THE Test Bank for Advanced Health Assessment and Differential Diagnosis Essentials for Clinical Practice 1st Edition Myrick Copyright © 2021 Springer Publishing Company, LLC

THE Test Bank for Advanced Health Assessment and Differential Diagnosis Essentials for Clinical Practice 1st Edition Myrick Copyright © 2021 Springer Publishing Company, LLC CHAPTER 1: HEALTH HISTORY, THE PATIENT INTERVIEW, AND MOTIVATIONAL INTERVIEWING 1. Which statement, if said by the nursing student, indicates a correct understanding of the health history? a. “The health history is a minor part of evaluating a patient’s health status.” b. “The health history provides a snapshot of the patient and their daily life.” c. “The health history does not reveal the patient’s understanding about health.” *d. “The health history is a holistic picture of the patient, their support systems, and habits.” Rationale: The health history is a crucial part of evaluating a patient’s health status. It establishes a baseline for the patient and can reveal the patient’s understanding about health and the factors that influence their health. Finally, it also provides a comprehensive, holistic picture of the patient, their support systems, habits, and daily life. 2. The clinician is getting ready to perform a health history but wants to ensure the patient can communicate before beginning. Which of the following areas should the clinician assess? Select all that apply. *a. Mental status *b. Memory c. Stressors *d. Reasoning e. Hygiene Rationale: A quick assessment of whether the patient is capable of providing accurate information is crucial to the entire process. The patient must be able to communicate, although not necessarily orally, in order to convey information. Mental status plays a role in history taking. Anyone whose mental status is altered may not provide accurate information. Memory and reasoning must be intact to be able to relay past events and how they may have led to the patient’s condition. Stressors and hygiene are assessed as part of the patient assessment, not their health history. 3. The clinician is performing a health history on a patient who does not speak English. In light of the language barrier, which of the following considerations are important for this patient? Select all that apply. *a. Address the patient, even if the interpreter is in the room. b. Focus on the interpreter. *c. Focus on the patient. d. Ask the patient to bring a family member to the visit to interpret. *e. Use an in-person interpreter when available. Rationale: Interpreters may be used in person or via an app which gives you the translation for a phrase or via phone. The provider still addresses the patient although the interpreter translates the language spoken. The provider should not be focused on the interpreter, but rather, the patient remains the focus of the conversation. Family members can be used as interpreters, although this may not be the best option because the patient may not want a family to accompany them in the room. Also, a family member may answer with their perspective versus the patient’s perspective, or may not fully translate what the patient says. Copyright © Springer Publishing Company, LLC. All Rights Reserved. 1 DOWNLOAD THE Test Bank for Advanced Health Assessment and Differential Diagnosis Essentials for Clinical Practice 1st Edition Myrick 2 Advanced Health Assessment and Differential Diagnosis 4. Clinicians try to ask open-ended questions to get patients to answer more fully. Which of the following questions is an example of an open-ended question? a. “Do you smoke?” *b. “How much alcohol do you drink?” c. “Are you in pain?” d. “Do you want to eat lunch?” Rationale: Exploring a patient’s health history involves asking different types of questions. Avoid asking closed-ended questions, which will only provide a yes or no answer. Rather, ask open-ended questions to capture more detail and help the provider focus on areas to clarify. 5. What information gathered by the clinician would be classified as the history of the present illness (HPI)? a. Age, gender, and occupation b. Support system, profession, and dietary habits *c. Onset, location, duration, frequency, intensity, and alleviating and exacerbating factors surrounding the patient’s symptom(s) d. The reason for the visit. It may be a direct quote or brief summary of patent’s comments. Rationale: Age, gender, and occupation relate to identification of the patient. The social history includes the patient’s support system, profession, living situation, exercise, dietary and other habits, and safety at home and at work. The onset, location, duration, frequency, intensity, and alleviating and exacerbating factors surrounding the patient’s symptom(s) comprise the HPI. The reason for the visit as a direct quote or brief summary of patient’s comments is the chief complaint (CC). 6. What information should the clinician include in the allergy section of the health history? Select all that apply. *a. When the allergy occurred b. The use of over-the-counter medications *c. The type of reaction experienced *d. The name of the offending substance *e. Any reaction related to eating shellfish Rationale: Allergies must be written in the patient’s chart including, if the patient recalls, when the allergy occurred and what the reaction was. The patient should name the offending substance. Reactions to shellfish could indicate an allergy to dye. The use of over-the-counter medications is not important here unless an allergy to one of them exists. 7. Why is the social history important for the clinician to document? *a. The social history addresses patient’s habits, such as smoking. b. The social history addresses only patient information. c. The social history should take place with family members in the room. d. The social history should include the habits of parents and children. Rationale: Understanding the social history of a patient has the potential to be clinically significant. It is important to interview the patient individually, without others present, so that they can respond truthfully. In the social interview, the provider learns about the patient’s family, significant others, friends, and anyone else in their support system. Some personal habits included in a patient’s social history include diet, exercise, and smoking.