A client presents to the primary care clinic and is disheveled in appearance, with stained, dirty clothing, body odor, and uncombed hair. Based on this observation, which topics should the nurse assess during the history and physical exam?
Select all that apply.
1. Occupation.
2. Depression.
3. Smoking history.
4. Self-concept.
5. Immunization status.
Correct Answer: 1, 2, 4
The way a client dresses and maintains physical hygiene may provide clues to a variety of things, such as what the client does for a living (perhaps the client has a physical job and has just come from work), the client's sense of self-esteem and body image, as well as be an indicator of mental illness, anxiety, or depression. The client's disheveled appearance does not directly clue the nurse to explore the client's smoking history. Clues that would lead the nurse to fully explore the client's smoking history would include the smell of smoke on the client, the discoloration of the fingers from tobacco, hoarseness of the voice, and/or a cough. The observations made by the nurse do not clue the nurse to assess the client's immunization status.
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