Chapter 7

Question 1

Listening

Answer 1

Paying undivided attention to what the patient says and does

Encourage patient to speak by saying “I see” and “Go on,” etc.

Question 2

Attending

Answer 2

Giving full attention to verbal and nonverbal messages
Body language may signal information that the patient may have omitted intentionally or unintentionally.
Maintain consistent, appropriate eye contact and use proper body positioning.

Question 3

Paraphrasing

Answer 3

Restating the patient’s message

Question 4

Leading

Answer 4

Helpful when starting an interaction or trying to get the patient to discuss specific health concerns
Direct leading, focusing, and questioning

Question 5

Questioning

Answer 5

Direct way of speaking with patients to obtain subjective data for decision making and planning care

Question 6

Reflecting

Answer 6

Repeating the patient’s verbal or nonverbal message

Silence can also be therapeutic.

Question 7

Summarizing

Answer 7

Reading the patient your notes and asking, “is that correct?”

Question 8

False Reassurance

Answer 8

Deprives right of patients to communicate their feelings
Includes “Everything will be all right” or “Don’t worry, you’ll be fine”
Can be implied by tone of voice
“You have a good surgeon, we’re trying our best”

Question 9

Passing Judgment

Answer 9

Convey a strong message that the patient must live up to the nurse’s value system to be accepted

Question 10

Cross-Examination

Answer 10

Helpful to pause between questions and ask how patient is tolerating the interview to this point
Encourage patients to express their feelings about the pace and nature of the interview

Question 11

Unwanted Advice

Answer 11

Nurse’s role is to offer expert guidance based on therapeutic principles intended to promote health and wellness.
For example, focus on physiological effects rather than social stigma when encouraging smoking cessation

Question 12

Technical Terms

Answer 12

Avoid jargon, slang, or clichés, initials and acronyms

Question 13

Sensitive Issues

Answer 13

Be sensitive to patient’s need for silence

Watch for nonverbal signs such as tear-filled eyes

Question 14

The Influence of Culture on Nurse–Patient Interactions

Answer 14

For example, silence may be viewed as uncomfortable in some societies but respectful in others.
Avoid stereotyping based on cultural background

Question 15

Carl Rogers

Answer 15

Patient-centered therapy
Promoting growth, development, maturity, improved functioning, and improved coping with life of the other
Attitude plays a key role in success.

Question 16

Positive Regard

Answer 16

Ability to appreciate and respect another person’s worth and dignity with a nonjudgmental attitude
Patients sense positive regard by nurses’ demeanor, attitudes, and verbal and nonverbal communication.

Question 17

Empathy

Answer 17

Capacity to respond to another’s feelings and experiences as if they were your own

Question 18

Concreteness

Answer 18

Promotes understanding and a sense of security in the patient
Implies that the nurse respects the patient’s ability to understand
Recognizes the patient’s right to know the details of the plan of care

Question 19

Sources of Information (health history)

Answer 19

The primary source: The patient is the only one who can describe personal symptoms, experiences, and factors leading to the current health concern.
If patient unable to provide accurate information, another source of information is indicated.
Secondary source: Person or record providing additional information about the patient
Obtain patient’s permission before requesting information from another person

Question 20

Phases of the Health Assessment Interview

Answer 20

Phase I: preinteraction
Collect data from the medical record, previous health screenings, therapists, dietitians, and other professionals

Phase II: the initial interview. Health history form often used. Responsibility to allay anxieties so patient can communicate as effectively as possible. Begin by describing the interview process and its importance.
Allow patient opportunity to express any final questions or concerns. Thank the patient

Phase III: the focused interview
Clarify previously obtained assessment data
Gather missing information about a concern
OLDCART & ICE

Question 21

Focused Interview for Pediatric Patients

Answer 21

Determine relationship between child and caretaker
Ask preschoolers and older children about complaint even if the information they provide is incomplete.
Determine whether primary caregiver is stressed or distracted prior to interview
Sleep deprivation can result in altered recall.

Question 22

Focused Interview for Older Adult Patients

Answer 22

Interview alone unless compromised mental status is previously known
Frailness does not mean an inability to respond appropriately.
Minimize background noise
Address patient by appropriate title
Know whether the patient is in pain and whether pain reduction therapies should be considered prior to interview