Health & Physical Assessment in Nursing, 4e (Fenske/Watkins/Saunders/D'Amico/Barbarito)

Chapter 5 Interviewing and Health History: Subjective Data

1. The student nurse is preparing to perform a health history interview. Which statements indicate that the student nurse requires further education regarding the purpose of the health history? Select all that apply.

1. "As the nurse, I will mainly focus on the course of the client's illness."

2. "The client's health history can be gathered during the initial interview."

3. "I realize that the client is sick but I also need to perform a wellness assessment."

4. "The healthcare provider's and nurse's assessments should be almost identical with the same focus."

5. "The nurse typically has a more holistic point of view regarding the client's health."

Page Ref: 45

Cognitive Level: Applying

Client Need & Sub: Safe and Effective Care Environment; Assignment, Delegation, and Supervision

Standards: QSEN Competencies: II.B.1. Participate effectively in appropriate data collection and other research activities. | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches. | NLN Competencies: Context and Environment: Conduct population-based transcultural health assessments and interventions. | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 5.1: Examine the purpose of a nursing health history in the health assessment.

MNL Learning Outcome: 5.3: Differentiate the different phases of the health history.

1. The nurse is assessing the health patterns of a client. Which questions by the nurse are appropriate for this during this portion of the health history? Select all that apply.

1. "Do you have a family history of glaucoma?"

2. "Do you consume a healthy diet?"

3. "How many hours do you sleep at night?"

4. "How frequently do you exercise?"

5. "Do you take any routine medications?"

Page Ref: 58

Cognitive Level: Applying

Client Need & Sub: Health Promotion and Maintenance; Health Screening

Standards: QSEN Competencies: II.B.1. Participate effectively in appropriate data collection and other research activities. | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches. | NLN Competencies: Context and Environment: Conduct population-based transcultural health assessments and interventions. | Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 5.5: Identify the purpose of each phase of the nursing health history interview.

MNL Learning Outcome: 5.3: Differentiate the different phases of the health history.

1. The nurse is performing a focused interview with the client. Which behaviors indicate that the client may be feeling threatened? Select all that apply.

1. The client begins to wiggle their foot back and forth.

2. The client frequently moves around in their chair.

3. The client crosses his arms and becomes very quiet.

4. The client leans forward in the chair making eye contact.

5. The client expresses anger when answering the questions.

Page Ref: 52

Cognitive Level: Applying

Client Need & Sub: Psychosocial Integrity; Therapeutic Communication

Standards: QSEN Competencies: I.B.1. Elicit patient values, preferences, and expressed needs as part of clinical interview, implementation of care plan, and evaluation of care. | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches. | NLN Competencies: Relationship and Care: Communicate information effectively and listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 5.2: Identify strategies that promote effective communication when conducting a health history interview.

MNL Learning Outcome: 5.1: Utilize strategies that promote effective communication when conducting a health history interview.

1. The nurse is preparing to gather the biographical data from a client. Which should be the nurse's priority immediately prior to obtaining the information?

1. Establish trust.

2. Exhibit positive regard.

3. Display genuineness.

4. Demonstrate empathy.

Page Ref: 52

Cognitive Level: Applying

Client Need & Sub: Psychosocial Integrity; Therapeutic Communication

Standards: QSEN Competencies: I.B.1. Elicit patient values, preferences, and expressed needs as part of clinical interview, implementation of care plan, and evaluation of care. | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches. | NLN Competencies: Relationship and Care: Communicate information effectively and listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 5.2: Identify strategies that promote effective communication when conducting a health history interview.

MNL Learning Outcome: 5.2: Recognize professional characteristics used in establishing a nurse—patient relationship and barriers to effective nurse—patient interaction.

1. The nurse is preparing to obtain a health history on a client. Which phase of the health history should the nurse recognize is occurring?

1. Preinteraction.

2. The initial interview.

3. The focused interview.

4. Closure of the interview.

Page Ref: 52

Cognitive Level: Applying

Client Need & Sub: Health Promotion and Maintenance; Health Screening

Standards: QSEN Competencies: I.B.1. Elicit patient values, preferences, and expressed needs as part of clinical interview, implementation of care plan, and evaluation of care. | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches. | NLN Competencies: Context and Environment: Conduct population-based transcultural health assessments and interventions. | Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 5.5: Identify the purpose of each phase of the nursing health history interview.

MNL Learning Outcome: 5.3: Differentiate the different phases of the health history.

1. The nurse is preparing to interview a client in their home. Which environmental factor should the nurse recognize will facilitate the client's comfort during the interview?

1. The nurse should remain approximately a foot away from the client.

2. After the client changes into a gown, provide a blanket for warmth.

3. The client can be interviewed in the backyard of their home.

4. The nurse should use a laptop to immediately record the client's information.

Page Ref: 51

Cognitive Level: Applying

Client Need & Sub: Psychosocial Integrity; Therapeutic Communication

Standards: QSEN Competencies: I.B.1. Elicit patient values, preferences, and expressed needs as part of clinical interview, implementation of care plan, and evaluation of care. | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches. | NLN Competencies: Relationship and Care: Communicate information effectively and listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 5.2: Identify strategies that promote effective communication when conducting a health history interview.

MNL Learning Outcome: 5.1: Utilize strategies that promote effective communication when conducting a health history interview.

1. The nurse is gathering information regarding the client's psychosocial history. Which question would be included in this assessment?

1. "How did your father die?"

2. "Have you had any major surgeries?"

3. "Have you noticed any change in your vision?"

4. "How long have you worked for your current employer?"

Page Ref: 61

Cognitive Level: Applying

Client Need & Sub: Health Promotion and Maintenance; Health Screening

Standards: QSEN Competencies: I.B.1. Elicit patient values, preferences, and expressed needs as part of clinical interview, implementation of care plan, and evaluation of care. | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches. | NLN Competencies: Context and Environment: Conduct population-based transcultural health assessments and interventions. | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 5.6: Explain the importance of each component of the nursing health history for patients across the lifespan.

MNL Learning Outcome: 5.3: Differentiate the different phases of the health history.

1. The nurse is obtaining information about a client's past medical history. Which source should the nurse anticipate using to obtain this data?

1. Medication list.

2. Immunization records.

3. Biographic data.

4. Family information.

Page Ref: 60

Cognitive Level: Understanding

Client Need & Sub: Health Promotion and Maintenance; Health Screening

Standards: QSEN Competencies: I.B.1. Elicit patient values, preferences, and expressed needs as part of clinical interview, implementation of care plan, and evaluation of care. | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches. | NLN Competencies: Context and Environment: Conduct population-based transcultural health assessments and interventions. | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 5.5: Identify the purpose of each phase of the nursing health history interview.

MNL Learning Outcome: 5.3: Differentiate the different phases of the health history.

1. The nurse is preparing to reassess a client admitted for congestive heart failure. Which part of the interview should the nurse use to update the diagnostic cues of the client?

1. Initial.

2. Focused.

3. Preinteraction.

4. Psychosocial.

Page Ref: 52

Cognitive Level: Applying

Client Need & Sub: Physiological Adaptation; Illness Management

Standards: QSEN Competencies: I.B.1. Elicit patient values, preferences, and expressed needs as part of clinical interview, implementation of care plan, and evaluation of care. | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches. | NLN Competencies: Context and Environment: Conduct population-based transcultural health assessments and interventions. | Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 5.1: Examine the purpose of a nursing health history in the health assessment.

MNL Learning Outcome: 5.4: Incorporate the components of a health history to a patient interview.

1. The nurse is gathering patient data from secondary sources. Which sources would the nurse utilize to collect this data? Select all that apply.

1. Medical records.

2. Patient.

3. History and physical.

4. Physical therapist.

5. Spouse.

Page Ref: 57

Cognitive Level: Understanding

Client Need & Sub: Safe and Effective Care Environment; Collaboration with Interdisciplinary Team

Standards: QSEN Competencies: III.B.1. Participate effectively in appropriate data collection and other research activities. | AACN Essentials Competencies: IV.6. Evaluate data from all relevant sources, including technology, to inform the delivery of care. | NLN Competencies: Context and Environment: Read and interpret data and apply health promotion/disease prevention strategies. | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 5.5: Identify the purpose of each phase of the nursing health history interview.

MNL Learning Outcome: 5.4: Incorporate the components of a health history to a patient interview.

1. The nurse is reviewing ways to obtain data for a client's sexual history. Which method should the nurse recognize would provide the most sensitivity?

1. Paper.

2. In-person.

3. Telephone.

4. Online questionnaire.

Page Ref: 53

Cognitive Level: Applying

Client Need & Sub: Safe and Effective Care Environment; Confidentiality/Information Security

Standards: QSEN Competencies: III.B.1. Participate effectively in appropriate data collection and other research activities. | AACN Essentials Competencies: VI.B.1. Seek education about how information is managed in care settings before providing care | NLN Competencies: Quality and Safety: Carefully maintain and use electronic and/or written health records. | Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 5.3: Outline the professional characteristics used in establishing a nurse—patient relationship.

MNL Learning Outcome: 5.4: Incorporate the components of a health history to a patient interview.

1. A client tells the nurse they were born in a rural area of the state. Which question should the nurse ask based on the information?

1. "Were you exposed to pesticides?"

2. "How long did you live there?"

3. "Have you lived anywhere else?"

4. "Was the area you were born in a farming community?"

Page Ref: 55

Cognitive Level: Applying

Client Need & Sub: Health Promotion and Maintenance; Health Screening

Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise, and evidence. | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches. | NLN Competencies: Context and Environment: Conduct population-based transcultural health assessments and interventions. | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 5.6: Explain the importance of each component of the nursing health history for patients across the lifespan.

MNL Learning Outcome: 5.4: Incorporate the components of a health history to a patient interview.

1. The nurse is preparing to review a client's current medications. Which question is the most important for the nurse to ask the client?

1. "Can you tell me how much the co-pay is for your medications?"

2. "Do you carry health insurance?"

3. "Can you tell me about any over-the-counter or prescription medications that you take?"

4. "Where do you store your medications in your home?"

Page Ref: 58

Cognitive Level: Applying

Client Need & Sub: Pharmacological and Parenteral Therapies; Expected Actions/Outcomes

Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise, and evidence. | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches. | NLN Competencies: Context and Environment: Conduct population-based transcultural health assessments and interventions. | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 5.5: Identify the purpose of each phase of the nursing health history interview.

MNL Learning Outcome: 5.4: Incorporate the components of a health history to a patient interview.

1. An incoherent client has been brought to the emergency department (ED) by a family member. Which resource should the nurse initially use to obtain information about the client's current state of health?

1. Call the client's healthcare provider.

2. Obtain the patient's records from the Medical Records department.

3. Discuss the situation with the family member who brought the client to the hospital.

4. Conduct a thorough physical assessment and document the health history as "unable to obtain."

Page Ref: 57

Cognitive Level: Applying

Client Need & Sub: Safe and Effective Care Environment; Concepts of Management

Standards: QSEN Competencies: III.B.1. Participate effectively in appropriate data collection and other research activities. | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches. | NLN Competencies: Context and Environment: Conduct population-based transcultural health assessments and interventions. | Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 5.2: Identify strategies that promote effective communication when conducting a health history interview.

MNL Learning Outcome: 5.1: Utilize strategies that promote effective communication when conducting a health history interview.

1. The nurse is assessing the client's pain using the acronym OLDCART & ICE. Rank the questions asked by the nurse following the order of the acronym OLDCART & ICE.

1: "How long have you had this pain?"

2: "Would you please point to the location of your pain?"

3: "How would you describe your pain? Is it sharp, dull, stabbing?"

4: "Can you tell me when your pain first began?"

Page Ref: 53

Cognitive Level: Applying

Client Need & Sub: Physiological Integrity; Basic Care and Comfort

Standards: QSEN Competencies: I.B.4. Assess presence and extent of pain and suffering. | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches. | NLN Competencies: Relationship Centered Care: Promote and accept the patient's emotions; accept and respond to distress in patient and self; and facilitate hope, trust, and faith. | Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 5.5: Identify the purpose of each phase of the nursing health history interview.

MNL Learning Outcome: 5.4: Incorporate the components of a health history to a patient interview.

1. The nurse is creating a genogram for a client. Which information should the nurse consider as critical in forming a plan of care for the client? Select all that apply.

1. Known genetic conditions.

2. Multiple family members with the same disease.

3. Late age of disease onset.

4. Death from chronic illness.

5. Multiple pregnancy losses.

Page Ref: 60

Cognitive Level: Applying

Client Need & Sub: Health Promotion and Maintenance; Health Screening

Standards: QSEN Competencies: III.A.1. Demonstrate knowledge of basic scientific methods and processes. | AACN Essentials Competencies: IX.2. Recognize the relationship of genetics and genomics to health, prevention, screening, diagnostics, prognostics, selection of treatment, and monitoring of treatment effectiveness, using a constructed pedigree from collected family history information as well as standardized symbols and terminology. | NLN Competencies: Context and Environment: Conduct population-based transcultural health assessments and interventions. | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 5.5: Identify the purpose of each phase of the nursing health history interview.

MNL Learning Outcome: 5.4: Incorporate the components of a health history to a patient interview.

1. The nurse is assessing a client's religious beliefs and practices. Which segments of the health history should the nurse recognize can provide opportunities to obtain information about the role of religion? Select all that apply.

1. Health practices.

2. Family history.

3. Past medical history.

4. History of present illness.

5. Psychosocial information.

Page Ref: 56

Cognitive Level: Applying

Client Need & Sub: Psychosocial Integrity; Religious and Spiritual Influences on Health

Standards: QSEN Competencies: I.A.2. Describe how diverse cultural, ethnic, and social backgrounds function as sources of patient, family, and community values. | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches. | NLN Competencies: Context and Environment: Conduct population-based transcultural health assessments and interventions. | Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 5.6: Explain the importance of each component of the nursing health history for patients across the lifespan.

MNL Learning Outcome: 5.3: Differentiate the different phases of the health history.

1. A patient tells the nurse a maternal grandparent had type I diabetes. Which part of the client's record should the nurse document the information in?

1. Genogram.

2. Health practices.

3. Past medical history.

4. Present health/illness.

Page Ref: 60

Cognitive Level: Applying

Client Need & Sub: Health Promotion and Maintenance; Health Screening

Standards: QSEN Competencies: III.A.1. Demonstrate knowledge of basic scientific methods and processes. | AACN Essentials Competencies: IX.2. Recognize the relationship of genetics and genomics to health, prevention, screening, diagnostics, prognostics, selection of treatment, and monitoring of treatment effectiveness, using a constructed pedigree from collected family history information as well as standardized symbols and terminology. | NLN Competencies: Context and Environment: Conduct population-based transcultural health assessments and interventions. | Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 5.6: Explain the importance of each component of the nursing health history for patients across the lifespan.

MNL Learning Outcome: 5.3: Differentiate the different phases of the health history.

1. A client tells the nurse that they do not need any information about skin cancer screening because they obtained the information on the internet. Which should the nurse do to ensure the client receives accurate information?

1. Provide additional education to the client.

2. Evaluate the accuracy of the information.

3. Instruct the client to discuss the information with the healthcare provider.

4. Encourage the patient to avoid seeking healthcare information on the internet.

Page Ref: 57

Cognitive Level: Applying

Client Need & Sub: Health Promotion and Maintenance; Health Promotion/Disease Prevention

Standards: QSEN Competencies: I.A.2. Describe how diverse cultural, ethnic, and social backgrounds function as sources of patient, family, and community values. | AACN Essentials Competencies: IX.5. Deliver compassionate, patient-centered, evidence-based care that respects patient and family preferences. | NLN Competencies: Context and Environment: Environmental health; health promotion/disease prevention (e.g., transmission of disease, disease patterns, epidemiological principles); chronic disease management; healthcare systems; transcultural approaches to health; and family dynamics. | Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 5.1: Examine the purpose of a nursing health history in the health assessment.

MNL Learning Outcome: 5.1: Utilize strategies that promote effective communication when conducting a health history interview.

1. The nurse is obtaining a health history for a client admitted to the unit. Which should the nurse understand is the purpose for obtaining the health history?

1. Documenting the client's response to health concerns.

2. Documenting the client's medication history.

3. Documenting the client's physical activity level.

4. Documenting the client's educational level.

Page Ref: 45

Cognitive Level: Understanding

Client Need & Sub: Health Promotion and Maintenance; Health Screening

Standards: QSEN Competencies: I.B.1. Elicit patient values, preferences, and expressed needs as part of clinical interview, implementation of care plan, and evaluation of care. | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches. | NLN Competencies: Context and Environment: Conduct population-based transcultural health assessments and interventions. | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 5.1: Examine the purpose of a nursing health history in the health assessment.

MNL Learning Outcome: 5.3: Differentiate the different phases of the health history.

1. The nurse is obtaining the subjective data for a health history. Which components should the nurse include? Select all that apply.

1. General survey.

2. Family medical history.

3. Description of ambulation.

4. History of present illness.

5. Review of body systems.

Page Ref: 54

Cognitive Level: Understanding

Client Need & Sub: Health Promotion and Maintenance; Health Screening

Standards: QSEN Competencies: I.B.1. Elicit patient values, preferences, and expressed needs as part of clinical interview, implementation of care plan, and evaluation of care. | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches. | NLN Competencies: Context and Environment: Conduct population-based transcultural health assessments and interventions. | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 5.5: Identify the purpose of each phase of the nursing health history interview.

MNL Learning Outcome: 5.4: Incorporate the components of a health history to a patient interview.

1. The nurse is assessing a client's past medical history. Which information should the nurse obtain during the assessment?

1. Allergies.

2. Marital status.

3. Health beliefs and practices.

4. Reason for seeking care.

Page Ref: 54

Cognitive Level: Applying

Client Need & Sub: Health Promotion and Maintenance; Health Screening

Standards: QSEN Competencies: I.B.1. Elicit patient values, preferences, and expressed needs as part of clinical interview, implementation of care plan, and evaluation of care. | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches. | NLN Competencies: Context and Environment: Conduct population-based transcultural health assessments and interventions. | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 5.5: Identify the purpose of each phase of the nursing health history interview.

MNL Learning Outcome: 5.4: Incorporate the components of a health history to a patient interview.

1. The nurse is conducting a review of systems assessment during a health history. Which question should the nurse ask the client?

1. "Have you ever had a surgical procedure?"

2. "What is your level of education?"

3. "Are you currently taking any medication?"

4. "Do you have a history of respiratory issues?"

Page Ref: 54

Cognitive Level: Analyzing

Client Need & Sub: Health Promotion and Maintenance; Health Screening

Standards: QSEN Competencies: I.B.1. Elicit patient values, preferences, and expressed needs as part of clinical interview, implementation of care plan, and evaluation of care. | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches. | NLN Competencies: Context and Environment: Conduct population-based transcultural health assessments and interventions. | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 5.4: Analyze personal bias and other barriers to effective nurse—patient interaction.

MNL Learning Outcome: 5.3: Differentiate the different phases of the health history.

1. The nurse is obtaining a health history from a client. Which should the nurse recognize is the most efficient and low-cost method of providing individualized care?

1. Obtaining a family history.

2. Obtaining a psychosocial history.

3. Obtaining a past medical history.

4. Obtaining a history of present illness.

Page Ref: 60

Cognitive Level: Applying

Client Need & Sub: Health Promotion and Maintenance; Health Screening

Standards: QSEN Competencies: III.A.1. Demonstrate knowledge of basic scientific methods and processes. | AACN Essentials Competencies: IX.2. Recognize the relationship of genetics and genomics to health, prevention, screening, diagnostics, prognostics, selection of treatment, and monitoring of treatment effectiveness, using a constructed pedigree from collected family history information as well as standardized symbols and terminology. | NLN Competencies: Context and Environment: Conduct population-based transcultural health assessments and interventions. | Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 5.1: Examine the purpose of a nursing health history in the health assessment.

MNL Learning Outcome: 5.3: Differentiate the different phases of the health history.

1. The nurse is obtaining the psychosocial history of a client. Which component of the history should the nurse recognize is most important to determine prior to discussing health problems with the client?

1. Income.

2. Living situation.

3. Education.

4. Self-concept.

Page Ref: 60

Cognitive Level: Applying

Client Need & Sub: Health Promotion and Maintenance; Health Screening

Standards: QSEN Competencies: I.B.1. Elicit patient values, preferences, and expressed needs as part of clinical interview, implementation of care plan, and evaluation of care. | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches. | NLN Competencies: Context and Environment: Conduct population-based transcultural health assessments and interventions. | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 5.4: Analyze personal bias and other barriers to effective nurse—patient interaction.

MNL Learning Outcome: 5.3: Differentiate the different phases of the health history.

1. The nurse is obtaining a health history interview. Which question should the nurse ask that will set the direction for the rest of the health history interview?

1. "Have you ever had any surgeries?"

2. "Are you currently taking any medications?"

3. "Do you have any medical problems?"

4. "Can you tell me why you are seeking care today?"

Page Ref: 57

Cognitive Level: Analyzing

Client Need & Sub: Psychosocial Integrity; Therapeutic Communication

Standards: QSEN Competencies: I.B.1. Elicit patient values, preferences, and expressed needs as part of clinical interview, implementation of care plan, and evaluation of care. | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches. | NLN Competencies: Context and Environment: Conduct population-based transcultural health assessments and interventions. | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 5.2: Identify strategies that promote effective communication when conducting a health history interview.

MNL Learning Outcome: 5.1: Utilize strategies that promote effective communication when conducting a health history interview.

1. A client tells the nurse they are worried that they have cancer. Which response should the nurse provide the client that demonstrates reflection?

1. "Everything will be all right."

2. "You may be over reacting."

3. "It sounds like you are worried about having cancer."

4. "You must be angry that this is happening to you."

Page Ref: 48

Cognitive Level: Applying

Client Need & Sub: Psychosocial Integrity; Therapeutic Communication

Standards: QSEN Competencies: I.B.1. Elicit patient values, preferences, and expressed needs as part of clinical interview, implementation of care plan, and evaluation of care. | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches. | NLN Competencies: Relationship and Centered Care: Factors that contribute to or threaten health. | Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 5.4: Analyze personal bias and other barriers to effective nurse—patient interaction.

MNL Learning Outcome: 5.1: Utilize strategies that promote effective communication when conducting a health history interview.

1. The nurse is summarizing the information obtained after a health history with a client. Which should the nurse recognize is a benefit of summary? Select all that apply.

1. Encourages open communication.

2. Shows the nurse has listened.

3. Indicates the nurse has understood the concerns.

4. Allows time for the patient to process information.

5. Signals closure of the interview.

Page Ref: 48

Cognitive Level: Applying

Client Need & Sub: Psychosocial Integrity; Therapeutic Communication

Standards: QSEN Competencies: I.B.1. Elicit patient values, preferences and expressed needs as part of clinical interview, implementation of care plan, and evaluation of care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches. | NLN Competencies: Relationship and Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 5.1: Examine the purpose of a nursing health history in the health assessment.

MNL Learning Outcome: 5.2: Recognize professional characteristics used in establishing a nurse—patient relationship and barriers to effective nurse—patient interaction.

1. The nurse is using several interactional skills during a health history assessment. Which should the nurse recognize reflects the skill of attending?

1. Tell the client what you want to discuss.

2. Slightly lean toward the client.

3. Ask questions to help the client gain insight.

4. Listen for the client's basic message.

Page Ref: 47

Cognitive Level: Applying

Client Need & Sub: Psychosocial Integrity; Therapeutic Communication

Standards: QSEN Competencies: I.B.1. Elicit patient values, preferences and expressed needs as part of clinical interview, implementation of care plan, and evaluation of care. | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches. | NLN Competencies: Relationship and Centered Care: Communicate information effectively and listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 5.3: Outline the professional characteristics used in establishing a nurse—patient relationship.

MNL Learning Outcome: 5.2: Recognize professional characteristics used in establishing a nurse—patient relationship and barriers to effective nurse—patient interaction.

1. The nurse is preparing to use a direct leading technique for a client that is experiencing pain. Which question should the nurse ask the client?

1. "Can you go over what you said about nothing relieving the pain?

2. "Do you think you know what caused the pain?

3. "Can you describe your pain?"

4. "When did your symptoms begin?"

Page Ref: 47

Cognitive Level: Applying

Client Need & Sub: Physiological Integrity; Basic Care and Comfort

Standards: QSEN Competencies: I.B.4. Assess presence and extent of pain and suffering. | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches. | NLN Competencies: Relationship and Centered Care: Promote and accept the patient's emotions; accept and respond to distress in patient and self; and facilitate hope, trust, and faith. | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 5.3: Outline the professional characteristics used in establishing a nurse—patient relationship.

MNL Learning Outcome: 5.1: Utilize strategies that promote effective communication when conducting a health history interview.