During the initial interview of a patient, the nurse should: (Select all that apply.)
assess the language capabilities of the patient.
limit the interview to approximately 30 minutes.
assess comprehension abilities of the patient.
make the patient as comfortable as possible.
use open-ended questions.
obtain the patient's medical history from the primary care provider.
Correct Answer : A,C,D,E
A. Assess the language capabilities of the patient. Understanding the patient’s language capabilities is essential for effective communication and ensuring that the patient can understand the questions being asked.
B. Limit the interview to approximately 30 minutes. While it’s important to manage time, the interview should be flexible based on the patient’s needs and the complexity of the issues being discussed. Rigidly limiting the time could hinder the quality of the assessment.
C. Assess comprehension abilities of the patient. Assessing comprehension helps the nurse determine whether the patient understands the information being provided and can respond appropriately during the interview.
D. Make the patient as comfortable as possible. Creating a comfortable environment is crucial in fostering open communication and trust, which can lead to a more effective interview process.
E. Use open-ended questions. Open-ended questions encourage the patient to provide more detailed responses and express their feelings or concerns, facilitating a better understanding of their situation.
F. Obtain the patient's medical history from the primary care provider. Although obtaining a comprehensive medical history is important, the initial interview should primarily focus on gathering information directly from the patient, as they can provide valuable insights about their experiences, concerns, and context that might not be captured in previous records.
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Correct Answer is A
Explanation
A. Be certain the patient is wearing his glasses and/or hearing aid. Ensuring the patient has optimal hearing and vision aids can improve comprehension and help the patient accurately learn the procedure.
B. Wait for the patient to ask any questions about the procedure. Waiting for questions might lead to gaps in understanding, as the patient may not feel comfortable initiating questions without encouragement.
C. Talk through the process rapidly to keep the patient from becoming tired. Rushing the instruction may cause the patient to miss important details, as learning may be slower in older adults.
D. Point out each mistake during the return demonstration. Correcting every error without constructive feedback can discourage the patient. It’s more effective to provide gentle guidance and support.
Correct Answer is D
Explanation
A. Actions of the nurse are appropriate since his neighbor is his confidante, and the neighbor has assured him the information provided will not be shared. Confidentiality must be maintained regardless of assurances from others; sharing patient information outside a professional context is a violation of privacy.
B. Nurse has not violated the confidentiality of the patient because the patient is terminal; sharing this information will not harm the patient. Confidentiality must be maintained regardless of the patient's condition. Privacy and confidentiality are ethical requirements for all patients, terminal or otherwise.
C. Nurse is actively promoting nursing as a profession, and it is important to share information that might encourage others to pursue a nursing career. While promoting the profession is valuable, using a patient’s personal information is inappropriate and unprofessional. There are ethical ways to promote nursing without breaching confidentiality.
D. Nurse has violated the confidentiality of the patient by discussing personal information about the patient with his neighbor. Sharing patient information with someone who is not involved in the patient’s care violates HIPAA and confidentiality standards. This action is unprofessional and unethical.