,Chapter m01:mThemHistory mandmInterviewing mProcess
Ball:mSeidel’s mGuidemtomPhysicalmExamination,m9thmEdition
MULTIPLEmCHOICE
1. Whichmquestionmwould mbemconsidered mam“leadingmquestion?”
a. “Pleasemdescribemanymassociated msymptomsmwithmyourmheadaches?”
b. “Youmdon't mget mheadachesmoften,mdomyou?”
c. “What mactivitiesmaffect mthemseveritymof myourmheadaches?”
d. “What mtimesmof mthemdaymaremyourmheadachesmthemmost msevere?”
e. “What mworriesmyoummost mabout myourmheadache?”
ANS:m B
Thismquestionmwould mlimit mtheminformationminmthempatient'smanswer.mThemothermchoicesmallow mthemp
atient mmoremdiscretionmabout mthemextent mof manmanswer.
TOP:m Discipline:mBehavioralmScience MSC:m Organ mSystem:mGeneral
2. Whichmactionmwould mbest mpromotemaccuratemtranslationsmasmwellmasmconfidentialitymwhenmt
hemcaregivermdoesmnot mspeakmthempatient'smlanguage?
a. Askmampersonmunfamiliarmwithmthempatient mtomtranslate.
b. Havemamfriend mof mthempatient mtranslate.
c. Askmsimplemleadingmquestionsmthat mthempatient mmaymunderstand.
d. Usemamneighbormasmtranslator.
e. Involvemthemfamilymwithmthemtranslation.
ANS:m A
Whenmyoumdomnot mspeakmthempatient'smlanguage,mfamilymmembersmormfriendsmmaymposemamcom
municationmbarriermand mmaymhavemissuesmof mconfidentiality;mamstrangermasmanminterpretermismless
mbiased.
TOP:m Discipline:mBehavioralmScience MSC:m Organ mSystem:mGeneral
3. Periodsmof msilencemduringmtheminterview mcanmservemimportant mpurposes,msuchmas:
a. allowingmthemclinicianmtomcatchmupmonmdocumentation.
b. givingmyoumamcluemthat myoumshould mspeed mupmtheminterview.
c. providingmtimemformreflection.
d. increasingmthemlengthmof mthemvisit.
e. promotingmamcalmmenvironment.
ANS:m C
Silencemismamusefulmtoolmduringminterviewsmformthempurposesmof mreflection,msummoningmof mcour
age,mand mdisplayingmcompassion.mIt mismusuallymamcluemformyoumtomgomslowermand mnot mtompushmto
omhard.
TOP:m Discipline:mBehavioralmScience MSC:m Organ mSystem:mGeneral
4. Whichmtechniquemismmost mlikelymtomresult min mthempatient'smunderstandingmof mquestions?
a. Usemphrasesmthat maremcommonlymused mbymothermpatientsminmthemarea.
b. Usemthempatient'smownmtermsmif mpossible.
, c. Usemlanguagemthat mkeepsmthempatient mfrommbeingmexpansiveminmhismormhermanswer.
d. Usempropermmedicalmand mtechnicalmterminology.
e. Usemthemsimplest mlanguagempossible.
ANS:m B
Tomensuremthat myourmquestionsmhavembeenmcorrectlymunderstood,mbemclear,mand mexplicit mwhilemu
singmthempatient'smidiommand mlevelmof munderstanding.
TOP:m Discipline:mBehavioralmScience MSC:m Organ mSystem:mGeneral
5. A mpatient mbecomesmrestlessmduringmthemhistorymand msays,m“I mdon't mhavemtimemformallmof mthi
smconversation.mI'vemgot mtomget mbackmtomwork.”mYourmmost mappropriatemresponsemwould mb
emto:
a. stopmusingmopen-ended mquestionsmand mbecomemmoremdirect.
b. askmanothermopen-ended mquestionmand minsist monmanmanswer.
c. askmquestionsmabout mhismangermand mmovemclosermtomhim.
d. acknowledgemhismangermand mproceed mwithmthemhistorymand mexamination.
e. ignoremhismdispleasuremand mbecomemmoremassertivemabout mgettingmanswers.
ANS:m D
Thismismthemonlymanswermthat mresistsmthemtendencymformpatient mmanipulation,mpursuesmtheminfor
mation,mand mconfrontsmthempatient'smanger.
TOP:m Discipline:mBehavioralmScience MSC:m Organ mSystem:mGeneral
6. Whenmquestioningmampatient mregardingmalcoholmintake,mshemtellsmyoumthat mshemism“onlymamsoc
ialmdrinker.”mWhichminitialmresponsem ismappropriate?
a. “I'mmglad mthat myoumaremamresponsiblemdrinker.”
b. “Manym peoplem whom arem r eN
allyRalcI hoG l ic m sBay.tChe yMar e m socialm drinkers.”
c. “What mamount mand mwhat mkind UmSommof
N mT
malcoholmdomyoumdrinkminmamweek?”
d. “If myoumonlymdrinkmsocially,myoumwon't mneed mtomworrymabout malwaysmhavin
gmamdesignated mdriver.”
e. “Domthemothermpeopleminmyourmhousehold mconsumemalcohol?”
ANS:m C
Thismanswermclarifiesmthempatient'smownmtermmwithout maskingmamleadingmquestionmormbeingmjudg
mental.
TOP:m Discipline:mBehavioralmScience MSC:m Organ mSystem:mGeneral
7. A m50-year-
old mmanmcomesmtomthemprimarymcaremclinic.mHemtellsmyoumhemismworried mbecausemhemhas mhad mse
veremchest mpainsmformthempast m2mweeks.mWhichminitialmhistoryminterview mquestionmismmost mappr
opriate?
a. “Canmyoumdescribemthempain?”
b. “Thempainmdoesn't mradiatemtomyourmarm,mdoesmit?”
c. “Havemyoumbeenmtreated mformanxietymbefore?”
d. “Doesmyourmfathermhavemheart mdisease?”
e. “Aremthempainsmworsemaftermyoumeat?”
ANS:m A
Initially,manmopen-
ended mquestionmismammoremappropriatemresponse.m“Canmyoumdescribemthempain?”mismanmopen-
ended mquestionmthat moffersmcluesmtomthemchief mconcern.
, TOP:m Discipline:mBehavioralmScience MSC:m Organ mSystem:mGeneral
8. Ms.mA.mstates,m“Mymlifemismjust mtoompainful.mIt misn't mworthmit.”mShemappearsmdepressed.mWhichm
onemof mthemfollowingmstatementsmismthemmost mappropriatemcaregivermresponse?
a. “Trymtomthinkmabout mthemgood mthingsminmlife.”
b. “Youmshouldn't mfeelmthat mway;mlookmat mallmthemgood mthingsminmyourmlife.”
c. “Youmcan't m meanm what m you'remsaying.”
d. “If myoumthinkmabout mit,mnothingmismworthmgettingmthismupset mabout.”
e. “What minmlifemismcausingmyoumsuchmpain?”
ANS:m E
Specificmyet mopen-
ended mquestionsmarembest mused mwhenmthempatient mhasmfeelingsmof mlossmof mself-
worthmand mdepression.mThemothermresponsesmhurrymthempatient mand moffermsuperficialmass
urance.
TOP:m Discipline:mBehavioralmScience MSC:m Organ mSystem:mGeneral
9. Duringmanminterview,myoumhavemthemimpressionmthat mampatient mmaymbemconsideringmsuici
de.mWhichmactionmismessential?
a. Immediatelymbeginmproceedingsmformanminvoluntarymcommitment.
b. Askmwhethermthempatient mhasmconsidered mself-harm.
c. Askmwhethermthempatient mwould mlikemtomvisit mampsychiatrist.
d. Record mthemimpressionminmthempatient'smchart mand mrefermthempatient mf
ormhospitalization.
e. Avoid mdirectlymconfrontingmthempatient mregardingmyourmimpression.
ANS:m B
Ifmyoumthinkmthempatientm maymbNem c R n s iId e r iGn g mB
su.
icC
ermissionmtomtalkmabout mit. UomS mN mT Oide,Mhemormshemprobablymis.mMentioningmitmgivesmp
TOP:m Discipline:mBehavioralmScience MSC:m Organ mSystem:mGeneral
10. Youmaremcollectingmamhistorymfrommanm11-year-
old mgirl.mHermmothermismsittingmnext mtomherminmthemexaminationmroom.mWhenmcollectingmhistor
ymfrommoldermchildrenmormadolescents,mtheymshould:
a. nevermbeminterviewed malonembecausemthismmaymalienatemthemparent.
b. bemmailed mamquestionnaireminmadvancemtomavoid mthemneed mformhermtomtalk.
c. bemgivenmthemopportunitymtombeminterviewed mwithout mthemparent mat msomempoint.
d. bemallowed mtomdirect mthemflow mof mtheminterview.
e. bemignored mwhilemyoumaddressmallmquestionsmtomthemparent.
ANS:m C
Anmoldermchild mshould mbemgivenmthemopportunitymtomgiveminformationmdirectly.mThismenhancesmthemp
robabilitymthat mthemchild mwillmfollow myourmadvice.
TOP:m Discipline:mBehavioralmScience MSC:m Organ mSystem:mGeneral
11. Whenmcommunicatingmwithmoldermchildrenmand mteenagers,myoumshould mbemsensitivemtomtheir:
a. parent'smneeds.
b. naturalmurgemtomcommunicate.
c. need mformverbalminstructions.
d. typicalmreluctancemtomtalk.
Ball:mSeidel’s mGuidemtomPhysicalmExamination,m9thmEdition
MULTIPLEmCHOICE
1. Whichmquestionmwould mbemconsidered mam“leadingmquestion?”
a. “Pleasemdescribemanymassociated msymptomsmwithmyourmheadaches?”
b. “Youmdon't mget mheadachesmoften,mdomyou?”
c. “What mactivitiesmaffect mthemseveritymof myourmheadaches?”
d. “What mtimesmof mthemdaymaremyourmheadachesmthemmost msevere?”
e. “What mworriesmyoummost mabout myourmheadache?”
ANS:m B
Thismquestionmwould mlimit mtheminformationminmthempatient'smanswer.mThemothermchoicesmallow mthemp
atient mmoremdiscretionmabout mthemextent mof manmanswer.
TOP:m Discipline:mBehavioralmScience MSC:m Organ mSystem:mGeneral
2. Whichmactionmwould mbest mpromotemaccuratemtranslationsmasmwellmasmconfidentialitymwhenmt
hemcaregivermdoesmnot mspeakmthempatient'smlanguage?
a. Askmampersonmunfamiliarmwithmthempatient mtomtranslate.
b. Havemamfriend mof mthempatient mtranslate.
c. Askmsimplemleadingmquestionsmthat mthempatient mmaymunderstand.
d. Usemamneighbormasmtranslator.
e. Involvemthemfamilymwithmthemtranslation.
ANS:m A
Whenmyoumdomnot mspeakmthempatient'smlanguage,mfamilymmembersmormfriendsmmaymposemamcom
municationmbarriermand mmaymhavemissuesmof mconfidentiality;mamstrangermasmanminterpretermismless
mbiased.
TOP:m Discipline:mBehavioralmScience MSC:m Organ mSystem:mGeneral
3. Periodsmof msilencemduringmtheminterview mcanmservemimportant mpurposes,msuchmas:
a. allowingmthemclinicianmtomcatchmupmonmdocumentation.
b. givingmyoumamcluemthat myoumshould mspeed mupmtheminterview.
c. providingmtimemformreflection.
d. increasingmthemlengthmof mthemvisit.
e. promotingmamcalmmenvironment.
ANS:m C
Silencemismamusefulmtoolmduringminterviewsmformthempurposesmof mreflection,msummoningmof mcour
age,mand mdisplayingmcompassion.mIt mismusuallymamcluemformyoumtomgomslowermand mnot mtompushmto
omhard.
TOP:m Discipline:mBehavioralmScience MSC:m Organ mSystem:mGeneral
4. Whichmtechniquemismmost mlikelymtomresult min mthempatient'smunderstandingmof mquestions?
a. Usemphrasesmthat maremcommonlymused mbymothermpatientsminmthemarea.
b. Usemthempatient'smownmtermsmif mpossible.
, c. Usemlanguagemthat mkeepsmthempatient mfrommbeingmexpansiveminmhismormhermanswer.
d. Usempropermmedicalmand mtechnicalmterminology.
e. Usemthemsimplest mlanguagempossible.
ANS:m B
Tomensuremthat myourmquestionsmhavembeenmcorrectlymunderstood,mbemclear,mand mexplicit mwhilemu
singmthempatient'smidiommand mlevelmof munderstanding.
TOP:m Discipline:mBehavioralmScience MSC:m Organ mSystem:mGeneral
5. A mpatient mbecomesmrestlessmduringmthemhistorymand msays,m“I mdon't mhavemtimemformallmof mthi
smconversation.mI'vemgot mtomget mbackmtomwork.”mYourmmost mappropriatemresponsemwould mb
emto:
a. stopmusingmopen-ended mquestionsmand mbecomemmoremdirect.
b. askmanothermopen-ended mquestionmand minsist monmanmanswer.
c. askmquestionsmabout mhismangermand mmovemclosermtomhim.
d. acknowledgemhismangermand mproceed mwithmthemhistorymand mexamination.
e. ignoremhismdispleasuremand mbecomemmoremassertivemabout mgettingmanswers.
ANS:m D
Thismismthemonlymanswermthat mresistsmthemtendencymformpatient mmanipulation,mpursuesmtheminfor
mation,mand mconfrontsmthempatient'smanger.
TOP:m Discipline:mBehavioralmScience MSC:m Organ mSystem:mGeneral
6. Whenmquestioningmampatient mregardingmalcoholmintake,mshemtellsmyoumthat mshemism“onlymamsoc
ialmdrinker.”mWhichminitialmresponsem ismappropriate?
a. “I'mmglad mthat myoumaremamresponsiblemdrinker.”
b. “Manym peoplem whom arem r eN
allyRalcI hoG l ic m sBay.tChe yMar e m socialm drinkers.”
c. “What mamount mand mwhat mkind UmSommof
N mT
malcoholmdomyoumdrinkminmamweek?”
d. “If myoumonlymdrinkmsocially,myoumwon't mneed mtomworrymabout malwaysmhavin
gmamdesignated mdriver.”
e. “Domthemothermpeopleminmyourmhousehold mconsumemalcohol?”
ANS:m C
Thismanswermclarifiesmthempatient'smownmtermmwithout maskingmamleadingmquestionmormbeingmjudg
mental.
TOP:m Discipline:mBehavioralmScience MSC:m Organ mSystem:mGeneral
7. A m50-year-
old mmanmcomesmtomthemprimarymcaremclinic.mHemtellsmyoumhemismworried mbecausemhemhas mhad mse
veremchest mpainsmformthempast m2mweeks.mWhichminitialmhistoryminterview mquestionmismmost mappr
opriate?
a. “Canmyoumdescribemthempain?”
b. “Thempainmdoesn't mradiatemtomyourmarm,mdoesmit?”
c. “Havemyoumbeenmtreated mformanxietymbefore?”
d. “Doesmyourmfathermhavemheart mdisease?”
e. “Aremthempainsmworsemaftermyoumeat?”
ANS:m A
Initially,manmopen-
ended mquestionmismammoremappropriatemresponse.m“Canmyoumdescribemthempain?”mismanmopen-
ended mquestionmthat moffersmcluesmtomthemchief mconcern.
, TOP:m Discipline:mBehavioralmScience MSC:m Organ mSystem:mGeneral
8. Ms.mA.mstates,m“Mymlifemismjust mtoompainful.mIt misn't mworthmit.”mShemappearsmdepressed.mWhichm
onemof mthemfollowingmstatementsmismthemmost mappropriatemcaregivermresponse?
a. “Trymtomthinkmabout mthemgood mthingsminmlife.”
b. “Youmshouldn't mfeelmthat mway;mlookmat mallmthemgood mthingsminmyourmlife.”
c. “Youmcan't m meanm what m you'remsaying.”
d. “If myoumthinkmabout mit,mnothingmismworthmgettingmthismupset mabout.”
e. “What minmlifemismcausingmyoumsuchmpain?”
ANS:m E
Specificmyet mopen-
ended mquestionsmarembest mused mwhenmthempatient mhasmfeelingsmof mlossmof mself-
worthmand mdepression.mThemothermresponsesmhurrymthempatient mand moffermsuperficialmass
urance.
TOP:m Discipline:mBehavioralmScience MSC:m Organ mSystem:mGeneral
9. Duringmanminterview,myoumhavemthemimpressionmthat mampatient mmaymbemconsideringmsuici
de.mWhichmactionmismessential?
a. Immediatelymbeginmproceedingsmformanminvoluntarymcommitment.
b. Askmwhethermthempatient mhasmconsidered mself-harm.
c. Askmwhethermthempatient mwould mlikemtomvisit mampsychiatrist.
d. Record mthemimpressionminmthempatient'smchart mand mrefermthempatient mf
ormhospitalization.
e. Avoid mdirectlymconfrontingmthempatient mregardingmyourmimpression.
ANS:m B
Ifmyoumthinkmthempatientm maymbNem c R n s iId e r iGn g mB
su.
icC
ermissionmtomtalkmabout mit. UomS mN mT Oide,Mhemormshemprobablymis.mMentioningmitmgivesmp
TOP:m Discipline:mBehavioralmScience MSC:m Organ mSystem:mGeneral
10. Youmaremcollectingmamhistorymfrommanm11-year-
old mgirl.mHermmothermismsittingmnext mtomherminmthemexaminationmroom.mWhenmcollectingmhistor
ymfrommoldermchildrenmormadolescents,mtheymshould:
a. nevermbeminterviewed malonembecausemthismmaymalienatemthemparent.
b. bemmailed mamquestionnaireminmadvancemtomavoid mthemneed mformhermtomtalk.
c. bemgivenmthemopportunitymtombeminterviewed mwithout mthemparent mat msomempoint.
d. bemallowed mtomdirect mthemflow mof mtheminterview.
e. bemignored mwhilemyoumaddressmallmquestionsmtomthemparent.
ANS:m C
Anmoldermchild mshould mbemgivenmthemopportunitymtomgiveminformationmdirectly.mThismenhancesmthemp
robabilitymthat mthemchild mwillmfollow myourmadvice.
TOP:m Discipline:mBehavioralmScience MSC:m Organ mSystem:mGeneral
11. Whenmcommunicatingmwithmoldermchildrenmand mteenagers,myoumshould mbemsensitivemtomtheir:
a. parent'smneeds.
b. naturalmurgemtomcommunicate.
c. need mformverbalminstructions.
d. typicalmreluctancemtomtalk.
