Question 1

During an interview, you have the impression that a patient may be considering suicide. Which action is essential?
A)Immediately begin proceedings for an involuntary commitment.
B)Ask whether the patient has considered self-harm.
C)Ask whether the patient would like to visit a psychiatrist.
D)Record the impression in the patient's chart and refer the patient for hospitalization.
E)Avoid directly confronting the patient regarding your impression.

Accepted Answer

If you think the patient may be considering suicide, he or she probably is. Mentioning it gives permission to talk about it.

Question 2

A patient becomes restless during the history and says, "I don't have time for all of this conversation. I've got to get back to work." Your most appropriate response would be to
A)stop using open-ended questions and become more direct.
B)ask another open-ended question and insist on an answer.
C)ask questions about his anger and move closer to him.
D)acknowledge his anger and proceed with the history and examination.
E)ignore his displeasure and become more assertive about getting answers.

Accepted Answer

This is the only that resists the tendency for patient manipulation, pursues the information, and confronts the patient's anger.

Question 3

When are open-ended questions generally most useful?
A)During the physical examination
B)After several close-ended questions have been asked
C)While designing the genogram
D)During the review of systems
E)During the initial part of the interview

Accepted Answer

Asking open-ended questions at the beginning of an interview allows you to gather more information and establishes yourself as an empathic listener, which is the first step of effective communication. Interviewing for the purpose of conducting a genogram or review of systems requires more focused data that can be more easily gathered with direct questioning.

Question 4

You are collecting a history from an 11-year-old girl. Her mother is sitting next to her in the examination room. When collecting history from older children or adolescents, they should
A)never be interviewed alone because this may alienate the parent.
B)be mailed a questionnaire in advance to avoid the need for her to talk.
C)be given the opportunity to be interviewed without the parent at some point
D)be allowed to direct the flow of the interview.
E)be ignored while you address all questions to the parent.

Accepted Answer

An older child should be given the opportunity to give information directly. This enhances the probability that the child will follow your advice.

Question 5

A 50-year-old man comes to the primary care clinic. He tells you he is worried because he has had severe chest pains for the past 2 weeks. Which initial history interview question is most appropriate?
A)"Can you describe the pain?"
B)"The pain doesn't radiate to your arm, does it?"
C)"Have you been treated for anxiety before?"
D)"Does your father have heart disease?"
E)"Are the pains worse after you eat?"

Accepted Answer

Initially, an open-ended question is a more appropriate response. "Can you describe the pain?" is an open-ended question that offers clues to the chief concern.

Question 6

Which technique is most likely to result in the patient's understanding of questions?
A)Use phrases that are commonly used by other patients in the area.
B)Use the patient's own terms if possible.
C)Use language that keeps the patient from being expansive in his or her answer.
D)Use proper medical and technical terminology.
E)Use the simplest language possible.

Accepted Answer

To ensure that your questions have been correctly understood, be clear and explicit while using the patient's idiom and level of understanding.

Question 7

Ms. A. states, "My life is just too painful. It isn't worth it." She appears depressed. Which one of the following statements is the most appropriate caregiver response?
A)"Try to think about the good things in life."
B)"You shouldn't feel that way; look at all the good things in your life."
C)"You can't mean what you're saying."
D)"If you think about it, nothing is worth getting this upset about."
E)"What in life is causing you such pain?"

Accepted Answer

Specific yet open-ended questions are best used when the patient has feelings of loss of self-worth and depression. The other responses hurry the patient and offer superficial assurance.

Question 8

Information that is needed during the initial interview of a pregnant woman includes all of the following except
A)the gender that the woman hopes the baby will be.
B)her past medical history.
C)her health care practices.
D)the woman's knowledge about pregnancy.
E)potential pregnancy risk factors.

Accepted Answer

The initial interview for the pregnant woman should include information of about her past history, assessment of health practices, identification of potential risk factors, and assessment of her knowledge because it affects the pregnancy.

Question 9

Periods of silence during the interview can serve important purposes, such as
A)allowing the clinician to catch up on documentation.
B)giving you a clue that you should speed up the interview.
C)providing time for reflection.
D)increasing the length of the visit.
E)promoting calm.

Accepted Answer

Silence is a useful tool during interviews for the purposes of reflection, summoning of courage, and displaying compassion. It is usually a clue for you to go slower and not to push too hard.

Question 10

Which question would be considered a "leading question?"
A)"Please describe any associated symptoms with your headaches?"
B)"You don't get headaches often, do you?"
C)"What activities affect the severity of your headaches?"
D)"What times of the day are your headaches the most severe?"
E)"What worries you most about your headache."

Accepted Answer

This question would limit the information in the patient's answer. The other choices allow the patient more discretion about the extent of an answer.

Question 11

When questioning a patient regarding alcohol intake, she tells you that she is "only a social drinker." Which initial response is appropriate?
A)"I'm glad that you are a responsible drinker."
B)"Many people who are really alcoholic say they are social drinkers."
C)"What amount and what kind of alcohol do you drink in a week?"
D)"If you only drink socially, you won't need to worry about always having a designated driver."
E)"Do the other people in your household consume alcohol?"

Accepted Answer

This answer clarifies the patient's own term without asking a leading question or being judgmental.

Question 12

Which action would best promote accurate translations as well as confidentiality when the caregiver does not speak the patient's language?
A)Ask a person unfamiliar with the patient to translate.
B)Have a friend of the patient translate.
C)Ask simple leading questions that the patient may understand.
D)Use a neighbor as translator.
E)Involve the family with the translation.

Accepted Answer

When you do not speak the patient's language, family members or friends may pose a communication barrier and may have issues of confidentiality; a stranger as an interpreter is less biased.

Question 13

A 36-year-old woman complains that she has had crushing chest pain for the past 2 days. She seems nervous as she speaks to you. An appropriate response is to
A)continue to collect information regarding the chief concern in an unhurried manner.
B)finish the interview as rapidly as possible.
C)ask the patient to take a deep breath and calm down.
D)ask the patient if she wants to wait until another day to talk to you.
E)ignore her, because anxiety rarely accompanies physical disorders.

Accepted Answer

With an anxious, vulnerable patient, it is best to not hurry; a calm demeanor communicates caring to the patient.

Question 14

Ms. T. is crying and states that her mother couldn't possibly have a tumor. "No one else in the family has ever had cancer!" exclaims the daughter. The most appropriate response to Ms. T. would be
A)"Has anyone explained hospice care to your mother?"
B)"I'm so sorry that your mother was diagnosed with cancer."
C)"Didn't you know that all tumors are not cancerous?"
D)"Why do you think that your mother's tumor is cancerous?"
E)"That is odd because cancer usually runs in families."

Accepted Answer

This is the only answer that is a direct exploration of the daughter's concern. The health care provider can explain and clarify the concerns of the daughter.

Question 15

Mr. F. is speaking with you, the health care provider, about his respiratory problem. Mr. F. says, "I've had this cough for 3 days, and it's getting worse." You reply, "Tell me more about your cough." Mr. F. states, "I wish I could tell you more. That's why I'm here. You tell me what's wrong!" Which caregiver response would be most appropriate for enhancing communication?
A)"After 3 days, you're tired of coughing. Have you had a fever?"
B)"I'd like to hear more about your experiences. Where were you born?"
C)"You may have a serious problem, and being confrontational will not help."
D)"I'll examine you and figure out the problem later."
E)"I don't know what's wrong. You could have almost any disease."

Accepted Answer

This is the only response aimed at focusing on the chief concern to gather more data and does not digress from the issue.

Question 16

During a history-taking session, Mr. B. appears to be avoiding certain questions. He keeps looking out the window. What should the caregiver do?
A)Ask direct questions and insist on a "yes" or "no" answer to each question.
B)Continue to ask questions until Mr. B. responds appropriately.
C)Let the patient know all relevant information should be revealed in one interview.
D)Stop the interview until the patient is ready to cooperate.
E)Make a note to pursue sensitive issues later in the interview.

Accepted Answer

When the patient dissembles, do not push too hard for an answer. Allow the interview to go on and come back to it later. Learning all that you may need to know about a patient may not happen in one interview.

Question 17

During an interview, tears appear in the patient's eyes, and his voice becomes shaky. Initially, you should
A)ask the patient what he is upset about.
B)offer a tissue and let him know it is all right to cry.
C)explain to the patient that you will be able to help him more if he can control his emotions.
D)keep the interview moving to distract the patient.
E)ask him if he would like some time alone.

Accepted Answer

When patients cry, it is best to allow the moment to pass at the patient's pace. If you suspect a need to cry but the patient is suppressing it, give permission.

Question 18

To prevent personal appearance from becoming an obstacle in patient care, the health care professional should
A)wear a uniform.
B)always wear a white coat.
C)avoid extremes in dress.
D)avoid wearing any jewelry.
E)avoid wearing white.

Accepted Answer

Sensible personal habits, along with avoidance of extremes in behavior and dress, contribute to establishing a trusting relationship between the provider of care and the patient. Uniforms help identify roles rather than relationships.

Question 19

Behaviors that diffuse anxiety during the interview include
A)trying to limit the patient to simple "yes" or "no" answers.
B)providing forthright answers to questions.
C)providing all necessary information before the patient has to ask for it.
D)completing the interview as quickly as possible.
E)avoiding the wearing of uniforms and laboratory coats.

Accepted Answer

To relieve anxiety, the health care professional should answer patient questions in a forthright manner, avoiding overload of information and without hurrying the conversation.

Question 20

After you ask a patient about her family history, she says, "Tell me about your family now." Which response is generally most appropriate?
A)Ignore the patient's comment and continue with the interview.
B)Give a brief, undetailed answer.
C)Ask a direct question that refocuses the patient on the chief concern.
D)Tell the patient that you do not discuss your family with patients.
E)Ask the patient why she needs to know.

Accepted Answer

This response will satisfy the patient's curiosity about yourself without invading your private life.

Quiz 1: The History and Interviewing Process

During an interview, you have the impression that a patient may be considering suicide. Which action is essential?

A patient becomes restless during the history and says, "I don't have time for all of this conversation. I've got to get back to work." Your most appropriate response would be to

When are open-ended questions generally most useful?

You are collecting a history from an 11-year-old girl. Her mother is sitting next to her in the examination room. When collecting history from older children or adolescents, they should

A 50-year-old man comes to the primary care clinic. He tells you he is worried because he has had severe chest pains for the past 2 weeks. Which initial history interview question is most appropriate?

Which technique is most likely to result in the patient's understanding of questions?

Ms. A. states, "My life is just too painful. It isn't worth it." She appears depressed. Which one of the following statements is the most appropriate caregiver response?

Information that is needed during the initial interview of a pregnant woman includes all of the following except

Periods of silence during the interview can serve important purposes, such as

Which question would be considered a "leading question?"

When questioning a patient regarding alcohol intake, she tells you that she is "only a social drinker." Which initial response is appropriate?

Which action would best promote accurate translations as well as confidentiality when the caregiver does not speak the patient's language?

A 36-year-old woman complains that she has had crushing chest pain for the past 2 days. She seems nervous as she speaks to you. An appropriate response is to

Ms. T. is crying and states that her mother couldn't possibly have a tumor. "No one else in the family has ever had cancer!" exclaims the daughter. The most appropriate response to Ms. T. would be

During a history-taking session, Mr. B. appears to be avoiding certain questions. He keeps looking out the window. What should the caregiver do?

During an interview, tears appear in the patient's eyes, and his voice becomes shaky. Initially, you should

To prevent personal appearance from becoming an obstacle in patient care, the health care professional should

Behaviors that diffuse anxiety during the interview include

After you ask a patient about her family history, she says, "Tell me about your family now." Which response is generally most appropriate?