When conducting a client health history, how should the nurse respond when the client hesitates to discuss sensitive topics?
Use therapeutic silence and allow the client time to gather their thoughts.
Provide a quick summary to move to the next question.
Skip the questions entirely to prevent awkwardness.
Press the client to provide answers immediately.
The Correct Answer is A
Choice A reason: Therapeutic silence is a powerful communication tool that conveys acceptance and patience. It provides the client with the necessary psychological space to process complex emotions or memories related to sensitive health information. This approach fosters a trusting nurse-client relationship, which often leads to more accurate and complete data.
Choice B reason: Moving quickly to the next question or providing a summary can be perceived by the client as dismissive or insensitive. This prevents the nurse from obtaining critical subjective data that may be vital for the care plan. Rushing the interview process often shuts down further communication on sensitive topics.
Choice C reason: Skipping essential health history questions to avoid awkwardness is a failure in the assessment phase. Sensitive topics, such as sexual health or substance use, are often critical to the diagnosis and treatment. The nurse must find a professional way to address these areas rather than ignoring them.
Choice D reason: Pressing a client for immediate answers is non-therapeutic and can be perceived as aggressive or judgmental. This approach increases the client's anxiety and defensiveness, making them less likely to share honest information. Effective data collection relies on the client feeling safe and respected throughout the interview.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: Starting with palpation, especially deep palpation, is more likely to decrease patient comfort if the patient has underlying abdominal pain or tenderness. This can lead to muscle guarding, which further complicates the examination. Proper sequencing actually promotes comfort by moving from the least invasive to the most invasive techniques.
Choice B reason: The assertion that there is no impact on examination results is clinically incorrect. Physical examination is a precise diagnostic tool, and the order of operations is standardized to minimize artifacts. Disregarding the correct sequence introduces variables that can obscure clinical findings and lead to errors in the assessment of gastrointestinal health.
Choice C reason: If palpation is performed before auscultation, the pressure applied to the intestines can stimulate hyperactive bowel sounds. A nurse might misinterpret these stimulated sounds as a sign of normal or increased motility when, in reality, the patient may have hypoactive sounds or an impending ileus, leading to an incorrect nursing diagnosis.
Choice D reason: Accuracy is significantly decreased, not increased, when the correct sequence is violated. Reliable assessment of bowel sounds requires that the intestines be in their natural state. By palpating first, the nurse induces artificial sounds, thereby compromising the diagnostic accuracy of the auscultation phase and potentially missing signs of intestinal obstruction.
Correct Answer is D
Explanation
Choice A reason: Attempting multiple home remedies simultaneously can lead to severe skin irritation, contact dermatitis, and unpredictable chemical interactions. This approach lacks scientific evidence and may exacerbate the inflammatory response of acne vulgaris, potentially leading to permanent scarring or post-inflammatory hyperpigmentation without addressing the underlying hormonal or bacterial causes.
Choice B reason: Increasing the frequency of over-the-counter medicated creams, which often contain benzoyl peroxide or salicylic acid, can excessively dry the stratum corneum. This can damage the skin's moisture barrier, causing redness and peeling, and may trigger compensatory seborrhea, where the skin produces even more oil.
Choice C reason: Washing the face more than 2 times a day can strip the skin of its natural acid mantle and essential lipids. Over-cleansing leads to mechanical irritation of the pilosebaceous units, which can worsen acne lesions. It does not address the deeper cystic or inflammatory components of the condition.
Choice D reason: When conservative management fails, a referral to a dermatologist is necessary for advanced pharmacological intervention. Dermatologists can prescribe systemic retinoids, hormonal therapies, or oral antibiotics to target Propionibacterium acnes and follicular hyperkeratosis. This specialized care is essential to prevent long-term physical scarring and the psychological distress associated with refractory acne.
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