While obtaining the health history of a client, the nurse learns the client's father was diagnosed with schizophrenia in his twenties, the same age the client is now. The client hesitates to discuss the topic and answer questions about the father. Which approach is best for the nurse to use to interview the client about mental health concerns?

Ask questions in a vague, nonspecific format.

Share personal values to put the client at ease.

Begin with questions that are less sensitive in nature.

Get the most difficult questions over with first.

Answer and Explanation

The Correct Answer is C

A.   While this approach may seem less intrusive, it can create confusion and may prevent the client from feeling fully understood. Asking vague questions could make it more difficult to get useful information about the client's health concerns.
B.   Sharing personal values is generally not appropriate in a clinical interview, as it could create boundaries that compromise the professional relationship. The nurse should maintain objectivity and empathy without sharing personal beliefs.
C.   Starting with less sensitive questions allows the nurse to build rapport and trust with the client before delving into more personal or difficult topics. This approach is helpful in easing the client into more sensitive discussions.
D.   Asking the most difficult questions right away can overwhelm the client, especially if they are hesitant or uncomfortable. It is better to establish a trusting relationship first and allow the client to open up at their own pace.

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Correct Answer is D

Explanation

A. Otitis media is an infection of the middle ear, and while it can affect hearing, it is not typically assessed using a tuning fork. Tuning forks are more useful for evaluating conductive hearing loss or bone conduction.
B. A tuning fork is generally not used to assess neurological pathology directly. Neurological conditions often require other diagnostic tools or tests to evaluate nerve function or reflexes.
C. Tinnitus is the perception of ringing in the ears and is usually assessed through patient reporting and audiometric testing. A tuning fork is not used to diagnose tinnitus, but it may be used to test hearing acuity.
D. A tuning fork is commonly used to assess for hearing loss, specifically conductive hearing loss. The fork helps test the function of bone and air conduction, which are important for determining the type of hearing impairment.

A. Compare the range of motion of both legs. B. Ask if the client often feels weak or hungry. C. Measure the client's capillary glucose. D. Palpate the client's dorsalis pedis pulses.

Correct Answer is D

Explanation

A. While comparing the range of motion of both legs could be useful for detecting joint or muscle- related issues, it does not directly address the vascular concerns suggested by the shiny skin and absence of hair growth. These signs are more likely related to poor circulation, which requires different diagnostic approaches.
B. Asking about feelings of weakness or hunger may be more relevant to assessing the client’s blood glucose control, but it is not directly related to the symptoms of shiny skin and hair loss on the lower legs, which suggest peripheral vascular changes common in diabetes.
C. While measuring blood glucose levels is important in managing diabetes, it will not help to assess the vascular insufficiency suggested by the physical findings. However, managing blood glucose is crucial to preventing further complications.
D. Palpating the dorsalis pedis pulses is the most appropriate next step. Decreased or absent pulses in the feet and lower extremities are commonly associated with peripheral vascular disease, which is common in clients with diabetes due to poor circulation.

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Naxlex Comprehensive Predictor Exams

When conducting a physical examination, the nurse uses a tuning fork to assess for which condition?

Correct Answer is D

Explanation

The nurse observes that the lower legs of a client with diabetes mellitus are shiny, and with no hair growth. To obtain additional data to support these findings, which assessment should the nurse perform?

Correct Answer is D

Explanation

The nurse is obtaining a health history for a client during an annual physical examination. When evaluating the client for menopausal symptoms, which finding indicates the client is perimenopausal?

The nurse detects a possible extra heart sound while assessing an adult client. To verify this finding, which action should the nurse take?

In assessing an adult client, the nurse calculates the body mass index (BMI) as 14 kg/m2. Which nursing problem should be included in this client's plan of care? Reference Range: Body mass index (BMI) [normal 18.0 to 24.9 kg/m2]

When assessing heart sounds of a client with rheumatic valvular heart disease, where should the nurse place the stethoscope to auscultate the tricuspid valve?

An older adult client is being evaluated for admission to an assisted living facility. During the health assessment, the nurse implements which technique to determine the client's ability to reside in this environment?

The nurse assesses that a client has nailbed clubbing. Which additional information is consistent with this finding?

The nurse is assessing a client who has a history of kidney stones and returns to the clinic with flank pain. Which intervention should the nurse implement first?

During a health assessment, the client reports being treated for osteoarthritis. The nurse examines a client's hands and finds Heberden's nodes. Which finding should the nurse document in the client's medical record?