While obtaining a client’s health history related to smoking cigarettes, the nurse plans to determine the client’s smoking pack years. What information should the nurse obtain for this calculation? Select all that apply.
Packs of cigarettes smoked per day.
Number of attempts to quit smoking.
Client’s current age.
Age when the client started smoking.
Number of years the client smoked.
Correct Answer : A,D,E
Choice A rationale
Packs of cigarettes smoked per day is essential information for calculating smoking pack years.
Choice B rationale
The number of attempts to quit smoking is not required for calculating smoking pack years.
Choice C rationale
The client’s current age is not required for calculating smoking pack years.
Choice D rationale
The age when the client started smoking is necessary to determine the total number of years smoked.
Choice E rationale
The number of years the client smoked is essential for calculating smoking pack years.
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Correct Answer is A
Explanation
Choice A rationale
Asking specifically about alcohol, marijuana, cocaine, heroin, and amounts provides a clear and direct approach to obtaining accurate information about the client’s substance use. This method helps in identifying potential health risks and planning appropriate care.
Choice B rationale
Using the term “illegal” or “illicit” to describe street drugs may cause the client to feel judged or defensive, which can hinder open communication. It is better to ask about specific substances directly.
Choice C rationale
Allowing the client to decline answering social questions may result in incomplete health history, which can affect the quality of care provided. It is important to encourage clients to share relevant information while ensuring confidentiality.
Choice D rationale
Obtaining a drug urine screen to verify the legitimacy of the client’s stated history is not an appropriate initial assessment technique. Trust and rapport should be established first through direct questioning.
Correct Answer is A
Explanation
Choice A rationale
Generalized lumpiness of both breasts with no discrete masses and no nipple discharge is a common finding, especially before menstrual periods. Assuring the client that her breasts are normal and advising annual evaluations is appropriate.
Choice B rationale
Requesting a return visit after her menstrual period for a breast exam re-check is unnecessary if the findings are consistent with normal premenstrual changes.
Choice C rationale
Explaining to the client that an ultrasound of the breast will likely be necessary is not warranted based on the current findings.
Choice D rationale
Suggesting that the client schedule a mammogram after her next menstrual period is not necessary for a young adolescent with normal premenstrual breast changes.