the end of an interview as it helps ensure that both the client and the clinician are on the same page and have a clear understanding of the client's concerns, goals, and treatment plan. It also provides an opportunity for the clinician to clarify any misunderstandings or missing information before concluding the session. A, B, and C are not appropriate actions to take at the end of an interview.

Question 17

What should the nurse do before the interview to facilitate the exchange of information?

Accepted Answer

Making the client physically and emotionally comfortable is important for the exchange of information. This can help build rapport and trust between the nurse and client, which can facilitate communication. Bringing in a family member or giving a questionnaire may not necessarily facilitate the exchange of information or build rapport. Taking the client to an open environment may be helpful, but it is not as important as ensuring their physical and emotional comfort.

Question 18

The nurse is preparing to interview a client. Which of the following are variables involved in determining the length of the interview?

Accepted Answer

The client's mental state is a variable that can significantly impact the length of the interview. If the client is highly anxious or agitated, they may struggle to answer questions or require more time to process information. On the other hand, if the client is highly focused and able to provide clear and concise answers, the interview may be shorter. Financial status, social status, and relationships are not typically relevant factors when determining the length of an interview.

Question 19

Questions about current and past use of prescription medications would probably be part of which of the following?

Accepted Answer

Questions about current and past use of prescription medications would be part of the client's past health history, as this section typically includes questions about past medical conditions, surgeries, hospitalizations, medications, allergies, and immunizations. The history of present illness focuses on the client's current symptoms and the context surrounding them, the chief complaint is the primary reason for the client seeking care, and the functional assessment explores the client's ability to perform activities of daily living.

Question 20

Which technique involves assessing an organ or body part by touching and feeling it with hands or fingertips?

Accepted Answer

Palpation involves assessing an organ or body part by touching and feeling it with hands or fingertips. Inspection involves observing the body, percussion involves tapping the body to produce sound, and auscultation involves listening to the sounds the body produces.

Quiz 4: Interviewing and Physical Assessment