# The nurse observes admission communication with a client who has limited English proficiency. Which actions require follow-up? Highlight the actions that threaten accuracy, privacy, or the client’s own voice. > source: MyMerci (mymerci.kr) > url: https://mymerci.kr/pages/nclex_q.php?qn_id=497296&lang=en > language: en > subject: Mental Health Concepts > category: PSI ## Question The nurse observes admission communication with a client who has limited English proficiency. Which actions require follow-up? Highlight the actions that threaten accuracy, privacy, or the client’s own voice. Nurses' Notes 1440: The nurse observes an admission interview with a client who has limited English proficiency. The chart shows that the client's preferred spoken and written language is documented in the admission record. At 1445, staff state that the client's minor child will interpret the medication history. The nurse obtains a qualified video interpreter, and the screen is positioned so the client can see both participants. The consent discussion begins, but a visiting neighbor is asked to explain the procedure and risks. During the interview, the clinician speaks only to the adult family member instead of addressing the client. The interpreter pauses after each short segment, and the client is given time to answer directly. The discharge packet is prepared, but vital medication warnings are provided only in English. The client asks for a spouse to remain present, and the requested support person stays with the client's permission. At 1500, the nurse uses teach-back through the qualified interpreter after each major teaching point. The interpreter documents completion of the encounter. The nurse stops the consent process until accurate language assistance and accessible information are available. The team confirms that family involvement will follow the client's preference rather than replace the client's decisions. ## Explanation Using a minor child as interpreter, asking an unqualified visitor to explain consent, speaking only to family, and skipping translated vital information require follow-up. Qualified language assistance protects meaning, privacy, and autonomy. ## In-depth explanation Quick answer Highlight reliance on the client’s minor child, use of an unqualified visitor for consent, directing the interview only to family, and omitting translated vital information. These actions can distort meaning or silence the client. Why this is correct Covered health programs must take reasonable steps to provide meaningful access for people with limited English proficiency. Qualified language assistance supports accurate communication, and minor children generally should not interpret except for a narrow emergency when no qualified interpreter is immediately available.[2] Easy analogy or mental picture Picture a clear communication channel between client and clinician. A qualified interpreter carries meaning through the channel, while side conversations and untrained helpers add noise; the picture does not remove the need to assess understanding directly. Memory hook Qualified help, speak to the client, protect meaning and privacy. NCLEX decision rule When language limits understanding, think qualified access before convenience; check interpreter qualification, client preference, direct client engagement, privacy, and translated vital information before consent or teaching. Why the other choices are wrong Documenting the preferred language, using a qualified video interpreter, pausing for interpretation, and asking the client to teach back through the interpreter support accurate care. Family may participate when the client wants them involved, but should not replace qualified assistance for critical communication.References - [1]NCSBN: 2026 NCLEX-RN Test PlanNational Council of State Boards of Nursing - [2]HHS: Section 1557 Civil Rights Training for Health ProvidersU.S. Department of Health and Human Services ## Related questions - [A client hospitalized for depression says, "My family would be better off without me." Whi…](https://mymerci.kr/pages/nclex_q.php?qn_id=393687&lang=en) - [A client with schizophrenia says, "The voices are telling me to do something bad." Which r…](https://mymerci.kr/pages/nclex_q.php?qn_id=394025&lang=en) - [A client arrives with bruises at different stages of healing. 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