Deck 2: Obtaining a Health History

Question 1

Which statement by the nurse demonstrates a patient-centered interview?

A) "I need to complete this questionnaire about your medical and family history."
B) "The hospital requires me to complete this assessment as soon as possible."
C) "Tell me about the symptoms you've been having."
D) "I've had the same symptoms that you've described."

Answer 1

"Tell me about the symptoms you've been having."

Question 2

During the history, the patient states that she does not use many drugs. What is the nurse's appropriate response to this statement?

A) "Tell me about the drugs you are using currently."
B) "To some people six or seven is not many."
C) "Do you mean prescription drugs or illicit drugs?"
D) "How often are you using these drugs?"

Answer 2

"Tell me about the drugs you are using currently."

Question 3

While giving a history, a male patient describes several events out of order that occurred in different decades in his life. What technique does the nurse use to understand the timeline of these events?

A) State the order of events as understood and ask the patient to verify the order.
B) Draw conclusions about the order of events from data given.
C) Ask the patient to elaborate about these events.
D) Ask the patient to repeat what he said about these events.

Answer 3

State the order of events as understood and ask the patient to verify the order.

Question 4

Which nurse demonstrates culturally competent care for a female patient from Russia?

A) Nurse A who asks the patient about cultural factors that influence health care
B) Nurse B who interacts with every patient from Russia in the same manner
C) Nurse C who learns the cultural variables of every culture, including Russia
D) Nurse D who relies on her previous experience with patients from Russia

Question 5

A patient answers questions quietly and appears sad. While answering questions about her marriage, she begins to cry. Which response by the nurse is appropriate in this situation?

A) "Don't cry! I'll come back when you've settled down."
B) "I only have a few more questions to ask, and then I'll leave you alone for a while."
C) "Everyone has ups and downs in their marriage. What problems are you having?"
D) "I see that you are upset. Is there something you'd like to discuss?"

Question 6

A male patient tells the nurse that he rarely sleeps more than 4 hours a night and has not experienced any problems because of the lack of sleep. Which response by the nurse is most appropriate?

A) "That is interesting."
B) "Only 4 hours of sleep? How do you stay awake during the day?"
C) "Really? Everyone needs more sleep than that."
D) "Did I understand that you sleep 4 hours every night?"

Question 7

The nurse is interviewing a woman with her husband present. The husband answers the questions for the wife most of the time. What is the most appropriate therapeutic nursing action to hear the patient's viewpoint?

A) Continue the interview.
B) Ask the husband to step out of the room.
C) Ask another nurse to complete the interview.
D) Tell the woman to speak up for herself.

Question 8

Which statement or question does the nurse use during the introduction phase of the interview?

A) "I'm here to learn more about the pain you're experiencing."
B) "Can you describe the pain that you're experiencing?"
C) "I heard you say that the pain is 'all over' your body."
D) "What relieves the pain you are having?"

Question 9

A nurse is interviewing a patient who was diagnosed with type 2 diabetes mellitus 6 months ago. Since that time, the patient has gained weight and her blood glucose levels remain high. The nurse suspects that the patient is noncompliant with her diet. Which response by the nurse enhances data collection in this situation?

A) "Tell me about what foods you eat and the frequency of your meals."
B) "What symptoms do you notice when your blood sugar levels are high?"
C) "You need to follow what the doctor has prescribed to manage your disease."
D) "Tell me what you know about the cause of type 2 diabetes."

Question 10

Which question is an example of an open-ended question?

A) "Have you experienced this pain before?"
B) "Do you have someone to help you at home?"
C) "How many times a day do you use your inhaler?"
D) "What were you doing when you felt the pain?"

Question 11

In which situation is the nurse's use of closed-ended questions most appropriate?

A) When clarifying vague or conflicting data
B) When obtaining a history from an overly talkative patient
C) When encouraging a patient to elaborate on details of his or her history
D) When collecting data about the current health problem

Question 12

Which technique should the nurse use to obtain more data about a patient's vague or ambiguous statement?

A) Laughing and smiling during conversation
B) Using phrases such as "Go on," and "Then?"
C) Repeating what the patient has said, but using different words
D) Asking the patient to explain a point

Question 13

During an interview, a patient begins to cry and appears angry. Which response by the nurse is most therapeutic?

A) "This topic prompted an emotional response, tell me what you are feeling."
B) "This topic does not usually cause such an emotional response."
C) "Calm down and tell me what is wrong."
D) "I will leave you alone for a few minutes so you can pull yourself together."

Question 14

A female Korean patient accompanied by her husband and son comes to the emergency department (ED) complaining of abdominal pain. The patient speaks and understands Korean only. Which person is the appropriate choice for the nurse to use to get a history from this patient?

A) The patient's husband who speaks Korean and English
B) The patient's son who speaks Korean and English
C) A male technician who works in the ED who speaks Korean and English
D) A female interpreter who speaks Korean and English and is available by phone

Question 15

Which statement is appropriate to use when beginning an interview with a new patient?

A) "Have you ever been a patient in this clinic before?"
B) "What is your purpose for coming to the clinic today?"
C) "Tell me a little about yourself and your family."
D) "Did you have any difficulty finding the clinic?"

Question 16

A male patient is very talkative and shares much information that is not relevant to his history or the reason for his admission. Which action by the nurse improves data collection in this situation?

A) Terminate the interview.
B) Use closed-ended questions.
C) Ask the patient to stay on the subject.
D) Ask another nurse to complete the interview.

Question 17

Which technique used by the nurse encourages a patient to continue talking during an interview?

A) Laughing and smiling during conversation
B) Using phrases such as "Go on," and "Then?"
C) Repeating what the patient said, but using different words
D) Asking the patient to clarify a point

Question 18

For which patient is a focused health history most appropriate?

A) A new patient at the health clinic for an annual examination
B) A patient admitted to the hospital with vomiting and abdominal pain
C) A patient at the health care provider's office for a sport physical
D) A patient discharged 11 months ago who is being readmitted today

Question 19

A nurse suspects a female patient is a victim of physical abuse. Which response is most likely to encourage the patient to confide in the nurse?

A) "You've got a huge bruise on your face. Did your husband hit you?"
B) "That bruise looks tender. I don't know how people can do that to one another."
C) "If your boyfriend hit you, you can get a restraining order against him."
D) "I've seen women who have been hurt by boyfriends or husbands. Does anyone hit you?"

Question 20

What does the nurse say to obtain more data about a patient's vague statement about diet such as, "My diet's okay"?

A) "Eating a variety of meats, fruits, and vegetables each day is important."
B) "Give me an example of the foods you eat in a typical day."
C) "Go on."
D) "Does your diet meet your needs or does it need improvement?"

Question 21

A patient tells the nurse at the clinic, "I can never seem to get warm lately and feel tired all the time." The nurse records these data under which section of the health history?

A) Past health history
B) Present health status
C) Reason for seeking care (chief complaint)
D) Subjective assessment data

Question 22

A nurse is interviewing a male patient who reports he has not had a tetanus immunization in about 15 years because he had a "bad reaction" to the last tetanus immunization. What is the most appropriate response by the nurse in this case?

A) Notify the health care provider that this immunization cannot be given.
B) Document that the patient is allergic to the tetanus vaccine.
C) Give the vaccine after explaining that adverse reactions are rare.
D) Ask the patient to describe the "bad reaction" to the vaccine in more detail.

Question 23

An example of a health promotion question included in the health history is:

A) "Do you have any allergies?"
B) "How often are you exercising?"
C) "What are you doing to relieve your leg pain?"
D) "What kind of herbs are you using?"

Question 24

A nurse is getting a history from a patient who is disabled from rheumatoid arthritis. Which question will provide data about this patient's functional ability?

A) "When did your arthritis symptoms begin?"
B) "How has your arthritis affected your daily life?"
C) "Why did you come to the clinic today?"
D) "How do you feel about your diagnosis of rheumatoid arthritis?"

Question 25

Which data do nurses document under the heading of Personal and Psychosocial History? (Select all that apply.)

A) Walks for 45 minutes each day
B) Eats meats, vegetables, and fruit at two meals daily
C) Is allergic to milk and milk products
D) Is married and has two daughters whom he is close to
E) Smokes marijuana once a week
F) Grandfather died from prostate cancer

Question 26

Which questions are pertinent to ask when obtaining a symptom analysis from a patient who reports breathing problems? (Select all that apply.)

A) How long have you had this problem with your breathing?
B) Do you have a family history of breathing problems?
C) Does this breathing problem come and go or is it constant?
D) What do you do to make your breathing better?
E) How does this breathing problem affect your work or daily activities?
F) How many packs of cigarettes do you smoke a day?

Question 27

Which questions are pertinent to ask when obtaining a symptom analysis from a patient who reports a headache? (Select all that apply.)

A) Describe what the headache feels like.
B) When was your last eye examination?
C) What makes the headaches worse?
D) How do you rate the headaches on a scale of 0 (meaning no pain) to 10 (meaning the worse pain ever)?
E) Do you have any symptoms with the headaches, such as nausea?
F) When did you first notice the headaches?

Question 28

A patient comes to the ambulatory surgery center for an elective procedure this morning. While giving the admission history, the patient states she is allergic to latex. What is the most appropriate response by the nurse at this time?

A) Removing all latex products from the patient's room
B) Using powdered gloves when providing care to this patient
C) Informing the surgeon that the patient has type I hypersensitivity to latex
D) Questioning the patient about symptoms experienced in the past with latex

Question 29

Which questions are pertinent for a nurse to ask a patient while performing a review of the cardiovascular system? (Select all that apply.)

A) Do you remember what your last cholesterol value was?
B) Have you had chest pain or shortness of breath?
C) Do you have trouble breathing when you lie down?
D) Are your feet cold, numb, or do they change color?
E) How much do you weigh?
F) Have you noticed edema in your ankles at the end of the day?

Question 30

Which data do nurses document under the heading of Past Health History? (Select all that apply.)

A) Father has Alzheimer disease.
B) Last tetanus in 2009
C) Had chicken pox as a child
D) Drinks three to four beers each day
E) Had a dental examination 6 months ago

Question 31

The patient reports having a persistent cough for the past 2 weeks and that the cough disrupts sleep and has not been helped by over-the-counter cough medicines. Which question is most appropriate for the nurse to ask next?

A) "So what do you think is causing this persistent cough?"
B) "Have you tried taking sleeping pills to help you sleep?"
C) "Did you think this will just go away on its own?"
D) "What other symptoms have you noticed related to this cough?"

Question 32

A patient admitted with pneumonia reports that she takes insulin for diabetes mellitus. In which section of the history does the nurse document the insulin and diabetes?

A) Past health history
B) Present health status
C) Reason for seeking care (chief complaint)
D) History of present illness