Nursing Communication & Assessment P2

A 72-year-old man with hearing loss arrives for a follow-up. He speaks softly and frequently asks you to repeat questions. Which communication approach is best?

• Speak more loudly and slow your pace.

• Face the patient, speak clearly at a normal volume, and reduce background noise.

• Use family members to interpret to speed the interview.

• Use complex medical words so the patient will take the visit seriously.

A nurse is taking a history from a patient who speaks limited English. Best practice is to:

• Ask the patient’s family member to interpret.

• Use a trained medical interpreter and speak directly to the patient.

• Use simple English and hope the patient understands.

• Rely on written instructions in English.

A patient states: “My chest pain got worse when I walked to the mailbox yesterday.” Which PQRSTU component does this illustrate?

• Palliative

• Quality

• Provocative/precipitating (P) — setting/activity

• Understanding

While performing a health history, you ask: “What brings you in today?” This is an example of:

• A closed question

• An authoritarian question

• An open-ended question

• A leading question

A patient with COPD becomes more dyspneic in the ED. You need to call the provider using SBAR. Which element belongs in the Recommendation?

• Past medical history of COPD.

• Current O2 saturation is 86% on room air.

• Request immediate evaluation and consider increasing oxygen/ABG and chest x-ray.

• Admitting diagnosis.

You are obtaining medication reconciliation. Patient lists “herbal drops for nerves.” Best action:

• Document as “herbal remedy, unspecified.”

• Ask for the name, dose, frequency and include it in the medication list.

• Tell the patient herbs are unimportant and ignore them.

• Remove all OTC and herbal agents from the med list.

A 4-year-old is anxious during immunization. Which technique is most appropriate?

• Offer a complex explanation of the vaccine benefits.

• Use short, simple directions and include the caregiver.

• Leave the child alone to calm down.

• Use medical jargon to assert authority.

During the review of systems the patient volunteers items already documented in the HPI. Best nursing action is to:

• Re-ask every question in the ROS regardless.

• Note that HPI addressed those items and avoid redundant questioning.

• Ignore the ROS entirely.

• Report that the patient is noncompliant.

A teen reveals suicidal ideation during HEEADSSS screening. Priority nursing action:

• Encourage the teen to journal at home.

• Assess for plan, intent, and means and initiate safety protocols.

• Tell the teen to call a hotline later.

• Refer to primary care in a week.

A patient says “I don’t want to tell you about my drinking.” You respond with:

• “Why not? You need help.”

• “I understand this is hard. Can you tell me more about your alcohol use?”

• “If you don’t tell me, I’ll document refusal.”

• “Other patients drink more than you.”