CH. 1 Seidel's Guide to Physical Examination
1. Which question would be considered a "leading question?"
a. "Please describe any associated symptoms with your
headaches?"
b. "You don't get headaches often, do you?"
c. "What activities affect the severity of your headaches?"
d. "What times of the day are your headaches the most
severe?"
e. "What worries you most about your headache?"
This question would limit the information in the patient's answer. The
other choices allow the patient more discretion about the extent of an
answer.
2. Which action would best promote accurate translations as
well as confi- dentiality 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. Ask simple leading questions that the patient may
understand.
d. Use a neighbor as translator.
e. Involve the family with the translation.
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 as an interpreter is less biased.
3. Periods of silence during the interview can serve
important purposes, such as:
a. allowing the clinician to catch up on documentation.
b. giving you a clue that you should speed up the interview.
c. providing time for reflection.
d. increasing the length of the visit.
e. promoting a calm environment.:
Silence is a useful tool during interviews for the purposes of reflection,
summoning of courage, and displaying compassion. It is usually a clue
for you to go slower and not to push too hard.
4. Which technique is most likely to result in the patient's
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,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 language that keeps the patient from being expansive
in his or her answer.
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, d. Use proper medical and technical terminology.
e. Use the simplest language possible.
To ensure that your questions have been correctly understood, be
clear, and explicit while using the patient's idiom and level of
understanding.
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. stop using open-ended questions and become more direct.
b. ask another open-ended question and insist on an answer.
c. ask questions about his anger and move closer to him.
d. acknowledge his anger and proceed with the history and
examination.
e. ignore his displeasure and become more assertive about
getting answers.-
This is the only answer that resists the tendency for patient
manipulation, pursues the information, and confronts the patient's
anger.
6. When 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. "Many people who are really alcoholic say. They are social
drinkers."
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."
e. "Do the other people in your household consume alcohol?"
This answer clarifies the patient's own term without asking a leading
question or being judgmental.
7. A 50-year-old man comes to the primary care clinic. He
tells you he is worried because he has had severe chest pains
for the past 2 weeks. Which initial history interview question
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1. Which question would be considered a "leading question?"
a. "Please describe any associated symptoms with your
headaches?"
b. "You don't get headaches often, do you?"
c. "What activities affect the severity of your headaches?"
d. "What times of the day are your headaches the most
severe?"
e. "What worries you most about your headache?"
This question would limit the information in the patient's answer. The
other choices allow the patient more discretion about the extent of an
answer.
2. Which action would best promote accurate translations as
well as confi- dentiality 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. Ask simple leading questions that the patient may
understand.
d. Use a neighbor as translator.
e. Involve the family with the translation.
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 as an interpreter is less biased.
3. Periods of silence during the interview can serve
important purposes, such as:
a. allowing the clinician to catch up on documentation.
b. giving you a clue that you should speed up the interview.
c. providing time for reflection.
d. increasing the length of the visit.
e. promoting a calm environment.:
Silence is a useful tool during interviews for the purposes of reflection,
summoning of courage, and displaying compassion. It is usually a clue
for you to go slower and not to push too hard.
4. Which technique is most likely to result in the patient's
1/9
,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 language that keeps the patient from being expansive
in his or her answer.
2/9
, d. Use proper medical and technical terminology.
e. Use the simplest language possible.
To ensure that your questions have been correctly understood, be
clear, and explicit while using the patient's idiom and level of
understanding.
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. stop using open-ended questions and become more direct.
b. ask another open-ended question and insist on an answer.
c. ask questions about his anger and move closer to him.
d. acknowledge his anger and proceed with the history and
examination.
e. ignore his displeasure and become more assertive about
getting answers.-
This is the only answer that resists the tendency for patient
manipulation, pursues the information, and confronts the patient's
anger.
6. When 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. "Many people who are really alcoholic say. They are social
drinkers."
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."
e. "Do the other people in your household consume alcohol?"
This answer clarifies the patient's own term without asking a leading
question or being judgmental.
7. A 50-year-old man comes to the primary care clinic. He
tells you he is worried because he has had severe chest pains
for the past 2 weeks. Which initial history interview question
3/9
