A nurse is making an initial home visit for a client who has hypertension, kidney failure, and chronic pulmonary disease. Which type of assessment should the nurse use in this situation?
A complete assessment
A follow-up assessment
An emergency assessment
A rapid assessment
The Correct Answer is A
A. A complete assessment: During an initial home visit, a complete assessment is appropriate because the nurse needs to gather comprehensive information about the client’s medical history, current health status, medications, and environmental factors to create a thorough plan of care.
B. A follow-up assessment: Follow-up assessments are used to monitor progress or evaluate ongoing treatment. Since this is the first visit, a follow-up assessment would be premature.
C. An emergency assessment: Emergency assessments are performed when a client presents with life-threatening or urgent conditions. A routine initial home visit does not indicate an immediate threat, so this is not appropriate.
D. A rapid assessment: Rapid assessments are brief evaluations used in urgent or unstable situations to identify immediate needs. This type of assessment is not suitable for a comprehensive initial home visit.
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Related Questions
Correct Answer is A
Explanation
A. Nonmaleficence: By completing training before administering chemotherapy, the nurse ensures they do not cause harm to clients. Nonmaleficence emphasizes the ethical responsibility to prevent injury or harm through safe and competent care.
B. Veracity: Veracity involves truthfulness and honesty in interactions with clients, such as providing accurate information about treatments. While important, completing training primarily addresses safety, not truth-telling.
C. Autonomy: Autonomy refers to respecting a client’s right to make informed decisions about their care. Completing training does not directly relate to client decision-making.
D. Fidelity: Fidelity involves keeping commitments and being faithful to professional responsibilities. While training supports professional competence, the key ethical principle demonstrated here is preventing harm, aligning with nonmaleficence.
Correct Answer is A
Explanation
A. Determine the preferred communication methods with the client: Identifying the client’s preferred methods, such as speaking clearly, using written notes, or adjusting hearing aids, ensures effective communication. This approach promotes accurate information gathering and client engagement during the interview.
B. Put a table between the nurse and the client to take notes: Placing a physical barrier can impede visual and auditory communication cues. Effective communication requires clear sightlines and direct interaction rather than obstacles that may hinder understanding.
C. Ask the client if they can bring a family member to the next visit: While family support can help with communication, the immediate priority is to establish effective communication directly with the client during the current interview, respecting their independence and privacy.
D. Sit in a chair to the side of the client: Sitting to the side may make it difficult for the client to see facial expressions and lip movements, which are important for clients with hearing impairments. Facing the client directly is more effective for clear communication.
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