The nurse is assessing a 67-year-old female client who has been admitted to the psychiatric unit.  When performing the patient history, the RN learns that the client’s chief complaint is “feelings of depression.”The nurse should ask the client which of the following COLDPHARTS questions when obtaining the history of present illness (HPI)?Please choose all that apply.  There may be more than one correct answer.

A nurse interviewing a client asks her the following 2 questions: 1. “Have you lost interest in things you formerly found pleasurable?” 2. “In the past month, have you experienced any feelings of hopelessness?”The nurse is assessing the client for which of the following?

The Glasgow Coma Scale is best described as a tool used by healthcare professionals to assess a client’s:

Please calculate the Glasgow Coma score for the client described in the scenario below:A registered nurse is working for a home health agency.  One of her clients, Mrs. Harris, experienced a debilitating cerebrovascular accident (CVA)/stroke 7 years ago.  During the RN’s visit to this client, she makes the following observations:When the RN asks the client what her name is, there is no response. She also doesn’t respond to gentle shaking.  However, the client opens her eyes and moans when the nurse applies a sternal rub. When the nurse attempts to draw blood from the large vein in the client’s right anticubital fossa, the patient jerks that arm away from the needle.The nurse will assign a Glasgow Coma Score (GCS) of:

When will the RN perform the “general survey” of his client?

A nurse working on a surgical unit is documenting her findings of the general inspection segment of a comprehensive examination on a newly admitted client.  She will include which of the following topics in her documentation of her general inspection?

An experienced nurse documents the following about her newly-admitted client:“Client is disheveled.”The student nurse understands this to mean that the client:

A 16-year-old female client presents to the CVS Minute Clinic doctor’s office complaining of an unremitting (will not go away) headache.The nurse practitioner asks the client, “Is the headache less painful when you lie down?”The SCC graduate knows that the answer to this COLDPHARTS question should be documented under which of the following categories?

Which one of the following explanations could not account for a client looking younger than s/he actually is?

An RN who works in the Emergency Department (ED) admits a homeless man with frostbite.  While performing her general inspection, the nurse identifies a strong body odor.The nurse will document this under which one of the following general inspection categories?