Exam 1: NUR 3066C (Latest Update) Clinical Reasoning: Health Assessment-Guide with Questions and Verified Answers- Grade A-100% Correct

Exam 1: NUR 3066C (Latest Update) Clinical Reasoning: Health Assessment-Guide with Questions and Verified Answers- Grade A-100% Correct Q: Interviewing an acutely ill patient Answer: Difficult to interview if patient has a critical or severe illness Need clear & direct communication Q: Interviewing a hearing impaired patient Answer: Check for hearing aids, in proper use Ask preferred method of communication: writing, signing, lip reading Signing Best to have a trained interpreter Can use family members as interpreters BUT they sometimes edit for the person Lip reading Lip reader understands only 50% of speech; helpful to add hand gestures Q: Interviewing a patient who has had drugs or alcohol Answer: Difficult to interview, depending on behavior from drugs CNS depressants CNS stimulants Need simple & direct communication Avoid confrontation while interviewing; nonthreatening approach Need to assess the name, amount, & time of last drink or taken Q: Interviewing a sexually aggressive patient Answer: Patients may act out in sexually aggressive ways Examples: "I am uncomfortable when you talk to me that way; please don't" You may feel shocked, embarrassed, or angry (is normal) Set verbal boundaries & remove yourself from situation if behavior continues Q: Interviewing a crying patient Answer: Allow patient to cry & express their feelings Reassure crying patient that you are there to listen Crying is a big relief to patient Do not go on to a new topic if patient is crying Q: Interviewing an angry or anxious patient Answer: Ask about the anger or anxiety & listen to the patient; don't take the anger personally Most sick patients have some anxiety (normal response) and this can become anger Patient is responding to their feelings of helplessness or anxiety Angry patient is not effective during interviewing Q: Interviewing a potentially violent patient Answer: Immediately de-escalate any sus- picious or threatening behavior Be safe; never turn your back; position yourself between the patient and the door Example behaviors: clenched fists, pacing back & forth, vacant stare, confusion, inappropriate behavior, history of recent drug use, history of recent loss of a job or loved one SAFETY is your goal---get support from other staff or security Do not raise voice Do not argue with patient Act calm & talk to the person in a soft voice Q: Identify therapeutic communication techniques - Asking Relevant Ques- tions Answer: Provides further exploration into a subject matter Open-ended vs. closed-ended questions Example: Nurse states, "Describe where the pain radiates to." (open-ended). "Does the pain radiate from your back to your hip?" (closed-ended) Q: Discuss appropriate documentation for the electronic health record (EHR)- Answer: The EHR is a comprehensive record of patient information and relevant clinical data The EHR is a legal document & can be called as evidence in a legal action (if it wasn't charted, it wasn't done) Know the organizational policies for releasing information Document only under YOUR username & password Do not document under someone else's username Do not copy and paste information Pros of using an EHR Transferable Less chance for error (no bad handwriting) Easy and efficient to track Can be locked (no files)