TEST BANK
Jane W. Ball: Seidel's Guide to
Physical Examination: An
Interprofessional Approach
Chapter 01: The History and Interviewing Process
MULTIPLE CHOICE
1. The primary objective of the initial encounter is to:
a. define the advice and care for the patient.
b. establish the tone of a successful partnership.
c. optimize your ability to help.
d. tell the patient the limits of care.
ANS: B
The first meeting with the patient sets the tone for a successful partnership. It is to discover
the details about patients’ concerns, explore expectations for the encounter, display genuine
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interest, and develop a partnership.
DIF: Cognitive Level: Remembering (Knowledge) REF: p. 1
OBJ: Nursing process—assessment MSC: Safe and Effective Care: Management of Care
2. If language is a barrier, the interpreter should be:
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a. a family member.
b. a language board.
c. a professional interpreter
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d. a staff person.
ANS: C
Someone other than a family member should act as an interpreter to bridge the language
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difference between a health care provider and the patient. A professional interpreter rather
than a family member should be used.
DIF: Cognitive Level: Remembering (Knowledge) REF: p. 4
OBJ: Nursing process—assessment MSC: Safe and Effective Care: Management of Care
3. Mary Jane has brought in her 16-year-old son, Kyle. She states that he has been sleeping more
and does not hang around his friends, and recently his girlfriend broke up with him. Your most
immediate question is to ask Kyle:
a. “Do you want to see a counselor today?”
b. “Is your father out of jail yet?”
c. “Are you taking any illegal drugs?”
d. “Have you made plans to harm yourself?”
ANS: D
If you sense that a patient is contemplating suicide, you should ask about suicidal ideation
directly. The most important area to address is the potential for suicide. The question “Is your
father out of jail yet?” may be relevant to the history, but is not an immediate concern.
DIF: Cognitive Level: Analyzing (Analysis) REF: p. 5
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
,4. Ms. Yale is a 52-year-old patient who presents to the office for evaluation. During the
interview, you say “Tell me what you do when you have knee pain.” The health care provider
is asking information about:
a. health promotion.
b. the description and character of the complaint.
c. the location and duration of the complaint.
d. aggravating and relieving factors of the complaint.
ANS: D
The health care provider is asking a symptom-analysis question to obtain more information
about the aggravating and alleviating factors of the knee pain. Asking the patient to describe a
typical attack of pain would help obtain information about the description and character of the
complaint. The question “When did you last feel well?” would help define the time of onset
and duration of the complaint. A question about health promotion would be directed toward
improving patient health.
DIF: Cognitive Level: Understanding (Comprehension) REF: p. 11
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
5. Which question would be considered a “leading question?”
a. “What do you think is causing your headaches?”
b. “You don’t get headaches often, do you?”
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c. “On a scale of 1 to 10, how would you rate the severity of your headaches?”
d. “At what time of the day are your headaches the most severe?”
ANS: B
Stating to the patient that he or she does not get headaches would limit the information in the
patient’s answer. Asking the patient what he or she thinks is causing the headaches is an open-
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ended question. Asking the patient how he or she would rate the severity of the headaches and
asking what time of the day the headaches are the most severe are direct questions.
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DIF: Cognitive Level: Applying (Application) REF: p. 4
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
A
6. To prevent personal appearance from becoming an obstacle in patient care, the health care
professional should:
a. wear a uniform.
b. avoid wearing white.
c. avoid extremes in dress.
d. avoid wearing any jewelry.
ANS: C
Sensible personal habits, along with avoidance of extremes in behavior and dress, contribute
to establishing a trusting relationship between the care provider and the patient.
DIF: Cognitive Level: Remembering (Knowledge) REF: p. 3
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
7. Which action would best promote accurate translation and confidentiality when the caregiver
does not speak the patient’s language?
a. Ask a person unfamiliar with the patient to translate.
b. Have a friend of the patient translate.
, c. Involve the family with the translation.
d. Use a neighbor as translator.
ANS: A
When you do not speak the patient’s language, family members or friends may pose a
communication barrier and may have issues of confidentiality; a stranger will be a less biased
interpreter. You should ask a person unfamiliar with the patient to translate.
DIF: Cognitive Level: Understanding (Comprehension) REF: p. 4
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
8. When are open-ended questions generally most useful?
a. During the initial part of the interview.
b. After several closed-ended questions have been asked.
c. While designing the genogram.
d. During the review of systems.
ANS: A
Asking open-ended questions at the beginning of an interview allows you to gather more
information and establishes you as an empathic listener, which is the first step of effective
communication. Interviewing for the purpose of designing a genogram or conducting a review
of systems requires more focused data than can be more easily gathered with direct
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questioning. Asking closed-ended questions may stifle the patient’s desire to discuss the
history of the illness.
DIF: Cognitive Level: Understanding (Comprehension) REF: p. 2
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
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9. Behaviors that diffuse anxiety during the interview include:
a. avoiding wearing uniforms or laboratory coats.
b. providing forthright answers to questions.
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c. providing all necessary information before the patient has to ask for it.
d. completing the interview as quickly as possible.
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ANS: B
To relieve anxiety, the health care professional should answer patient questions forthrightly,
should avoid an overload of information, and should not hurry the conversation. Uniforms, lab
coats, and scrub suits are common in health care. It is impossible to anticipate every question
that a patient may ask. Completing the interview as quickly as possible may make the patient
feel rushed.
DIF: Cognitive Level: Understanding (Comprehension) REF: p. 4
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
10. Periods of silence during the interview can serve important purposes, such as:
a. allowing the clinician to catch up on documentation.
b. promoting calm.
c. providing time for reflection.
d. increasing the length of the visit.
ANS: C
, Silence is a useful tool during interviews for the purposes of reflection, summoning courage,
and displaying compassion. This is not a time to document in the chart, but rather to focus on
the patient. Periods of silence may cause anxiety rather than promote calm. The length of the
visit is less important than getting critical information.
DIF: Cognitive Level: Understanding (Comprehension) REF: p. 4
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
11. Which technique is most likely to result in the patient’s understanding of questions?
a. Use phrases that are commonly used by other patients in the area.
b. Use the patient’s own terms if possible.
c. Use the simplest language possible.
d. Use proper medical and technical terminology.
ANS: B
To ensure that your questions have been correctly understood, be clear and explicit while
using the patient’s own terms and level of understanding. Using phrases commonly used by
other patients may not help ensure that your questions have been correctly understood by this
patient. You should be clear and explicit while using the patient’s own terms and level of
understanding. Using the simplest language will not help ensure that your questions have been
correctly understood. It is important to avoid the use of medical terminology, because the
patient may not understand it.
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DIF: Cognitive Level: Applying (Application) REF: p. 2
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
12. Mr. Franklin is speaking with you, the health care provider, about his respiratory problem. Mr.
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Franklin says, “I’ve had this cough for 3 days, and it’s getting worse.” You reply, “Tell me
more about your cough.” Mr. Franklin states, “I wish I could tell you more. That’s why I’m
here. You tell me what’s wrong!” Which caregiver response would be most appropriate for
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enhancing communication?
a. “After 3 days, you’re tired of coughing. Have you had a fever?”
b. “I’d like to hear more about your experiences. Where were you born?”
c. “I don’t know what’s wrong. You could have almost any disease.”
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d. “I’ll examine you and figure out later what the problem is.”
ANS: A
“After 3 days, you’re tired of coughing. Have you had a fever?” is the only response aimed at
focusing on the chief compliant to gather more data and does not digress from the issue.
DIF: Cognitive Level: Analyzing (Analysis) REF: p. 5
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
13. Mr. Miller is a 46-year-old patient who becomes restless during the history and says, “I don’t
have time for all of this conversation. I’ve got to get back to work.” Your most appropriate
response would be to:
a. remember (acknowledge) his anger and proceed with the history and examination.
b. ask another open-ended question and insist on an answer.
c. ask questions about his anger and move closer to him.
d. ignore his displeasure and become more assertive about getting answers.
ANS: A
, Acknowledging his anger and proceeding with the history and examination is the only
response that resists the tendency for patient manipulation, pursues the information, and
confronts the anger.
DIF: Cognitive Level: Applying (Application) REF: p. 5
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
14. When you are questioning a patient regarding alcohol intake, she tells you that she is “only a
social drinker.” Which initial response is appropriate?
a. “I’m glad that you are a responsible drinker.”
b. “Do the other people in your household consume alcohol?”
c. “What amount and what kind of alcohol do you drink in a week?”
d. “If you only drink socially, you won’t need to worry about always having a
designated driver.”
ANS: C
“What amount and what kind of alcohol do you drink in a week?” clarifies the patient’s own
statement without asking a leading question or being judgmental.
DIF: Cognitive Level: Analyzing (Analysis) REF: p. 8
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
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15. Ms. T is crying and states that her mother couldn’t possibly have a tumor. “No one else in the
family has ever had cancer!” exclaims the daughter. The most appropriate response to Ms. T
would be:
a. “Has anyone explained hospice care to your mother?”
b. “I’m so sorry that your mother was diagnosed with cancer.”
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c. “That is odd, since cancer usually runs in families.”
d. “Why do you think that your mother’s tumor is cancerous?”
ANS: D
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“Why do you think that your mother’s tumor is cancerous?” is the only answer that is a direct
exploration of the daughter’s concern. The health care provider can address and clarify the
concerns of the daughter.
A
DIF: Cognitive Level: Analyzing (Analysis) REF: p. 5
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
16. After you ask a patient about her family history, she says, “Tell me about your family now.”
Which response is generally most appropriate?
a. Ignore the patient’s comment and continue with the interview.
b. Give a brief, undetailed answer.
c. Ask the patient why she needs to know.
d. Tell the patient that you do not discuss your family with patients.
ANS: B
Giving a brief, undetailed answer will satisfy the patient’s curiosity about yourself without
invading your private life. Ignoring the patient’s comment, continuing with the interview, and
telling the patient that you do not discuss your family with patients will potentially anger or
frustrate her and keep her from sharing openly. Asking the patient why she needs to know will
distract from the real reason she is seeking care and instead move the interview conversation
away from the topics that should be discussed.
, DIF: Cognitive Level: Applying (Application) REF: p. 4
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
17. A 36-year-old woman complains that she has had crushing chest pain for the past 2 days. She
seems nervous as she speaks to you. An appropriate response is to:
a. continue to collect information regarding the chief complaint in an unhurried
manner.
b. finish the interview as rapidly as possible.
c. ask the patient to take a deep breath and calm down.
d. ask the patient if she wants to wait until another day to talk to you.
ANS: A
With an anxious, vulnerable patient, it is best to not hurry; a calm demeanor will communicate
caring to the patient. If you as the health care provider are hurried, the patient will be more
anxious. The best way to assist an anxious patient is to not hurry and remain calm, because
this will communicate caring to the patient. Asking the patient if she wants to wait until
another day to talk to you delays the needed health care.
DIF: Cognitive Level: Applying (Application) REF: p. 4
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
KA
18. Ms. A states, “My life is just too painful. It isn’t worth it.” She appears depressed. Which one
of the following statements is the most appropriate caregiver response?
a. “Try to think about the good things in life.”
b. “What in life is causing you such pain?”
c. “You can’t mean what you’re saying.”
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d. “If you think about it, nothing is worth getting this upset about.”
ANS: B
Specific but open-ended questions are best used when the patient has feelings of loss of self-
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worth and depression. “Try to think about the good things in life,” “You can’t mean what
you’re saying,” and “If you think about it, nothing is worth getting this upset about” are
statements that will hurry the patient and offer only superficial assurance.
A
DIF: Cognitive Level: Analyzing (Analysis) REF: pp. 4-6
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
19. During an interview, tears appear in the patient’s eyes and his voice becomes shaky. Initially,
you should:
a. ask him if he would like some time alone.
b. offer a tissue and let him know it is all right to cry.
c. explain to the patient that you will be able to help him more if he can control his
emotions.
d. ask the patient what he is upset about.
ANS: B
