The nurse is planning to perform a physical assessment on an adult client. Before beginning this phase of the client's health assessment, which action by the nurse is the most appropriate?
1. Provide a gown for the client to change into.
2. Explain to the client what will happen during the examination.
3. Obtain a written consent.
4. Wash hands in the presence of the client.
Correct Answer: 2
The first thing the nurse should do prior to beginning the physical assessment of a client is explain to the client what is about to happen. This helps to relieve a client's anxiety and enlists the client's cooperation with the assessment. The client may need to change into a gown in order for the nurse to perform the assessment; however, the nurse should first explain what will be happening before asking the client to change clothing. Obtaining a written consent is not necessary, unless an invasive procedure will be performed. Handwashing should be performed just before the nurse begins to touch the client and after a full explanation of the process is given.
You might also like to view...
During an annual physical examination, a 43-year-old patient states that she does not perform monthly breast self-examinations (BSEs). She tells the nurse that she believes that mammograms "do a much better job than I ever could to find a lump."
The nurse should explain to her that: a. BSEs may detect lumps that appear between mammograms. b. BSEs are unnecessary until the age of 50 years. c. She is correctâ€"mammography is a good replacement for BSE. d. She does not need to perform BSEs as long as a physician checks her breasts annually.
What is one way to enhance the nutrition of the hospitalized toddler?
a. Reward with sweets for eating meals b. Discourage participation in noneating activities c. Offer nutritious fluids frequently d. Leave nutritious finger foods out for the child to eat
The posterior hypothalamus helps control temperature by
a. Causing vasoconstriction. b. Shunting blood to the skin and extremities. c. Increasing sweat production. d. Causing vasodilation.
A drug ________ is an abnormal response that occurs because a person has developed antibodies against a particular drug.
Fill in the blank(s) with the appropriate word(s).