Nokea
The nurse at the clinic asks the client about what brought them in to see the health care provider today. What is the purpose of asking the client about their primary health concern?
- A. To discover what the client perceives as the health problem that needs treatment
- B. To determine if the client really needs to see the health care provider today
- C. To determine if the insurance company will pay for the visit
- D. To see if a prescription can be called in without having to see the health care provider
Correct Answer: A
Rationale: The purpose of asking the client about their primary health concern is to discover what the client perceives as the health problem that needs treatment. Recording information in the client's own words is best. The nurse cannot determine if the client should see the health care provider today and whether the client should be denied treatment based on the insurance company's willingness to pay. The client can opt to pay for the visit out of pocket. Health care providers do not generally give prescriptions any longer without seeing the clients.
You may also like to solve these questions
A client is being seen at the clinic for the first time, and the nurse asks the client about what brought them to the clinic today as well as the past medical history. What part of the interview process does this represent?
- A. Introductory phase
- B. Working phase
- C. Summary phase
- D. Closing phase
Correct Answer: B
Rationale: During the working phase, the nurse asks the client questions to gather data for the client database. The introductory phase involves the beginning introductions as well as establishing rapport. The summary or closing phase is at the end of the interview.
What type of assessment is the nurse performing when beginning the assessment at the head and progressing down to the lower extremities?
- A. Focused assessment
- B. Head-to-toe assessment
- C. Total body assessment
- D. Systems method
Correct Answer: B
Rationale: A head-to-toe assessment begins at the top of the body and progresses downward. A focused assessment focuses on a part of the body that is the primary site of problem such as a respiratory assessment for a cough. The total body assessment has no direction for an assessment and can be done in any order. A systems method approaches the examination by assessing each body system separately.
The nurse is caring for a client who has been admitted to the hospital with abdominal pain and is suspected to have appendicitis. What data obtained is considered objective data?
- A. Bowel sounds hypoactive in the right lower quadrant
- B. Complaints of pain when right lower quadrant palpated
- C. Client states that the pain began 3 hours ago
- D. Client states feeling nauseated.
Correct Answer: A
Rationale: Objective data are facts obtained through observation, physical examination, and diagnostic testing. When assessing blood pressure or heart rate, or examining results from urinalysis, the nurse is obtaining objective data. The other answers are examples of subjective data.
The nurse is having difficulty with the working phase of the interview process with a client who is not maintaining eye contact or responding openly to questions that are being asked. What question can the nurse ask that could require more discussion?
- A. Are you married?'
- B. Can you tell me more about what brought you to the hospital?'
- C. How many children do you have?'
- D. Do you work outside of the home?'
Correct Answer: B
Rationale: Questions are best phrased as open-ended questions that require discussion. 'Can you tell me more about what brought you to the hospital?' requires more than just a yes or no answer. The other answers are closed-ended questions and only require a yes or no response.
The client comes to the clinic and says to the nurse, 'I am coming in today to see the doctor because I started having diarrhea 2 days ago and am going six to eight times per day.' How would the nurse document this statement?
- A. Concern: Client is afraid of becoming dehydrated due to amount of diarrhea.
- B. Problem: Client is having diarrhea at least six to eight times per day.
- C. The client is having diarrhea and wants to see the physician.
- D. Chief complaint: 'Diarrhea began 2 days ago and having six to eight stools per day.'
Correct Answer: D
Rationale: The chief complaint is the current reason the client is seeking care. 'Concern' is not a relevant response and is not what the client stated. 'The client is having diarrhea and wants to see the physician' is vague and does not give enough information. 'Problem: Client is having diarrhea' is not appropriate, and not informative documentation.