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 B
Explanation
A. "Blood not drawn because tests are no longer desired by patient."
This statement is vague and lacks specific details regarding the patient's exact refusal and the communication with the doctor.
B. "Refuses to have blood drawn; says tests are 'useless.' Doctor notified."
This response documents the patient's refusal with their exact words ("useless") and also notes that the doctor has been informed, which is essential for clear, complete documentation.
C. "Doctor notified of failure to draw ordered blood work."
This documentation lacks the reason for the blood draw failure (patient refusal) and omits the patient’s specific wording.
D. "Refuses to have blood drawn. Doctor notified."
Although this documents the refusal and the doctor’s notification, it omits the patient’s exact words, which can provide additional context for the healthcare team.
Correct Answer is D
Explanation
A. Confuses the patient by giving information. False reassurance does not typically involve the giving of information; instead, it involves providing comforting statements that may not be truthful or realistic.
B. Shows a judgmental attitude on the part of the nurse.
False reassurance is not necessarily judgmental but is dismissive, offering unrealistic comfort rather than addressing the patient’s actual concerns.
C. Summarizes the patient's concerns and closes communication.
False reassurance does not summarize concerns; it usually bypasses them altogether, offering hollow comfort instead of genuine acknowledgment of the patient’s feelings.
D. Discounts the patient's stated concerns.
False reassurance can harm communication because it dismisses or minimizes the patient’s concerns rather than validating them, making the patient feel unheard or misunderstood.