The nurse is beginning a health history interview. Which of the following will best guide the rest of the health history interview?
"Have you ever had any surgeries?"
"Tell me about any medical problems that you have had."
"Tell me about any medications you are currently taking."
"Tell me why you are seeking care today."
The Correct Answer is D
A) "Have you ever had any surgeries?": While this question is important, it is more specific and may not provide the comprehensive context needed to guide the interview. It could lead to a narrow focus on past surgical history without addressing the client’s current health status or concerns.
B) "Tell me about any medical problems that you have had.": This question is useful but lacks the immediate relevance to the client's current situation. It may prompt the client to recount past issues rather than focusing on their current health needs and reasons for seeking care.
C) "Tell me about any medications you are currently taking.": This is an essential aspect of health history, but like the previous options, it doesn't address the client’s immediate concerns or symptoms that may guide the rest of the interview.
D) "Tell me why you are seeking care today.": This question is the most effective starting point as it directly addresses the client’s current health issue or concern. Understanding the reason for seeking care helps the nurse prioritize topics, gather relevant information, and tailor the rest of the health history interview to the client’s specific needs, making it a crucial guide for further questioning.
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Correct Answer is A
Explanation
A) "Women should be familiar with their own breasts so that they can report any changes to their provider": This statement aligns with current recommendations emphasizing the importance of breast self-awareness. Women are encouraged to be familiar with their breast tissue so they can recognize any changes, such as lumps or alterations in size or shape, and report these changes to their healthcare provider. This proactive approach can lead to earlier detection of breast cancer.
B) "All women should have a breast screening with an MRI beginning at age 40": This statement is misleading, as the American Cancer Society does not recommend routine MRI screenings for all women. MRI is typically reserved for women at high risk for breast cancer. The standard guideline includes annual mammograms starting at age 40, but not MRI for all.
C) "Mammograms do not help with detecting breast cancer until after age 54": This statement is incorrect. Mammograms are effective in detecting breast cancer well before age 54, and the American Cancer Society recommends that women start getting annual mammograms at age 40. Early detection through regular screenings is critical for improving outcomes.
D) "Mammograms are only indicated if there is a strong family history": This statement is also inaccurate. While family history can increase the risk for breast cancer and may influence screening frequency, all women are encouraged to have regular mammograms starting at age 40, regardless of family history. This guideline aims to catch potential cancers early in all women.
Correct Answer is D
Explanation
A) The patient has asthma: While asthma can lead to respiratory symptoms and issues, it is not typically associated with clubbing of the fingernails. Asthma primarily affects airway constriction and inflammation, rather than causing the long-term changes in nail morphology seen with clubbing.
B) The patient has cardiovascular disease: Although some cardiovascular conditions can lead to clubbing, it is more commonly associated with chronic lung diseases. Cardiovascular disease might cause other signs or symptoms, but clubbing alone is not a definitive indicator of this condition.
C) The patient has emphysema: Emphysema, a type of chronic obstructive pulmonary disease (COPD), is characterized by the destruction of lung tissue and impaired airflow. While it can contribute to hypoxemia, clubbing is not a common finding specifically associated with emphysema.
D) The patient has chronic hypoxemia: Clubbing of the fingernails is a classic sign of chronic hypoxemia, often resulting from long-term respiratory conditions like COPD, interstitial lung disease, or lung cancer. It indicates a prolonged lack of oxygen in the blood, leading to changes in the nail bed and digit shape. Given the patient's long smoking history, chronic hypoxemia is the most likely explanation for this finding.