Question 1

A tool used to screen adolescents for alcoholism is the:
A) CAGE.
B) CRAFFT.
C) PACES.
D) HITS.

Accepted Answer

The CRAFFT tool is used to screen for alcoholism in adolescents. The CAGE test is used to screen for alcoholism in adults. PACES is used to screen adolescents for important issues in their life. HITS is the screen for domestic violence.

Question 2

Mrs. G reports an increase in her alcohol intake over the past 5 years. To screen her for problem drinking, you would use the:
A) CAGE questionnaire.
B) PACES assessment.
C) Miller Analogies Test.
D) Glasgow Coma Scale.

Accepted Answer

The CAGE questionnaire is a model for approaching a discussion of the use of alcohol. PACES is used to screen adolescents for important issues in their life. The Miller Analogies Test is used is used to test cognitive functioning. The Glasgow Coma Scale is a neurology assessment.

Question 3

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 be:
A) given the opportunity to be interviewed without the parent at some point during the interview.
B) mailed a questionnaire in advance to avoid the need for them to talk.
C) ignored while you address all questions to the parent.
D) allowed to direct the flow of the interview.

Accepted Answer

The older child should be given the opportunity to give information directly. This enhances the probability that the child will follow your advice. Mailing a questionnaire in advance to avoid the need for her to talk does not assist the child in learning to respond to answers regarding her health. The parent can help fill in gaps at the end. If she is ignored while you address all questions to the parent, the patient will feel as though she is just being discussed and is not part of the process for the health care. The health care provider should always direct the flow of the interview according to the patient's responses.

Question 4

Pain is difficult to assess in older adults because:
A) drugs act more rapidly with age.
B) their language skills decline.
C) they tend to exaggerate symptoms.
D) sharp pain may be felt as a dull ache.

Accepted Answer

Pain is often an unreliable symptom in older adults because they lose pain perception and experience pain in a different manner than those of other age groups. Older adults tend to think pain in aging is normal.

Question 5

When you enter the examination room of a 3-year-old girl, you find her sitting on her father's lap. She turns away from you when you greet her. Initially, your best response is to:
A) leave the child sitting in the father's lap while you talk to the father.
B) ask the child to be seated on the examination table so that you can talk to her father.
C) explain to the child that you will not hurt her and that she will have to trust you.
D) ask the father to persuade the child to cooperate with you.

Accepted Answer

Interaction with children must be modified according to the child's age and in a manner that promotes trust.

Question 6

Mr. D complains of a headache. During the history, he mentions his use of alcohol and illicit drugs. This information would most likely belong in the:
A) chief complaint.
B) past medical history.
C) personal and social history.
D) review of systems.

Accepted Answer

Habits are included within the personal and social history. The chief complaint is the reason the patient is seeking health care. The past medical history is made up of the previous medical conditions that the patient has had. The review of systems is an overview of problems with other body systems.

Question 7

A pedigree diagram is drafted for the purpose of obtaining:
A) sexual orientation and history.
B) growth and developmental status.
C) genetic and familial health problems.
D) ethnic and cultural backgrounds.

Accepted Answer

A pedigree diagram, or genogram, shows consanguinity of health problems. Sexual orientation and history are noted in the review of systems (ROS). Growth and development are plotted on a percentile chart. Ethnic and cultural backgrounds are noted in the family history.

Question 8

To what extent should the patient with a physical disability or emotional disorder be involved in providing health history information to the health professional?
A) The patient should be present during information collection but should not be addressed directly.
B) All information should be collected from past records and family members while the patient is in another room.
C) The patient should be involved only when you sense that he or she may feel ignored.
D) The patient should be fully involved to the limit of his or her ability.

Accepted Answer

Patients who are disabled may not give an effective history, but they must be respected, and the history must be obtained from them to the greatest extent possible. Patients should be addressed directly and participate in the interview to the extent of their ability.

Question 9

When questioning the patient regarding his or her sexual history, which question should be asked initially?
A) "Do you have any particular sexual likes or dislikes?"
B) "Do you have any worries or concerns regarding your sex life?"
C) "How often do you have intercourse and with whom?"
D) "Do you have any reason to think you may have been exposed to a sexually transmitted infection?"

Accepted Answer

When approaching questioning about a sensitive area, it is recommended that the provider first ask open-ended questions that explore the patient's feelings about the issue. "Do you have any particular sexual likes or dislikes?" is not a question that should be asked in an interview regarding sexual history. "How often do you have intercourse and with whom?" and "Do you have any reason to think you may have been exposed to a sexually transmitted infection?" are not questions that should be asked initially in an interview regarding the patient's sexual history.

Question 10

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) Make a note to pursue sensitive issues later in the interview.
D) Stop the interview until the patient is ready to cooperate.

Accepted Answer

When the patient dissembles, do not push too hard for an answer. Allow the interview to go on and come back to the questions he avoided answering later. Yes or no questions will close the interview process. Continue with the interview, making a note to return to questioning about that issue later in the interview. Continuing to ask questions until Mr. B responds appropriately will not allow the patient time to reflect and answer. Stopping the interview until the patient is ready to cooperate will stop the flow of communication.

Question 11

A brief statement of the reason the patient is seeking health care is called the:
A) medical history.
B) chief complaint.
C) assessment.
D) diagnosis.

Accepted Answer

The chief complaint is a brief statement of why the patient is seeking health care. The medical history, assessment, and diagnosis are not the reasons that the patient is seeking health care.

Question 12

Mr. Mills is a 55-year-old patient who presents to the office for an initial visit for health promotion. A survey of mobility and activities of daily living (ADLs) is part of a(n):
A) ethnic assessment.
B) functional assessment.
C) genetic examination.
D) social history.

Accepted Answer

A functional assessment is an assessment of a patient's mobility, upper extremity movement, household management, ADLs, and instrumental activities of daily living (IADLs).

Question 13

When interviewing older adults, the examiner should:
A) speak extremely loudly, because most older adults have significant hearing impairment.
B) provide a written questionnaire in place of an interview.
C) position himself or herself facing the patient.
D) dim the lights to decrease anxiety.

Accepted Answer

The health care provider should position himself or herself so that the older patient can see his or her face. Shouting distorts speech, dimming the lights impairs vision, and a written interview may be necessary if all else fails.

Question 14

When communicating with older children and teenagers, you should be sensitive to their:
A) desire for adult companionship.
B) natural urge to communicate.
C) need for verbal instructions.
D) typical reluctance to talk.

Accepted Answer

Adolescents are usually reluctant to talk; therefore the provider should clearly communicate a respect for confidentiality.

Question 15

When you suspect that your 81-year-old patient has short-term memory loss because he cannot remember what he had for breakfast, you should:
A) order a neurology consult.
B) stop all of his medications.
C) validate the concern with his family or caregivers.
D) dismiss the finding as a normal age-related change.

Accepted Answer

When older adults experience memory loss for recent events, consult other family members to clarify discrepancies or to fill in the gaps. You may want to consult neurology later, but to assess the memory loss, you need validation of the patient's responses. Stopping medications will not identify the short-term memory loss. Short-term memory loss is not an age-related change.

Question 16

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

Accepted Answer

The initial interview for the pregnant woman should include information about her past medical history, assessment of health practices, identification of potential risk factors, and assessment of remembering (knowledge) as it affects the pregnancy. The gender of the fetus is not as important as the information about her past medical history, health care practices, and the woman's remembering (knowledge) about her pregnancy.

Question 17

A guideline for history taking is for caregivers to:
A) ask direct questions before open-ended questions so that data move from simple to complex.
B) ask for a complete history at once so that data are not forgotten between meetings.
C) make notes sparingly so that the patient can be observed during the history taking.
D) write detailed information as stated by patients so that their priorities are reflected.

Accepted Answer

During the interview, you should maintain eye contact with the patient, observing body language and proceeding from open-ended to direct questions. Asking direct questions first may upset the patient. During the interview you should gather as much information as you need for the current reason the patient is seeking health care. It is important to focus on the patient. Brief notes can be charted, but you should maintain eye contact with the patient, observing body language and proceeding from open-ended to direct questions.

Question 18

Direct questioning about domestic violence in the home should be:
A) a routine component of history taking with female patients.
B) avoided for fear of offending the woman's partner.
C) conducted only in cases in which there is a history of abuse.
D) used only when the patient is obviously being victimized.

Accepted Answer

The presence of domestic violence should be routinely queried, and the questioning should be direct for all female patients. Direct questioning about domestic violence in the home should not be avoided for fear of offending the woman's partner, should be part of a routine examination, and should not be used only when the patient is obviously being victimized.

Question 19

Tom is a 16-year-old diabetic who does not follow his diet. He enjoys his dirt bike and seems unconcerned about any consequences of his activities. Which factor is typical of adolescence and pertinent to Tom's health?
A) Attachment to parents
B) High self-esteem
C) Low peer support needs
D) Propensity for risk taking

Accepted Answer

Adolescents tend to experiment with risky behaviors that can lead to a high incidence of morbidity and mortality.

Question 20

When taking a history, you should:
A) ask the patient to give you any information they can recall about their health.
B) start the interview with the patient's family history.
C) use a chronologic and sequential framework.
D) use a holistic and eclectic structure.

Accepted Answer

To give structure to the present problem or chief complaint, the provider should proceed in a chronologic and sequential framework. Asking patients to give you any information they can recall about their health and using a holistic and electric structure do not provide structure to the history. Gathering the patient's family history is only the first step.

Quiz 1: The History and Interviewing Process

A tool used to screen adolescents for alcoholism is the:

Mrs. G reports an increase in her alcohol intake over the past 5 years. To screen her for problem drinking, you would use the:

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 be:

Pain is difficult to assess in older adults because:

When you enter the examination room of a 3-year-old girl, you find her sitting on her father's lap. She turns away from you when you greet her. Initially, your best response is to:

Mr. D complains of a headache. During the history, he mentions his use of alcohol and illicit drugs. This information would most likely belong in the:

A pedigree diagram is drafted for the purpose of obtaining:

To what extent should the patient with a physical disability or emotional disorder be involved in providing health history information to the health professional?

When questioning the patient regarding his or her sexual history, which question should be asked initially?

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 brief statement of the reason the patient is seeking health care is called the:

Mr. Mills is a 55-year-old patient who presents to the office for an initial visit for health promotion. A survey of mobility and activities of daily living (ADLs) is part of a(n) :

When interviewing older adults, the examiner should:

When communicating with older children and teenagers, you should be sensitive to their:

When you suspect that your 81-year-old patient has short-term memory loss because he cannot remember what he had for breakfast, you should:

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

A guideline for history taking is for caregivers to:

Direct questioning about domestic violence in the home should be:

Tom is a 16-year-old diabetic who does not follow his diet. He enjoys his dirt bike and seems unconcerned about any consequences of his activities. Which factor is typical of adolescence and pertinent to Tom's health?

When taking a history, you should: