Deck 2: The Medical History and the Interview

Question 1

Communication between individuals is affected by which of the following factors?
1) The time of day
2) The cultural heritage
3) The day of the week
4) The level of education

A)2 and 4
B)1 and 3
C)3 and 4
D)1 and 2

Answer 1

2 and 4

Question 2

The review of systems is very important because it provides the interviewer with:

A) information grouped by major organs and physiologic systems.
B) additional subjective information about the patient's problem.
C) a combination of subjective and objective data in a narrative form.
D) information relevant to the patient's problem that may have been overlooked.

Answer 2

information relevant to the patient's problem that may have been overlooked.

Question 3

One disadvantage of using the pack-year method for calculating cigarette consumption is that:

A) the method is not used widely throughout the United States.
B) advanced mathematical calculations are required to obtain the figure.
C) the method does not reveal how many packs per day were smoked over how many years.
D) the values are more meaningful to RTs and physicians than to other health care providers.

Answer 3

the method does not reveal how many packs per day were smoked over how many years.

Question 4

Which of the following are reasons for obtaining a family history?
1) To assess the current health status of the extended family
2) To learn about the health status of the patient's blood relatives
3) To determine whether the patient is adopted
4) To identify the presence in the family of diseases with a hereditary tendency

A)2 and 4
B)1 and 3
C)2, 3, and 4
D)1, 2, and 4

Question 5

When one is conducting an interview with a patient, which of the following points is most important in facilitating an effective interaction with the patient?

A) Recognizing the nonverbal signals that the patient is sending
B) Your ability to project a sense of undivided interest in the patient
C) Introducing yourself appropriately at the beginning of the interview
D) Answering all of the patient's questions completely without using jargon

Question 6

If a patient is unable to provide an accurate history, the respiratory therapist (RT) should:

A) ask a family member or friend to supply the information.
B) ask shorter and more direct questions to determine the cause of the problem.
C) proceed to treat the patient's symptoms based on information already obtained.
D) refuse to treat the patient because effective therapy cannot be initiated without a complete history.

Question 7

Modern-day office workers may be exposed to which of the following occupational and environmental diseases?

A) Bagassosis
B) Monday fever
C) Pneumoconiosis
D) Sick building syndrome

Question 8

Which of the following diseases would be recorded in the family history as a hereditary disorder?
1) Asthma
2) Pneumonia
3) Cystic fibrosis
4) $\alpha$ ₁-antitrypsin deficiency

A)2 and 4
B)1 and 3
C)2, 3, and 4
D)1, 3, and 4

Question 9

Obtaining background information during an interview is very important because it allows the RT to:
1) Learn the impact of culture, relationships, and finances on his or her health.
2) Predict whether the patient is willing to cooperate in the treatment of his or her disease.
3) Develop a basic understanding of the patient's experience with his or her disease.
4) Diagnosis the patient's problem.

A)2 and 4
B)1 and 3
C)2, 3, and 4
D)1, 2, and 3

Question 10

Which of the following should the RT keep in mind when obtaining a pulmonary history?

A) Assessment usually is limited to the respiratory system.
B) Evaluation of the patient's entire health status is essential.
C) Signs and symptoms of pulmonary disease will rarely be seen outside the cardiopulmonary system.
D) Patients with long-standing chronic disease can give a detailed account of how their lives have changed and of the signs and symptoms that the disease has caused.

Question 11

Which of the following formulas should be used to calculate the pack-year history of cigarette consumption?

A) Packs per day times Years smoked
B) Packs per day minus Years smoked
C) packs per day plus Years smoked
D) Packs per day plus Years smoked

Question 12

When a patient is interviewed so the chief complaint can be determined, the best questions that can be asked to elicit this information are:
1) Direct questions.
2) Neutral questions.
3) Open-ended questions.
4) A series of direct questions.

A)2 and 4
B)1 and 3
C)2, 3, and 4
D)1, 2, and 3

Question 13

Screening information is:

A) obtained at health fairs to determine whether the person should see a physician.
B) designed to uncover problem areas that the patient forgot to mention or omitted.
C) given to the interviewer by the patient at the very beginning of the interview process.
D) obtained by the triage nurse in the emergency department to determine how life-threatening the patient's symptoms are.

Question 14

The main purpose of the chief complaint is to:

A) give a brief explanation about why the patient sought health care.
B) direct the interviewer to the organ system in which the problem is located.
C) present a diagnosis that is based on information obtained during the interview.
D) list symptoms in order from most severe to least severe according to organ system involvement.

Question 15

Which of the following cardiopulmonary conditions would be found in the chief complaint list?
1) Asthma
2) Wheezing
3) COPD
4) Hemoptysis

A)2 and 4
B)1 and 3
C)1 and 2
D)3 and 4

Question 16

Which of the following types of questions are preferred for all interactions with a patient?

A) Direct questions
B) Neutral questions
C) Indirect questions
D) Open-ended questions

Question 17

Communication between two people can occur only if:
1) The speaker speaks clearly.
2) The receiver understands the message.
3) Each person understands medical terminology.
4) Both people are in the same room.

A)2 and 4
B)1 and 3
C)3 and 4
D)1 and 2

Question 18

A pertinent positive is defined as:

A) any positive response made by the patient during the interview.
B) a direct question asked during the interview that elicits a positive response.
C) an affirmative response by the patient when asked whether he or she needs a breathing treatment.
D) an affirmative response to an important interview question about the patient's symptoms.

Question 19

Which of the following would be found in the history of present illness section of an interview?

A) Injuries and accidents
B) Surgeries and hospitalizations
C) Associated symptoms and aggravating factors
D) Over-the-counter medications, vitamins, and "home remedies"

Question 20

A pertinent negative is defined as:

A) any negative response made by the patient during the interview.
B) refusal by the patient to answer questions about a certain topic.
C) any negative response by the patient to an important question about possible symptoms.
D) a negative response by a patient to a therapist who asks whether the patient needs a breathing treatment.

Question 21

Which of the following symptoms is often seen in patients with tight building syndrome?
1) Headache
2) Eye irritation
3) Cough
4) Palpitations

A)2 and 4
B)1 and 3
C)2, 3, and 4
D)1, 2, and 3

Question 22

Which of the following questions would be ineffective in eliciting additional information about a patient's location and level of pain?

A) Earlier, you briefly mentioned some pain around your lower ribs. Could you tell me more about it?
B) Earlier, you briefly mentioned some pain around your lower ribs. Could you point to exactly where it is?
C) Earlier, you briefly mentioned some pain around your lower ribs. What do you think is causing it?
D) Earlier, you briefly mentioned some pain around your lower ribs. Could you rate this pain for me on a scale of 1 to 10, with 1 meaning no pain and 10 meaning the worst pain possible?

Question 23

In the physical examination, subjective data gathered are referred to as:

A) measurements.
B) symptoms.
C) variables.
D) signs.

Question 24

A patient being interviewed says that he wakes up nearly every night feeling very hot and with his body bathed in sweat. This fact, along with his hemoptysis, is a very strong indication that he may have tuberculosis. The night sweats would be an example of:

A) objective data (a sign).
B) objective data (a symptom).
C) subjective data (a sign).
D) subjective data (a symptom).

Question 25

Monday fever is commonly seen with inhalation of:

A) cotton dust.
B) asbestosis fibers.
C) paint and glue fumes.
D) outdoor pollutants.

Question 26

In which section of the patient record should the following entry appear? "Patient presented in the emergency department following a fall. Patient is confused with a large hematoma on this left forehead."

A) Admission note
B) Physician orders
C) Progress notes
D) Discharge plan

Question 27

A "constitutional" symptom would include all of the following except:

A) chills and fever.
B) anorexia and/or weight loss.
C) fatigue.
D) wheezing.

Question 28

A history of a patient's tobacco use is important for which of the following reasons?
1) There is a strong relationship between smoking and chronic obstructive pulmonary disease (COPD).
2) There is a strong relationship between smoking and the use of illicit drugs such as marijuana, cocaine, and heroin.
3) There is a strong relationship between smoking and cardiovascular disease.
4) There is a strong relationship between smoking and lung cancer.

A)2 and 4
B)1 and 2
C)1, 3, and 4
D)1, 2, and 3

Question 29

The RT has been called STAT to the bedside of a patient who is in extreme respiratory distress in the intensive care unit (ICU). Shortly after arriving, the patient's cardiac monitor shows a pattern of ventricular fibrillation, and shortly thereafter the patient ceases breathing. The nurse states that the patient has a do not resuscitate (DNR) order. The RT should take which of the following actions?

A) Do nothing, because a DNR order means that no resuscitative measures should be attempted.
B) Call a full code and institute full resuscitative measures because the therapist knows that the physician who wrote the DNR order is not working in the unit this week.
C) Call a code so that cardiac medications can be given to correct the ventricular fibrillation; the DNR order means that the patient cannot be intubated.
D) Place a non-rebreather mask on the patient for "comfort measures."

Question 30

A good interview should contain which of the following elements?
1) The interviewer should dress and act professionally.
2) The interviewer should project a sense of undivided interest.
3) The interviewer should use a formal speaking style.
4) The interviewer should respect the patient's beliefs and attitudes.

A)2 and 4
B)1 and 3
C)2, 3, and 4
D)1, 2, and 4

Question 31

In which section of the patient record should the following entry appear? "Day 4 of hospitalization. Patient febrile (39° C). Rales in both lung bases; sputum moderate, thick, green, tinged with blood. Plan: Continue ordered antibiotic therapy. Bronchoscopy tomorrow in AM."

A) Admission note
B) Physician orders
C) Progress notes
D) Discharge plan

Question 32

An RT examining a patient auscultates wheezes in the right lower lobe (RLL). This would be an example of:

A) objective data (a sign).
B) objective data (a symptom).
C) subjective data (a sign).
D) subjective data (a symptom).

Question 33

In the physical examination, objective data gathered are referred to as:

A) measurements.
B) symptoms.
C) variables.
D) signs.

Question 34

What pulmonary disorder is associated with visiting or living in Ohio, Maryland, and the central Mississippi Valley?

A) Blastomycosis
B) Histoplasmosis
C) Coccidioidomycosis
D) Silicosis

Question 35

All patient histories generally contain which of the following information?
1) Descriptions of present health status or illness
2) Patient's primary care physician
3) General background information
4) Screening information

A)2 and 4
B)1 and 2
C)1, 3, and 4
D)1, 2, and 3