A nurse is caring for a client brought to the emergency room. The client’s caregiver reports the client had a sudden onset of confusion. Which intervening technique by the nurse is most appropriate to evaluate mentation for this client?

Ask close-ended questions.

Ask open-ended questions.

Use directive questions.

Use reflective questions.

Answer and Explanation

The Correct Answer is B

Choice A Reason:

Ask close-ended questions is incorrect. Close-ended questions typically elicit short, specific responses such as “yes” or “no.” While they can be useful in certain situations, they do not provide enough information to thoroughly assess a client’s mental status. Open-ended questions allow the client to express themselves more fully, providing the nurse with better insight into their cognitive function.

Choice B Reason:

Ask open-ended questions is correct. Open-ended questions encourage the client to elaborate on their thoughts and feelings, which can reveal more about their mental status. This type of questioning helps the nurse assess the client’s orientation, memory, and thought processes more effectively.

Choice C Reason:

Use directive questions is incorrect. Directive questions are more structured and guide the client towards specific answers. While they can be useful for obtaining specific information, they do not allow for a comprehensive assessment of the client’s mental status.

Choice D Reason:

Use reflective questions is incorrect. Reflective questions are used to encourage the client to think more deeply about their responses and feelings. While they can be helpful in therapeutic settings, they are not the most effective for an initial assessment of mental status.

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Correct Answer is ["A","D"]

Explanation

Choice A Reason:

Date of birth is an acceptable client identifier. The Joint Commission specifies that using the date of birth helps ensure accurate identification of the client. This identifier is unique to each individual and is less likely to be duplicated.

Choice B Reason:

Photograph identification is not typically listed as an acceptable identifier by the Joint Commission. While it can be useful in some settings, it is not one of the primary identifiers recommended for ensuring patient safety.

Choice C Reason:

Facility room number is not an acceptable client identifier. The Joint Commission explicitly states that room numbers should not be used as identifiers because they can change and are not unique to the individual.

Choice D Reason:

Client’s full name is an acceptable client identifier. Using the full name helps to accurately identify the client and match them with their medical records and treatment plans.

A. Pee privacy B. Otoscope C. Tannic acid D. Pupil dilation

Correct Answer is ["A"]

Explanation

Choice A reason: Pee privacy

Ensuring privacy for a patient, especially one who is pregnant, is crucial. Privacy helps maintain the patient’s dignity and comfort during medical procedures. It also fosters a trusting relationship between the patient and the healthcare provider. In this context, “Pee privacy” likely refers to ensuring the patient has privacy when providing a urine sample, which is a common procedure during pregnancy check-ups to monitor for conditions like gestational diabetes or preeclampsia.

Choice B reason: Otoscope

An otoscope is a medical device used to look into the ears. While it is an essential tool in many medical examinations, it is not specifically related to the care of a pregnant patient unless there is a specific concern about ear health. Therefore, this choice is less relevant in the context of routine pregnancy care.

Choice C reason: Tannic acid

Tannic acid is a substance that can be used for various medical purposes, including treating burns and stopping bleeding. However, it is not typically associated with routine pregnancy care. Its inclusion in this list seems out of place unless there is a specific, unusual medical condition being addressed.

Choice D reason: Pupil dilation

Pupil dilation is a procedure often performed during eye examinations to allow a better view of the retina and other structures inside the eye. While important in ophthalmology, it is not a standard procedure in the care of a pregnant patient unless there is a specific concern about the patient’s vision or eye health.

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A nurse is caring for a client brought to the emergency room. The client’s caregiver reports the client had a sudden onset of confusion. Which intervening technique by the nurse is most appropriate to evaluate mentation for this client?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is preparing to administer oral medications to a client. According to the Joint Commission, which are acceptable client identifiers? (Select all that apply.)

Correct Answer is ["A","D"]

Explanation

A nurse is caring for a patient who is pregnant. Check the name tag (select all that apply):

Correct Answer is ["A"]

Explanation

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Edited TextA nurse is auditing a client. During the assessment, the nurse notes the client has multiple cavities, chipped, and missing teeth. The client reports having difficulty eating. Which diet should the nurse recommend the primary health care provider to order for this client?