Question 1

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

Accepted Answer

Sensible personal habits, along with avoidance of extremes in behavior and dress, contribute to establishing a trusting relationship between the care provider and the patient.

Question 2

Which action would best promote accurate translation and 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) Involve the family with the translation.
D) Use a neighbor as translator.

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 will be a less biased interpreter. You should ask a person unfamiliar with the patient to translate.

Question 3

During an interview, tears appear in the patient's eyes and his voice becomes shaky. Initially, you should:
A) ask him if he would like some time alone.
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) ask the patient what he is upset about.

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. Asking him if he would like some time to himself will leave the patient alone during a time of sad feelings. Explaining to the patient that you will be able to help him more if he can control his emotions will shut down the patient's emotions. Asking the patient what he is upset about will not give the patient time to cry and express his emotions.

Question 4

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 the patient why she needs to know.
D) Tell the patient that you do not discuss your family with patients.

Accepted Answer

Giving a brief, undetailed answer will satisfy the patient's curiosity about yourself without invading your private life. Ignoring the patient's comment, continuing with the interview, and telling the patient that you do not discuss your family with patients will potentially anger or frustrate her and keep her from sharing openly. Asking the patient why she needs to know will distract from the real reason she is seeking care and instead move the interview conversation away from the topics that should be discussed.

Question 5

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) "That is odd, since cancer usually runs in families."
D) "Why do you think that your mother's tumor is cancerous?"

Accepted Answer

"Why do you think that your mother's tumor is cancerous?" is the only answer that is a direct exploration of the daughter's concern. The health care provider can address and clarify the concerns of the daughter.

Question 6

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 complaint 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.

Accepted Answer

With an anxious, vulnerable patient, it is best to not hurry; a calm demeanor will communicate caring to the patient. If you as the health care provider are hurried, the patient will be more anxious. The best way to assist an anxious patient is to not hurry and remain calm, because this will communicate caring to the patient. Asking the patient if she wants to wait until another day to talk to you delays the needed health care.

Question 7

Periods of silence during the interview can serve important purposes, such as:
A) allowing the clinician to catch up on documentation.
B) promoting calm.
C) providing time for reflection.
D) increasing the length of the visit.

Accepted Answer

Silence is a useful tool during interviews for the purposes of reflection, summoning courage, and displaying compassion. This is not a time to document in the chart, but rather to focus on the patient. Periods of silence may cause anxiety rather than promote calm. The length of the visit is less important than getting critical information.

Question 8

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

Accepted Answer

Asking open-ended questions at the beginning of an interview allows you to gather more information and establishes you as an empathic listener, which is the first step of effective communication. Interviewing for the purpose of designing a genogram or conducting a review of systems requires more focused data than can be more easily gathered with direct questioning. Asking closed-ended questions may stifle the patient's desire to discuss the history of the illness.

Question 9

Mr. Miller is a 46-year-old patient who 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) remember (acknowledge) his anger and proceed with the history and examination.
B) ask another open-ended question and insist on an answer.
C) ask questions about his anger and move closer to him.
D) ignore his displeasure and become more assertive about getting answers.

Accepted Answer

Acknowledging his anger and proceeding with the history and examination is the only response that resists the tendency for patient manipulation, pursues the information, and confronts the anger.

Question 10

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) "What in life is causing you such pain?"
C) "You can't mean what you're saying."
D) "If you think about it, nothing is worth getting this upset about."

Accepted Answer

Specific but open-ended questions are best used when the patient has feelings of loss of self-worth and depression. "Try to think about the good things in life," "You can't mean what you're saying," and "If you think about it, nothing is worth getting this upset about" are statements that will hurry the patient and offer only superficial assurance.

Question 11

Mr. Franklin is speaking with you, the health care provider, about his respiratory problem. Mr. Franklin says, "I've had this cough for 3 days, and it's getting worse." You reply, "Tell me more about your cough." Mr. Franklin 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) "I don't know what's wrong. You could have almost any disease."
D) "I'll examine you and figure out later what the problem is."

Accepted Answer

"After 3 days, you're tired of coughing. Have you had a fever?" is the only response aimed at focusing on the chief compliant to gather more data and does not digress from the issue.

Question 12

The primary objective of the initial encounter is to:
A) define the advice and care for the patient.
B) establish the tone of a successful partnership.
C) optimize your ability to help.
D) tell the patient the limits of care.

Accepted Answer

The first meeting with the patient sets the tone for a successful partnership. It is to discover the details about patients' concerns, explore expectations for the encounter, display genuine interest, and develop a partnership.

Question 13

When you are 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) "Do the other people in your household consume alcohol?"
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."

Accepted Answer

"What amount and what kind of alcohol do you drink in a week?" clarifies the patient's own statement without asking a leading question or being judgmental.

Question 14

If language is a barrier, the interpreter should be:
A) a family member.
B) a language board.
C) a professional interpreter
D) a staff person.

Accepted Answer

Someone other than a family member should act as an interpreter to bridge the language difference between a health care provider and the patient. A professional interpreter rather than a family member should be used.

Question 15

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 the simplest language possible.
D) Use proper medical and technical terminology.

Accepted Answer

To ensure that your questions have been correctly understood, be clear and explicit while using the patient's own terms and level of understanding. Using phrases commonly used by other patients may not help ensure that your questions have been correctly understood by this patient. You should be clear and explicit while using the patient's own terms and level of understanding. Using the simplest language will not help ensure that your questions have been correctly understood. It is important to avoid the use of medical terminology, because the patient may not understand it.

Question 16

Behaviors that diffuse anxiety during the interview include:
A) avoiding wearing uniforms or laboratory coats.
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.

Accepted Answer

To relieve anxiety, the health care professional should answer patient questions forthrightly, should avoid an overload of information, and should not hurry the conversation. Uniforms, lab coats, and scrub suits are common in health care. It is impossible to anticipate every question that a patient may ask. Completing the interview as quickly as possible may make the patient feel rushed.

Question 17

Which question would be considered a "leading question?"
A) "What do you think is causing your headaches?"
B) "You don't get headaches often, do you?"
C) "On a scale of 1 to 10, how would you rate the severity of your headaches?"
D) "At what time of the day are your headaches the most severe?"

Accepted Answer

Stating to the patient that he or she does not get headaches would limit the information in the patient's answer. Asking the patient what he or she thinks is causing the headaches is an open-ended question. Asking the patient how he or she would rate the severity of the headaches and asking what time of the day the headaches are the most severe are direct questions.

Question 18

Ms. Yale is a 52-year-old patient who presents to the office for evaluation. During the interview, you say "Tell me what you do when you have knee pain." The health care provider is asking information about:
A) health promotion.
B) the description and character of the complaint.
C) the location and duration of the complaint.
D) aggravating and relieving factors of the complaint.

Accepted Answer

The health care provider is asking a symptom-analysis question to obtain more information about the aggravating and alleviating factors of the knee pain. Asking the patient to describe a typical attack of pain would help obtain information about the description and character of the complaint. The question "When did you last feel well?" would help define the time of onset and duration of the complaint. A question about health promotion would be directed toward improving patient health.

Question 19

Mary Jane has brought in her 16-year-old son, Kyle. She states that he has been sleeping more and does not hang around his friends, and recently his girlfriend broke up with him. Your most immediate question is to ask Kyle:
A) "Do you want to see a counselor today?"
B) "Is your father out of jail yet?"
C) "Are you taking any illegal drugs?"
D) "Have you made plans to harm yourself?"

Accepted Answer

If you sense that a patient is contemplating suicide, you should ask about suicidal ideation directly. The most important area to address is the potential for suicide. The question "Is your father out of jail yet?" may be relevant to the history, but is not an immediate concern.

Question 20

During an interview, you have the impression that a patient may be considering suicide. Which action is essential?
A) Ask whether the patient has considered self-harm.
B) Avoid directly confronting the patient regarding your impression.
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.

Accepted Answer

If you think the patient may be considering suicide, he or she probably is. Mentioning it gives permission to talk about it. Do not avoid directly confronting the patient regarding your impression. It is important to confront the suicidal thoughts. Asking whether the patient would like to visit a psychiatrist does not allow the patient to talk about the suicidal thoughts before you determine that she or he needs a specialist level of care. Recording the impression in the patient's chart and referring the patient for hospitalization does not collaborate with the patient and does not give him or her permission to talk about the thoughts of self-harm.

Quiz 1: The History and Interviewing Process

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

Which action would best promote accurate translation and confidentiality when the caregiver does not speak the patient's language?

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

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

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 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:

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

When are open-ended questions generally most useful?

Mr. Miller is a 46-year-old patient who 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:

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?

The primary objective of the initial encounter is to:

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

If language is a barrier, the interpreter should be:

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

Behaviors that diffuse anxiety during the interview include:

Which question would be considered a "leading question?"

Ms. Yale is a 52-year-old patient who presents to the office for evaluation. During the interview, you say "Tell me what you do when you have knee pain." The health care provider is asking information about:

Mary Jane has brought in her 16-year-old son, Kyle. She states that he has been sleeping more and does not hang around his friends, and recently his girlfriend broke up with him. Your most immediate question is to ask Kyle:

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