The nurse determines that a male client has smoked 2 packs of cigarettes daily for the past 20 years. In calculating his smoking history, how many pack-years should be documented for this client? (Enter numeric value only.)

Rationale:
A. Ask the interpreter to tell the client to write down questions: Asking the client to write down questions places an unnecessary burden on communication and may not be feasible if the client struggles with written English or literacy. It does not foster an open and supportive dialogue during the interview.

B. Give the interpreter a form that lists the interview questions: Providing the interpreter with a form could help with preparation but does not substitute for real-time interpretation and direct engagement. It risks turning the encounter into a transactional experience rather than building therapeutic rapport with the client.

C. Use an interpreter throughout client's hospitalization: While it is important to use an interpreter when needed, the question asks about what the nurse should implement during the interview itself. Additionally, not all interactions may require an interpreter if communication becomes clearer over time, so blanket use is not always appropriate.

D. Maintain eye contact with the client when questions are asked: Maintaining eye contact reinforces that the nurse is communicating directly with the client, not the interpreter. It promotes trust, respect, and engagement, helping the client feel heard and respected even when a language barrier exists.

Rationale:
A. Begin with questions that are less sensitive in nature: Starting with general, non-threatening questions helps build trust and rapport, making the client more comfortable. Gradually progressing to more sensitive topics like alcohol and substance use encourages openness and honesty during the interview.

B. Get the most difficult questions over with first: Diving into sensitive topics immediately can make clients defensive or anxious, leading to incomplete or inaccurate information. Building a foundation of trust first is critical when discussing delicate matters.

C. Ask questions in a vague, nonspecific format: Vague questions can lead to confusion or incomplete answers. Clear, specific, and nonjudgmental questions are essential for accurately assessing substance use behaviors.

D. Share personal values to put the client at ease: Sharing personal values may unintentionally introduce bias or judgment into the interview, making the client less likely to disclose sensitive information. The focus should remain on the client’s experiences, not the nurse’s personal beliefs.