A nurse is completing the intake health assessment at a clinic. Which of the following is the priority action for the nurse to take?

Ensure that the client has filled out a release of information form from their previous primary care provider.

Document allergies in the electronic medical record.

Getting a list of all medications that have been prescribed to the client.

Ask the client what the biggest concern is at this time.

Answer and Explanation

The Correct Answer is D

Identifying the client's primary health issue or reason for seeking care, the nurse can prioritize the assessment and subsequent care interventions accordingly. This approach ensures that urgent or important health issues are addressed promptly, contributing to patient safety and satisfaction.

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Correct Answer is B

Explanation

Maintaining a nonjudgmental attitude allows the client to feel comfortable discussing their alcohol use without fear of criticism or condemnation. It also helps foster honest communication and promotes engagement in the treatment process.

A. It's important to balance sympathy with professionalism and maintain appropriate boundaries.

C. Expressing disapproval of the client's substance abuse can be counterproductive and may hinder the therapeutic relationship.

D. While it's important for the nurse to maintain professionalism and emotional boundaries, completely avoiding displaying any emotional response may come across as cold or detached.

A. Determine the client's level of fluency in his primary language. B. Encourage the client to nod to indicate understanding. C. Speak directly to the interpreter when teaching the client. D. Make sure a family member is present to interpret for the staff.

Correct Answer is A

Explanation

This is important because it allows the nurse to assess the client's ability to communicate in their primary language. Knowing the client's level of fluency helps the nurse determine the most effective communication strategies and whether an interpreter is necessary.

B. While nodding can be a form of nonverbal communication indicating understanding, relying solely on this may not accurately gauge the client's comprehension.

C. Even in the presence of n interpreter, the nurse should speak directly to the client.

D. Family members may not be proficient in both languages or may not accurately convey medical information.

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A nurse is completing the intake health assessment at a clinic. Which of the following is the priority action for the nurse to take?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is B

Explanation

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Correct Answer is A

Explanation

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