Chapter 01: The History and Interviewing Process
h h h h h h
Ball: Seidel’s Guide to Physical Examination, 9th Edition
h h h h h h h
MULTIPLEhCHOICE
1. Whichhquestionhwouldhbehconsideredhah“leadinghquestion?”
a. “Pleasehdescribehanyhassociatedhsymptomshwithhyourhheadaches?”
b. “Youhdon'thgethheadacheshoften,hdohyou?”
c. “Whathactivitieshaffecththehseverityhofhyourhheadaches?”
d. “Whathtimeshofhthehdayharehyourhheadacheshthehmosthsevere?”
e. “Whathworrieshyouhmosthabouthyourhheadache?”
ANS:h B
Thishquestionhwouldhlimiththehinformationhinhthehpatient'shanswer.hThehotherhchoiceshallowhthe
patienthmorehdiscretionhabouththehextenthofhanhanswer.
TOP:h Discipline:hBehavioralhScience MSC:h OrganhSystem:hGeneral
2. Whichhactionhwouldhbesthpromotehaccuratehtranslationshashwellhashconfidentialityhwhenhthe
caregiverhdoeshnothspeakhthehpatient'shlanguage?
a. Askhahpersonhunfamiliarhwithhthehpatienthtohtranslate.
b. Havehahfriendhofhthehpatienthtranslate.
c. Askhsimplehleadinghquestionshthaththehpatienthmayhunderstand.
d. Usehahneighborhashtranslator.
e. Involvehthehfamilyhwithhthehtranslation.
ANS:h A NURSINGTB.COM
Whenhyouhdohnothspeakhthehpatient'shlanguage,hfamilyhmembershorhfriendshmayhposehahcommu
nicationhbarrierhandhmayhhavehissueshofhconfidentiality;hahstrangerhashanhinterpreterhishlesshbiase
d.
TOP:h Discipline:hBehavioralhScience MSC:h OrganhSystem:hGeneral
3. Periodshofhsilencehduringhthehinterviewhcanhservehimportanthpurposes,hsuchhas:
a. allowinghthehclinicianhtohcatchhuphonhdocumentation.
b. givinghyouhahcluehthathyouhshouldhspeedhuphthehinterview.
c. providinghtimehforhreflection.
d. increasinghthehlengthhofhthehvisit.
e. promotinghahcalmhenvironment.
ANS:h C
Silencehishahusefulhtoolhduringhinterviewshforhthehpurposeshofhreflection,hsummoninghofhcourag
e,handhdisplayinghcompassion.hIthishusuallyhahcluehforhyouhtohgohslowerhandhnothtohpushhtoohhard.
TOP:h Discipline:hBehavioralhScience MSC:h OrganhSystem:hGeneral
4. Whichhtechniquehishmosthlikelyhtohresulthinhthehpatient'shunderstandinghofhquestions?
a. Usehphraseshthatharehcommonlyhusedhbyhotherhpatientshinhtheharea.
b. Usehthehpatient'shownhtermshifhpossible.
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c. Usehlanguagehthathkeepshthehpatienthfromhbeinghexpansivehinhhishorhherhanswer.
d. Usehproperhmedicalhandhtechnicalhterminology.
e. Usehthehsimplesthlanguagehpossible.
ANS:h B
Tohensurehthathyourhquestionshhavehbeenhcorrectlyhunderstood,hbehclear,handhexplicithwhile
usinghthehpatient'shidiomhandhlevelhofhunderstanding.
TOP:h Discipline:hBehavioralhScience MSC:h OrganhSystem:hGeneral
5. Ahpatienthbecomeshrestlesshduringhthehhistoryhandhsays,h“Ihdon'thhavehtimehforhallhofhthis
conversation.hI'vehgothtohgethbackhtohwork.”hYourhmosthappropriatehresponsehwouldhbehto:
a. stophusinghopen-endedhquestionshandhbecomehmorehdirect.
b. askhanotherhopen-endedhquestionhandhinsisthonhanhanswer.
c. askhquestionshabouthhishangerhandhmovehcloserhtohhim.
d. acknowledgehhishangerhandhproceedhwithhthehhistoryhandhexamination.
e. ignorehhishdispleasurehandhbecomehmorehassertivehabouthgettinghanswers.
ANS:h D
Thishishthehonlyhanswerhthathresistshthehtendencyhforhpatienthmanipulation,hpursueshthe
information,handhconfrontshthehpatient'shanger.
TOP:h Discipline:hBehavioralhScience MSC:h OrganhSystem:hGeneral
6. Whenhquestioninghahpatienthregardinghalcoholhintake,hshehtellshyouhthathshehish“onlyhahsocialhd
rinker.”hWhichhinitialhresponsehishappropriate?
a. “I'mhgladhthathyouharehahresponsiblehdrinker.”
b. “ManyhpeoplehwhoharehreN allyRalcI ohoGlichsB
ay.tC
heyMarehsocialhdrinkers.”
c. “Whathamounthandhwhathkind UhhSofhN hT O
halcoholhdohyouhdrinkhinhahweek?”
d. “Ifhyouhonlyhdrinkhsocially,hyouhwon'thneedhtohworryhabouthalwayshhavinghahd
esignatedhdriver.”
e. “Dohthehotherhpeoplehinhyourhhouseholdhconsumehalcohol?”
ANS:h C
Thishanswerhclarifieshthehpatient'shownhtermhwithouthaskinghahleadinghquestionhorhbeing
judgmental.
TOP:h Discipline:hBehavioralhScience MSC:h OrganhSystem:hGeneral
7. Ah50-year-
oldhmanhcomeshtohthehprimaryhcarehclinic.hHehtellshyouhhehishworriedhbecausehhehhashhadhseverehc
hesthpainshforhthehpasth2hweeks.hWhichhinitialhhistoryhinterviewhquestionhishmosthappropriate?
a. “Canhyouhdescribehthehpain?”
b. “Thehpainhdoesn'thradiatehtohyourharm,hdoeshit?”
c. “Havehyouhbeenhtreatedhforhanxietyhbefore?”
d. “Doeshyourhfatherhhavehhearthdisease?”
e. “Arehthehpainshworsehafterhyouheat?”
ANS:h A
Initially,hanhopen-endedhquestionhishahmorehappropriatehresponse.h“Canhyouhdescribehthehpain?”
ishanhopen-endedhquestionhthathoffershclueshtohthehchiefhconcern.
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TOP:h Discipline:hBehavioralhScience MSC:h OrganhSystem:hGeneral
8. Ms.hA.hstates,h“Myhlifehishjusthtoohpainful.hIthisn'thworthhit.”hShehappearshdepressed.hWhichhone
ofhthehfollowinghstatementshishthehmosthappropriatehcaregiverhresponse?
a. “Tryhtohthinkhabouththehgoodhthingshinhlife.”
b. “Youhshouldn'thfeelhthathway;hlookhathallhthehgoodhthingshinhyourhlife.”
c. “Youh can'th meanh whath you'reh saying.”
d. “Ifhyouhthinkhabouthit,hnothinghishworthhgettinghthishupsethabout.”
e. “Whathinhlifehishcausinghyouhsuchhpain?”
ANS:h E
Specifichyethopen-
endedhquestionsharehbesthusedhwhenhthehpatienthhashfeelingshofhlosshofhself-
worthhandhdepression.hThehotherhresponseshhurryhthehpatienthandhofferhsuperficialhassura
nce.
TOP:h Discipline:hBehavioralhScience MSC:h OrganhSystem:hGeneral
9. Duringhanhinterview,hyouhhavehthehimpressionhthathahpatienthmayhbehconsideringhsuicide.h
Whichhactionhishessential?
a. Immediatelyhbeginhproceedingshforhanhinvoluntaryhcommitment.
b. Askhwhetherhthehpatienthhashconsideredhself-harm.
c. Askhwhetherhthehpatienthwouldhlikehtohvisithahpsychiatrist.
d. Recordhthehimpressionhinhthehpatient'shcharthandhreferhthehpatienthfor
hospitalization.
e. Avoidhdirectlyhconfrontinghthehpatienthregardinghyourhimpression.
ANS:h B
IfhyouhthinkhthehpatienthmayhbNeUcR
onSsiI
deNrG ghB
inT su.
icC e,Mhehorhshehprobablyhis.hMentioninghithgiveshper
idO
missionhtohtalkhabouthit.
TOP:h Discipline:hBehavioralhScience MSC:h OrganhSystem:hGeneral
10. Youharehcollectinghahhistoryhfromhanh11-year-
oldhgirl.hHerhmotherhishsittinghnexthtohherhinhthehexaminationhroom.hWhenhcollectinghhistoryhfro
mholderhchildrenhorhadolescents,htheyhshould:
a. neverhbehinterviewedhalonehbecausehthishmayhalienatehthehparent.
b. behmailedhahquestionnairehinhadvancehtohavoidhthehneedhforhherhtohtalk.
c. behgivenhthehopportunityhtohbehinterviewedhwithouththehparenthathsomehpoint.
d. behallowedhtohdirecththehflowhofhthehinterview.
e. behignoredhwhilehyouhaddresshallhquestionshtohthehparent.
ANS:h C
Anholderhchildhshouldhbehgivenhthehopportunityhtohgivehinformationhdirectly.hThishenhanceshthehpro
babilityhthaththehchildhwillhfollowhyourhadvice.
TOP:h Discipline:hBehavioralhScience MSC:h OrganhSystem:hGeneral
11. Whenhcommunicatinghwithholderhchildrenhandhteenagers,hyouhshouldhbehsensitivehtohtheir:
a. parent'sh needs.
b. naturalhurgehtohcommunicate.
c. needhforhverbalhinstructions.
d. typicalhreluctancehtohtalk.
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e. desirehforhadulthcompanionship.
ANS:h D
Adolescentsharehusuallyhreluctanthtohtalk;htherefore,hthehproviderhshouldhclearlyhcommunicatehahr
especthforhtheirhconfidentiality.
TOP:h Discipline:hBehavioralhSciencehhhhhhhh MSC:h OrganhSystem:hGeneral
12. Whenhyouhsuspecththathyourh81-year-oldhpatienthhashshort-
termhmemoryhlosshbecausehhehcannothrememberhwhathhehhadhforhbreakfast,hyouhshould:
a. orderhahneurologyhconsult.
b. stophallhofhhishmedications.
c. continuehtohpresshthehpatienthforhappropriatehanswers.
d. validatehthehconcernhwithhhishfamilyhorhcaregivers.
e. dismisshthehfindinghashahnormalhage-relatedhchange.
ANS:h D
Whenholderhadultshexperiencehmemoryhlosshforhrecenthevents,hconsulthotherhfamilyhmembershtohc
larifyhdiscrepancieshorhtohfillhinhthehgaps.
TOP:h Discipline:hBehavioralhSciencehhhhhhhh MSC:h OrganhSystem:hGeneral
13. Tohwhathextenthshouldhthehpatienthwithhahphysicalhdisabilityhorhemotionalhdisorderhbehinvolvedhi
nhprovidinghhealthhhistoryhinformationhtohthehhealthhprofessional?
a. Allhinformationhshouldhbehobtainedhfromhfamilyhmembers.
b. Allhinformationhshouldhbehcollectedhfromhpasthrecordshwhilehthehpatienthishinha
notherhroom.
c. ThehpatienthshouldhbehinvN olveRdhoI
nly G
wheBn.yC
ouhsM
ensehthathhehorhshehmayhfeelhi
gnored.
U hShNhT O
d. Thehpatienthshouldhbehfullyhinvolvedhtohthehlimithofhhishorhherhability.
e. Thehpatienthshouldhbehpresenthduringhinformationhcollectionhbuthshouldhnothbeha
ddressedhdirectly.
ANS:h D
Patientshwithhdisabilitieshmayhnothgivehanheffectivehhistory,hbuththeyhmusthbehrespected,handhthehh
istoryhmusthbehobtainedhfromhthemhtohthehgreatesthextenthpossible.hFamilyhmembershmayhhelphpr
ovidehahmorehcompletehhistoryhbuthnothaththehexclusionhofhthehpatient.
TOP:h Discipline:hBehavioralhSciencehhhhhhhh MSC:h OrganhSystem:hGeneral
14. Whenhtakinghahhistory,hyouhshould:
a. askhpatientshtohgivehyouhanyhinformationhtheyhcanhrecallhabouththeirhhealth.
b. starththehinterviewhwithhthehpatient'shfamilyhhistory.
c. usehahchronologichandhsequentialhframework.
d. usehahholistichandheclectichstructure.
e. starththehinterviewhwithhthehsocialhhistory.
ANS:h C
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