Exam (elaborations)
Chapter 06 Assessment
- Course
- Fundamentals of Nursing
- Institution
- Oxford College Of Emory University
Chapter 06 Assessment
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DAWITChapter 06: Assessment
Yoost & Crawford: Fundamentals of Nursing: Active Learning for Collaborative
Practice, 3RD Edition
MULTIPLE CHOICE
1. The nurse is caring for a patient with pneumonia, who is a retired soldier who served in World
War II. With this information in mind, what should the nurse do in regarding this patient?
a.Shake the patient‘s hand and allow the patient time to ―warm up.‖
b.Expect the patient to be optimistic and question everything.
c.Allow the patient to multitask and talk in short ―sound bites.‖
d.Understand that the patient is probably technologically literate.
ANS: A
Establishing rapport is paramount to gaining the trust of the patient. The nurse should consider
the patient‘s generational cohort, which may influence behavior, and willingness to share
personal information during the interview process. Veterans (born before 1945) respect
authority; are detail oriented; communicate in a discrete, formal, respectful way; may be slow
to warm up; value family and community; and accept physical touch as an effective form of
therapeutic communication. Baby Boomers (born 1946 to 1964) are optimistic, relationship
oriented, and communicate by using open or direct speech, using body language, and
answering questions thoroughly. They expect detailed information, question everything, and
value success. Generation X members (born 1965 to 1976) are informal; are technology
immigrants; multitask; communicate in a blunt or direct, factual, and informal style; may talk
in short sound bites; share information frequently; and value time. Millennials, also called
Generation Y (born 1977 to 1N994R) arI flG
exibB
le.
;Care M
natives; multitask; communicate U bySeusing technologically literate or are technology
action verbs and humor; may be brief in the form of
texting or e-mail exchanges; like personal attention; and value individuality. Individuals from
Generation Z (born 1995 to 2012) are digitally connected, value group work, want immediate
feedback, are accepting of others, value honesty and family, and are entrepreneurial.
DIF: Applying OBJ: 6.1 TOP: Implementation
MSC: NCLEX Client Needs Category: Safe and Effective Care Environment: Management of Care
NOT: Concepts: Communication
2. The patient interview consists of three phases: orientation (introductory), working, and
termination. Each phase contributes to the development of trust and engagement between the
nurse and the patient. During the orientation phase of a patient interview, the nurse carries out
what action?
a. Obtain demographic data using open-ended questions.
b. Establish the name by which the patient prefers to be addressed.
c. Gather general information using closed-ended questions.
d. Stand by the bedside to ask the needed questions.
ANS: B
, DAWIT
The patient interview consists of three phases: orientation (introductory), working, and
termination. Each phase contributes to the development of trust and engagement between the
nurse and the patient. During the orientation phase of the interview, the nurse should establish
the name by which the patient prefers to be addressed. Some individuals prefer formal titles of
respect (e.g., Dr., Mr., Ms., Professor) and the use of surnames, whereas others are
comfortable with less formality. How a patient is addressed is the patient‘s choice.
Demographic data should be collected by asking focused or closed-ended questions. More
general information can be gathered by open-ended communication techniques. When
feasible, the nurse and the patient should be seated at eye level with each other. In this way,
the interaction between the nurse and the patient is horizontal instead of vertical. Standing
over someone implies control, power, and authority. The implication of power can result in
less-than-optimal data collection and a potential conflict as the patient strives to regain control
over the situation.
DIF: Applying OBJ: 6.1 TOP: Implementation
MSC: NCLEX Client Needs Category: Safe and Effective Care Environment: Management of Care
NOT: Concepts: Communication
3. A nurse is conducting a health interview on a newly admitted patient. To establish a trusting
relationship with the patient, the nurse carries out which action?
a. Avoid eye contact to appear less threatening.
b. Demonstrate professionalism by not smiling.
c. Sit close and leans in slightly toward the patient.
d. Speaks in a slow rate of speech and low tone.
ANS: C
Nonverbal behaviors of the nurse can influence the information obtained from the patient.
Negative nonverbal cues suchNaUsRdS isI
traNcG
tinTgBg.estuO
res (e.g., tapping a pen, swinging a foot,
looking at a watch), inappropriate facial expressions, and lack of eye contact communicate
disinterest. To establish a trusting relationship with the patient before the physical
examination is conducted, the nurse should communicate professionally, sit close and lean in
slightly toward the patient, listen attentively and demonstrate appropriate eye contact, smile,
and use a moderate rate of speech and tone of voice.
DIF: Applying OBJ: 6.1 TOP: Implementation
MSC: NCLEX Client Needs Category: Safe and Effective Care Environment: Management of Care
NOT: Concepts: Communication
4. The nurse is assigned the admission health history and physical for a patient diagnosed with a
fever of unknown etiology. The patient tells the nurse, ―I just don‘t feel good. I‘m so hot and I
feel sick to my stomach. Can you ask me those questions later?‖ What would be the best
response by the nurse?
a. ―It will not take too long. I can hurry.‖
b. ―We need the information to complete your admission paperwork.‖
c. ―I will come back in a few minutes and we can start over.‖
d. ―Let me see if you can have something for the nausea and then talk later.‖
ANS: D
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