The nurse is preparing to perform an initial assessment on an older adult client who is hard of hearing and speaks limited English, which of the following actions should the nurse take to promote therapeutic communication? (Select all that apply)

Choice A reason: Recording objective findings is the definition of the physical examination, not the Review of Systems (ROS). Objective findings are observable and measurable data, such as blood pressure or lung sounds, whereas the ROS is a subjective component of the health history based on the client's reports.

Choice B reason: The Review of Systems (ROS) is a systematic method for collecting subjective data about the client's past and current health status across all major body systems. It helps identify symptoms that the client may have forgotten to mention and provides a comprehensive overview of the client's functional health.

Choice C reason: A statement describing the overall health state is usually referred to as a "General Survey" or a "Reason for Seeking Care." While the ROS contributes to this understanding, it is far more detailed, specifically broken down by physiological systems to ensure no clinical symptoms are overlooked during the history.

Choice D reason: Documentation of the problem as described by the patient is typically called the "Chief Complaint" or "History of Present Illness." While the ROS includes patient-described symptoms, it is a broader screening tool covering the entire body, whereas the Chief Complaint focuses on the specific reason for the visit.

Choice A reason: Interrupting a client can be perceived as disrespectful and may cause them to withhold important information. While the nurse must direct the interview, using redirection techniques is more effective than abrupt interruption. Constant interruptions break the client's train of thought and hinder the development of a therapeutic, trusting relationship.

Choice B reason: Therapeutic silence is a vital communication tool that allows the client time to organize their thoughts and elaborate on sensitive topics. It signals that the nurse is attentive and willing to wait for the client’s input, which often leads to the disclosure of more detailed and accurate health data.

Choice C reason: A nonjudgmental attitude is essential for fostering a safe environment where the client feels comfortable sharing honest information about lifestyle choices, drug use, or sexual history. If a client senses judgment, they may provide socially desirable answers rather than accurate health information, compromising the assessment.

Choice D reason: Interviews should typically begin with open-ended questions to allow the client to describe their concerns in their own words. Closed-ended questions are useful for clarifying specific details later, but starting with them limits the scope of the information gathered and may miss the client's primary reason for seeking care.

Choice E reason: Sitting at eye level establishes a sense of equality and helps to diminish the power imbalance between the nurse and the client. This positioning facilitates better eye contact and nonverbal communication, making the nurse appear more approachable and focused on the client's needs rather than appearing rushed or authoritative.