Chapter01:TheHistoryandInterviewingProcess y,
Ball:Seidel’sGuidetoPhysicalExamination,9thEdition
y, y, y,
MULTIPLECHOICE
1. Which questionwould beconsidereda ―leadingquestion?‖
y, y, y, y, y,
a. ―Pleasedescribeanyassociatedsymptoms withyourheadaches?‖ y,
b. ―Youdon'tgetheadachesoften, do you?‖
y, y, y,
c. ―What activities affect theseverityofyourheadaches?‖
y, y, y, y,
d. ―Whattimes ofthe dayare yourheadachesthemostsevere?‖
y, y,
e. ―What worries you most about yourheadache?‖
y, y, y,
SELECTEDANSWER:
y,
B
This question would limit the information in the patient's selected answerwer. Theother
y, y,
choices allow the
patient morediscretion about theextent of an selected answerwer.
TOPIC: Discipline: BehavioralScience MSC: Organ System: General
2. Whichaction wouldbest promoteaccuratetrselected answerlations as well as
confidentiality when the
caregiver does not speak the patient's language?
a. Askaperson unfamiliar with thepatient to trselected answerlate.
b. Have a friend of thepatient trselected answerlate.
c. Asksimple leadingquestions that the patient mayunderstand.
d. Useaneighbor as trselected answerlator.
e. Involve thefamilywith the trselected answerlation.
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SELECT
ED
ANSWE
R: A
When you do not speak the patient's language, family members or friends may
pose a communication barrier andmayhaveissues of confidentiality; astranger as an
y, y,
interpreter is less biased.
TOPIC: Discipline: BehavioralScience MSC: Organ System: General
3. Periodsofsilence during the interview can serveimportant purposes, such as:
a. allowingthe clinician to catch up on documentation.
b. giving you a clue that you should speed up theinterview.
c. providingtime forreflection.
d. increasingthe length of thevisit.
e. promoting a calm environment.
y,
SELECTEDANSWER: C
Silence is a useful tool during interviews for the purposes of reflection, summoning of
y, y, y, y,
courage, and displayingcompassion. It isusuallya clue for you to go slower and y,
not to push too hard.
y, y,
TOPIC: Discipline: BehavioralScience MSC: Organ System: General
y,
4. Whichtechnique is most likely to result in the patient's understanding of questions?
y, y, y,
a. Usephrases that are commonlyused by other patients in the area. y, y,
b. Use the patient's own terms if possible.
y, y,
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c. Uselanguagethat keeps thepatient from beingexpselected answerivein hisor her
selected answerwer.
d. Useproper medical and technical terminology.
e. Usethe simplest language possible.
SELECTEDANSWER: B
To ensurethat yourquestions havebeen correctlyunderstood, be clear, and explicit while y,
using the patient's idiom and level of understanding.
TOPIC: Discipline: BehavioralScience MSC: Organ System: General
5. A patient 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. sTOPICusingopen-ended questions and become moredirect.
b. ask another open-ended question andinsist on an selected answerwer.
y,
c. ask questions about hisanger and move closer to him.
y,
d. acknowledgehis anger and proceed with the history and examination. y,
e. ignorehis displeasureand become more assertive about gettingselected answerwers.
SELECTEDANSWER: D
Thisistheonlyselected answerwerthat resists thetendencyfor patient manipulation, pursues the y,
information, and confronts the patient's anger.
TOPIC: Discipline: BehavioralScience MSC: Organ System: General y,
6. Whenquestioningapatientregardingalcoholintake,shetellsyou thatsheis―onlyasocial
y, y, y, y,
drinker.‖ Which initial response is appropriate? y, y,
a. ―I'm glad that youarea responsible drinker.‖
y, y, y, y, y,
b. ―Many people who are reN allyRalcIohoGlic sBa y. tCh e yMa re social drinkers.‖
USNT doyoudrinkinaweek?‖
c. ―Whatamount and whatkindofalcohol
y, y, y, y, y, y,
d. ―Ifyou onlydrinksocially, you won'tneed toworryaboutalways having a
y, y, y, y, y, y,
designated driver.‖
e. ―Dothe otherpeople in yourhousehold consumealcohol?‖
y, y, y, y, y,
SELECTEDANSWER: C
This selected answerwer clarifies the patient's own term without askingaleading question or y, y,
being judgmental.
TOPIC: Discipline: BehavioralScience y, MSC: Organ System: General
7. A 50-year-old man comes to theprimarycareclinic. Hetells you he is worried becausehe
has had severe chest pains for the past 2 weeks. Which initial history interview y, y,
question is most appropriate?
a. ―Can you describe thepain?‖
y, y, y,
b. ―Thepaindoesn'tradiatetoyourarm,doesit?‖ y, y, y,
c. ―Have youbeentreatedforanxietybefore?‖
d. ―Doesyourfatherhaveheart disease?‖ y,
e. ―Arethepainsworseafteryou eat?‖
y, y,
SELECTEDANSWER: A
Initially,anopen-ended questionisamoreappropriateresponse.―Canyoudescribethepain?‖ is y, y,
an open-ended question that offers clues to the chief concern.
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TOPIC: Discipline: BehavioralScience MSC: Organ System: General
8. Ms.A.states,―Mylifeis just toopainful. It isn'tworthit.‖Sheappearsdepressed.Which one of y, y,
the following statements is the most appropriate caregiver response?
a. ―Tryto think aboutthegood things in life.‖
y, y, y, y, y,
b. ―Youshouldn'tfeelthatway;look atallthegood thingsin yourlife.‖ y, y, y, y,
c. ―You can't mean what you'resaying.‖
y, y, y, y,
d. ―Ifyou think about it,nothing is worthgetting thisupsetabout.‖
y, y, y, y, y, y, y,
e. ―What in lifeis causing you such pain?‖
y, y, y, y, y, y,
SELECTEDANSWER: E
Specific yetopen-ended questionsarebestused whenthepatienthasfeelings
oflossof self-worth and depression. The other responses hurry the patient
and offer superficial assurance.
y,
TOPIC: Discipline: BehavioralScience MSC: Organ System: General
9. During an interview, you havethe impression that a patient y, y,
maybe considering suicide. Which action is essential?
y,
a. Immediatelybegin proceedings for an involuntarycommitment.
b. Askwhetherthe patient hasconsidered self-harm.
c. Askwhetherthe patient wouldlike to visit apsychiatrist. y,
d. Record theimpression in the patient's chart and refer the y, y,
patient for hospitalization.
y,
e. Avoid directlyconfronting the patient regarding yourimpression.
y, y,
SELECTEDANSWER: B
Ifyou thinkthepatient maybNe c R
y, oUn sSiI e r iGn g B
Nd T s u.
icC
y, ide,Mhe or sheprobablyis. Mentioningit gives
y, y, y, y,
permission to talk about it.
y,
TOPIC: Discipline: BehavioralScience MSC: Organ System: General
10. You are collecting a history from an 11-year-old girl. Her motheris sitting next to
y, y,
her in the examination room. When collecting historyfrom olderchildren or y, y,
adolescents, theyshould:
a. neverbeinterviewed alone because this mayalienate the parent. y,
b. be mailed aquestionnaire in advance to avoid the need forher to talk.
y,
c. be given theopportunityto beinterviewed without theparent at some point.
d. beallowed to direct the flow ofthe interview. y,
e. be ignored while youaddress all questions tothe parent.
y,
SELECTEDANSWER: y , C
Anolder child should begiventheopportunityto giveinformationdirectly. This enhancesthe
probability that the child will follow your advice.
y,
TOPIC: Discipline: BehavioralScience MSC: Organ System: General
11. Whencommunicating with olderchildren and teenagers, youshouldbe sensitive to their:
a. parent'sneeds.
b. natural urgeto communicate.
c. need forverbal instructions.
d. typicalreluctanceto talk.