HESI Health Assessment Exam 2 Content
Module 1:
● State the factors that affect communication
● Environmental:
● comfortable room temperature
● good lighting
● quiet place
● ensure privacy
● External Factors:
● Eye contact-shows interest, assess culture bc some avoid eye contact
● Posture- arms & legs crossed looks defensive and uninviting
● Dress- interviewer is professional, uniform or lab coat worn over clothing
● Dress for patient- normal clothes, gown for examination
● Note taking may be avoided- breaks eye contact, diminishes patients
sense of importance, interrupts narrative flow
● Tape and video recording
● Don’t interrupt, unless emergency
● Distance and equal status seating- Eye level with patient
● Internal Factors:
● Liking others- need warmth & caring
● Empathy-feel with the person instead of feeling like the person.
● Ex: “This must be very hard for you”, “I am here to help”
● Ability to listen- be attentive & don’t interrupt
● Self-awareness- know YOUR values and beliefs, BUT put them aside
and care for patients
● Ex: you are catholic and don't believe in abortion, but your patient
needs a referral for her health to visit an abortion clinic
● Discuss the meaning of verbal and nonverbal communication
● Verbal-specific content must have meaning. Receiver must understand
message being sent by sender
● Nonverbal- less under conscious control, reflects true feelings
● Posture, gestures, facial expressions, eye contact, foot tapping, touch,
even where you place your chair
,● Identify therapeutic communication techniques and how to overcome barriers to
effective communication
● Active listening and focusing, engage when necessary
● Facilitation: providing vocal and action cues. Ex: uh-huh, go on
● Reflection-repeat what the patient said in a summarized version
● Share Observation-make comments about how the pt looks.
● Ex: “you look like you are uncomfortable” (Helps limit extensive questioning)
● Share hope, humor, and empathy= relaxes patient
● Ex: Hope- “I know you are having a hard time, but I can see that you are
making progress.”
● Clarification- reiterate what the patient did/might have said
● Ex: “Are you saying that your pain is interfering with your daily activities?”
● SOLER: encourages the pt to say more and shows you are interested in them.
● Squarely facing speaker
● Open your posture
● Lean towards the speaker
, ● Eye contact is maintained
● Relax while listening
● Describe the communication techniques as indicated by each patient’s
developmental stage, special needs, or cultural practices
● Nutritional: The Joint Commission requires nutrition assessment for all
patients. In addition to information about food intake, it includes information
related to personal, psychosocial, and economic problems that may affect
nutrition.
● Pain: TJC standards require pain screening for all patients during initial and
ongoing assessments. A comprehensive pain assessment may be required for
ongoing, unrelieved, or severe pain.
● Cultural: Awareness of cultural influences should guide your assessment and
nursing care.
● Some cultures don’t prefer touching
● Spiritual health: For ill persons, spirituality can be a problem or a source of
support. Spiritual health assessment provides insight into how a client’s
spirituality is affected by current life events and health status—far more than
merely asking about the client’s religious preference.
● Psychosocial: A psychosocial assessment typically includes data about family,
lifestyle, usual coping patterns, understanding of the current illness, personality
style, previous psychiatric disorders, recent stressors, major issues related to the
illness, and mental status.
● Infants- face directly, use quiet and calm voice
● Toddlers- keep it simple, one thing at a time, short sentences
● Preschoolers- short and simple tasks, educate through playing
● School age- nonjudgmental approach, child wants to know why & how
● Adolescents (puberty)- use honest and respectful approach
● Older adults- do not shout for disabled hearing, no “elderspeak”
● Acutely Ill- need clear and direct communication
● Sexually aggressive- set boundaries and communicate inappropriate behavior
● Angry, anxious, violent patients- ask about their feelings and listen,
don’t take it personally, immediately de-escalate suspicious behavior,
never turn your back
, ● Crying patient- allow them to cry and express their feelings, reassure you are
there to listen. Do not change the subject if pt is crying
● Patient under influence- need simple and direct communication
● Non-threatening approach, avoid confrontation, and assess the name,
amount, & time of last drink/drug taken
● Hearing Impaired: check for hearing aids & if in use
● Ask preferred method of communication
● Use a trained interpreter if signing, family might change things
● Discuss how to use SBAR as a form of professional communication and collaboration
● Improves effectiveness of communication between individuals
● Situation-clearly and briefly define the situation
● Background- provide clear and relevant background info regarding the situation
● Assessment- statement of your professional conclusion
● Recommendation- what do you need to clarify regarding the patient
● Compare and contrast the different types of written documentation and electronic charting
● Hand written documentation can be misinterpreted if poor penmanship
● EHR reduces risk and error, it's more efficient, and more secure than paper
Module 1:
● State the factors that affect communication
● Environmental:
● comfortable room temperature
● good lighting
● quiet place
● ensure privacy
● External Factors:
● Eye contact-shows interest, assess culture bc some avoid eye contact
● Posture- arms & legs crossed looks defensive and uninviting
● Dress- interviewer is professional, uniform or lab coat worn over clothing
● Dress for patient- normal clothes, gown for examination
● Note taking may be avoided- breaks eye contact, diminishes patients
sense of importance, interrupts narrative flow
● Tape and video recording
● Don’t interrupt, unless emergency
● Distance and equal status seating- Eye level with patient
● Internal Factors:
● Liking others- need warmth & caring
● Empathy-feel with the person instead of feeling like the person.
● Ex: “This must be very hard for you”, “I am here to help”
● Ability to listen- be attentive & don’t interrupt
● Self-awareness- know YOUR values and beliefs, BUT put them aside
and care for patients
● Ex: you are catholic and don't believe in abortion, but your patient
needs a referral for her health to visit an abortion clinic
● Discuss the meaning of verbal and nonverbal communication
● Verbal-specific content must have meaning. Receiver must understand
message being sent by sender
● Nonverbal- less under conscious control, reflects true feelings
● Posture, gestures, facial expressions, eye contact, foot tapping, touch,
even where you place your chair
,● Identify therapeutic communication techniques and how to overcome barriers to
effective communication
● Active listening and focusing, engage when necessary
● Facilitation: providing vocal and action cues. Ex: uh-huh, go on
● Reflection-repeat what the patient said in a summarized version
● Share Observation-make comments about how the pt looks.
● Ex: “you look like you are uncomfortable” (Helps limit extensive questioning)
● Share hope, humor, and empathy= relaxes patient
● Ex: Hope- “I know you are having a hard time, but I can see that you are
making progress.”
● Clarification- reiterate what the patient did/might have said
● Ex: “Are you saying that your pain is interfering with your daily activities?”
● SOLER: encourages the pt to say more and shows you are interested in them.
● Squarely facing speaker
● Open your posture
● Lean towards the speaker
, ● Eye contact is maintained
● Relax while listening
● Describe the communication techniques as indicated by each patient’s
developmental stage, special needs, or cultural practices
● Nutritional: The Joint Commission requires nutrition assessment for all
patients. In addition to information about food intake, it includes information
related to personal, psychosocial, and economic problems that may affect
nutrition.
● Pain: TJC standards require pain screening for all patients during initial and
ongoing assessments. A comprehensive pain assessment may be required for
ongoing, unrelieved, or severe pain.
● Cultural: Awareness of cultural influences should guide your assessment and
nursing care.
● Some cultures don’t prefer touching
● Spiritual health: For ill persons, spirituality can be a problem or a source of
support. Spiritual health assessment provides insight into how a client’s
spirituality is affected by current life events and health status—far more than
merely asking about the client’s religious preference.
● Psychosocial: A psychosocial assessment typically includes data about family,
lifestyle, usual coping patterns, understanding of the current illness, personality
style, previous psychiatric disorders, recent stressors, major issues related to the
illness, and mental status.
● Infants- face directly, use quiet and calm voice
● Toddlers- keep it simple, one thing at a time, short sentences
● Preschoolers- short and simple tasks, educate through playing
● School age- nonjudgmental approach, child wants to know why & how
● Adolescents (puberty)- use honest and respectful approach
● Older adults- do not shout for disabled hearing, no “elderspeak”
● Acutely Ill- need clear and direct communication
● Sexually aggressive- set boundaries and communicate inappropriate behavior
● Angry, anxious, violent patients- ask about their feelings and listen,
don’t take it personally, immediately de-escalate suspicious behavior,
never turn your back
, ● Crying patient- allow them to cry and express their feelings, reassure you are
there to listen. Do not change the subject if pt is crying
● Patient under influence- need simple and direct communication
● Non-threatening approach, avoid confrontation, and assess the name,
amount, & time of last drink/drug taken
● Hearing Impaired: check for hearing aids & if in use
● Ask preferred method of communication
● Use a trained interpreter if signing, family might change things
● Discuss how to use SBAR as a form of professional communication and collaboration
● Improves effectiveness of communication between individuals
● Situation-clearly and briefly define the situation
● Background- provide clear and relevant background info regarding the situation
● Assessment- statement of your professional conclusion
● Recommendation- what do you need to clarify regarding the patient
● Compare and contrast the different types of written documentation and electronic charting
● Hand written documentation can be misinterpreted if poor penmanship
● EHR reduces risk and error, it's more efficient, and more secure than paper
