The nurse is obtaining a health history for a client prior to a scheduled cholecystectomy. While interviewing the client, which assessment technique should the nurse use when asking about the client's use of illegal drugs and alcohol?

Obtain a drug urine screen to verify legitimacy of client's stated history.

Use the term illegal or illicit to describe street drugs.

Allow the client to decline answering social questions.

Ask specifically about alcohol, marijuana, cocaine, heroin, and amounts.

Answer and Explanation

The Correct Answer is D

A. Obtain a drug urine screen to verify the legitimacy of the client's stated history. This may be necessary but is not the initial approach for obtaining a health history.

B. Use the term illegal or illicit to describe street drugs. Using stigmatizing terms may make the client uncomfortable and less likely to disclose information.

C. Allow the client to decline answering social questions. The nurse should encourage open communication, but also respect the client's right to privacy.

D. Ask specifically about alcohol, marijuana, cocaine, heroin, and amounts. This is the correct approach. Specific questions about substances and quantities help obtain accurate information.

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Correct Answer is B

Explanation

A. Measure the blood pressure when the client is lying and standing. Measuring blood pressure in different positions assesses for orthostatic hypotension, not orthopnea.

B. Ask the client how many pillows are used to sleep on at night. This is the best choice because orthopnea is often managed by sleeping with multiple pillows to relieve difficulty breathing when lying flat.

C. Observe for jugular vein distention while the client is flat in bed. Jugular vein distention can indicate heart failure but does not directly assess orthopnea.

D. Auscultate breath sounds while the client is supine. This assesses lung sounds but does not directly address the client's sleep position or orthopnea.

A. Impaired memory. B. Impaired concentration. C. Impaired thinking. D. Normal mental status for age.

Correct Answer is C

Explanation

A. Impaired memory.This assesses recall rather than interpretation of abstract concepts.

B. Impaired concentration. This assesses the ability to maintain attention, not abstract reasoning.

C. Impaired thinking. This is the best choice as misinterpreting a proverb indicates difficulty with abstract thinking.

D. Normal mental status for age. Misinterpreting a common proverb indicates a cognitive issue, not a normal mental status.

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The nurse is obtaining a health history for a client prior to a scheduled cholecystectomy. While interviewing the client, which assessment technique should the nurse use when asking about the client's use of illegal drugs and alcohol?

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The nurse is obtaining a health history for a client prior to a scheduled cholecystectomy. While interviewing the client, which assessment technique should the nurse use when asking about the client's use of illegal drugs and alcohol?