Question 1

The nurse is nearing the end of an interview. Which statement is appropriate at this time?

Accepted Answer

This question offers the person a final opportunity for self-expression. No new topic should be introduced. The other questions are not appropriate. Asking the person "Did we forget anything?" is a direct question eliciting a yes or no response and does not provide an opportunity for self-expression or additional information. Stating that you need to go to another patient and will be back or that you want to talk about the person's upcoming surgery while you're there is not appropriate as you are not allowing the patient to express anything further and are introducing a new topic.

Question 2

The nurse is conducting an interview. Which of these statements is true regarding open-ended questions? (Select all that apply.)

Accepted Answer

Open-ended questions allow for self-expression, build and enhance rapport, and obtain narrative information. These features enhance communication during an interview. The other statements are appropriate for closed or direct questions. Open-ended questions do not elicit hard facts or one- or two-word answers but allow for self-expression and narrative information.

Question 3

The nurse is performing a health interview on a patient who has a language barrier, and no interpreter is available. Which is the best example of an appropriate question for the nurse to ask in this situation?

Accepted Answer

In a situation during which a language barrier exists and no interpreter is available, simple words should be used, such as "Do you take medicine" or the word pain rather than discomfort. The use of medical jargon, contractions, and pronouns should be avoided. Nouns should be repeatedly used, and one topic at a time should be discussed. Simple words like pain should be used rather than words like discomfort, nausea, and vomiting. The use of contractions such as "haven't" as well as medical jargon and pronouns should be avoided.

Question 4

A female patient does not speak English well, and the nurse needs to choose an interpreter. Which of the following would be the most appropriate choice?

Accepted Answer

Whenever possible, the nurse should use a trained interpreter. This person knows interpreting techniques, has a health care background, and understands patients' rights. A trained interpreter is also knowledgeable about cultural beliefs and health practices. He or she can help you bridge the cultural gap and advise you concerning the cultural appropriateness of your recommendations. Although it is tempting to ask ad hoc interpreters such as a male or female family member, or volunteer college student from the foreign language studies department, there are several disadvantages to that. Using an ad hoc interpreter can violate the patient's confidentiality and they often are not familiar with medical terminology, hospital or clinical procedures, or medical ethics. Having a relative interpret can add stress to an already stressful situation and may disrupt family relationships. In addition, in some cultures full disclosures of a diagnosis such as cancer are taboo, so an ad hoc interpreter may edit the diagnosis or not fully disclose the information.

Question 5

The nurse says to a patient, "I know it may be hard, but you should do what the doctor ordered because she is the expert in this field." Which statement is correct about the nurse's comment?

Accepted Answer

Using authority responses promotes dependency and inferiority. Avoiding the use of authority is best. Although the health care provider and patient do not have equal professional knowledge, both have equally worthy roles in the health process. The other statements are not correct. The comment "I know it may be hard, but you should do what the doctor ordered because she is the expert in this field" by the nurse does not show bias. In addition, not all members in the health care field are considered experts and using authority should be avoided. Although the health care professional may have more professional knowledge than the patient, both have equally important roles since the patient must make the final decision about his or her health. Using authority responses promotes dependency and inferiority and avoiding the use of authority is best.

Question 6

A 16-year-old boy has just been admitted to the hospital for overnight observation after being in an automobile accident. What is the best approach for the nurse to use to communicate with him?

Accepted Answer

The guidelines for communicating with adolescents are simple. The first consideration is one's attitude, which must be one of respect. Second, communication must be totally honest. An adolescent's intuition is highly tuned and can detect phoniness or the withholding of information. Always tell him or her the truth. The nurse should avoid periods of silence when communicating with adolescents as silence can be seen as threatening to them. The nurse should not tell an adolescent that everything will be confidential as that is not true. Something need to be reported by law or for the adolescent's well-being. While it is helpful to understand the jargon or slang used by adolescents, the nurse should not use that language as they are not part of the adolescent's peer group and won't be accepted as a peer.

Question 7

A female nurse is interviewing a male patient who is near the same age as the nurse. During the interview, the patient makes an overtly sexual comment. Which is the best response by the nurse?

Accepted Answer

The nurse's response must make it clear that she is a health professional who can best care for the person by maintaining a professional relationship. At the same time, the nurse should communicate that he or she accepts the person and understands the person's need to be self-assertive but that sexual advances cannot be tolerated. Saying "Stop that immediately," "Oh, you are too funny. Let's keep going with the interview," or "Do you really think I would be interested?" do not acknowledge how the patient's actions make the nurse feel and do not make it clear that they must maintain a professional relationship in order to best care for the patient.

Question 8

What data should the nurse collect during the interview portion of a health assessment.

Accepted Answer

The interview is the first, and really the most important, part of data collection. During the interview, the nurse collects subjective data; that is, what the person says about him or herself. Physical data is gathered in the physical examination portion of a health assessment. Historical data is gathered from the medical records. Objective data is what the nurse observes, this typically occurs during the physical examination, not the interview. During the interview, the nurse collects subjective data; that is, what the person says about him or herself.

Question 9

During an examination of a preschool child, the nurse will need to take her blood pressure. What might the nurse do to try to gain the child's full cooperation?

Accepted Answer

Preschoolers' communication is direct, concrete, literal, and set in the present. Therefore, health care providers should use short, simple sentences with a concrete explanation for any unfamiliar equipment that will be used on the child. Preschoolers are animistic; they imagine inanimate objects can come alive and have human characteristics. Thus a blood pressure cuff can wake up and bite or pinch. Preschoolers are animistic; they imagine inanimate objects can come alive and have human characteristics. Thus, the nurse should not say that the blood pressure cuff will give her arm a hug, that it is asleep, or that give it a name as those are humanistic characteristics and the blood cuff could wake up or come alive. Therefore, health care providers should use short, simple sentences with a concrete explanation for any unfamiliar equipment that will be used on the child.

Question 10

The nurse is interviewing a male patient who has a hearing impairment and came in because of a cold. What techniques would be most beneficial in communicating with this patient?

Accepted Answer

The nurse should ask a person with a hearing impairment the preferred way to communicate-by signing, lip reading, or writing. If the person prefers lip reading, then the nurse should be sure to face him squarely and have good lighting on the nurse's face. The nurse should not exaggerate lip movements because this distorts words. Similarly, shouting distorts the reception of a hearing aid the person may wear. The nurse should speak slowly and supplement his or her voice with appropriate hand gestures or pantomime. The nurse does not need to avoid facial expressions or hand gestures as these nonverbal cues are important adjuncts and supplement his or her voice. The nurse should find out the person's preferred communication method before arranging for a sign language interpreter. The nurse should not speak too loudly because that actually distorts the reception of hearing aids and exaggerated lip and facial movements when talking distorts the words.

Question 11

A mother brings her 28-month-old daughter into the clinic for a well-child visit. At the beginning of the visit, the nurse focuses attention away from the toddler, but as the interview progresses, the toddler begins to "warm up" and is smiling shyly at the nurse. The nurse will be most successful in interacting with the toddler if which is done next?

Accepted Answer

Although most of the communication is with the parent, the nurse should not completely ignore the child. Making contact will help ease the toddler later during the physical examination. The nurse should begin by asking about the toys the child is playing with or about a special doll or teddy bear brought from home. "Does your doll have a name?" or "What can your truck do?" Stoop down to meet the child at his or her eye level. Although making contact with the toddler will help ease him/her later during the physical examination, the nurse should begin by asking about the toys the child is playing with or about a special doll or teddy bear brought from home before touching or tickling them. Children are frightened by quick or grandiose gestures. The nurse should not completely ignore the child as making contact will help ease the toddler later during the physical examination. The nurse should not ask the mother to leave during the examination as that will cause anxiety for the toddler.

Question 12

The nurse is conducting an interview in an outpatient clinic and is using a computer to record data. Which are the best uses of the computer in this situation? (Select all that apply.)

Accepted Answer

The use of a computer can become a barrier. The nurse should begin the interview as usual by greeting the patient, establishing rapport, and collecting the patient's narrative story in a direct, face-to-face manner. Only after the narrative is fully explored should the nurse type data into the computer. When typing, the nurse should position the monitor so that the patient can see it. The use of a computer can become a barrier. The nurse should begin the interview as usual by greeting the patient, establishing rapport, and collecting the patient's narrative story in a direct, face-to-face manner.

Question 13

A man arrives at the clinic for his annual wellness physical. He is experiencing no acute health problems. Which question or statement by the nurse is most appropriate when beginning the interview?

Accepted Answer

Open-ended questions are used for gathering narrative information. This type of questioning should be used to begin the interview, to introduce a new section of questions, and whenever the person introduces a new topic. "How is your family" and "How is your job" are small talk and do not provide any information on the patient's health. The nurse should not begin with asking about the patient's hypertension but should begin the interview with a more general open-ended question.

Question 14

During an interview, the nurse would expect that most of the interview will take place at what distance?

Accepted Answer

Social distance, 4 to 12 feet, is usually the distance category for most of the interview. Public distance, over 12 feet, is too much distance; the intimate zone is inappropriate, and the personal distance will be used for the physical assessment. The intimate, personal public zones are inappropriate to conduct an interview. The intimate zone (1-1 ft.) is usually uncomfortable for people. The personal zone (1 to 4 ft.) will be used for the physical assessment. The public zone (12+ ft.) is too far away to allow for confidentiality of information or to express interest in someone.
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Question 15

During a prenatal check, a patient begins to cry as the nurse asks her about previous pregnancies. She states that she is remembering her last pregnancy, which ended in miscarriage. Which is the best response by the nurse?

Accepted Answer

A beginning examiner may feel uncomfortable when a patient starts crying. When the nurse says something that "makes the person cry," the nurse should not think he or she has hurt the person. The nurse has simply hit on an important topic; therefore, the nurse should allow the person to cry and to express his or her feelings fully. The nurse can offer a tissue and wait until the crying subsides to talk. When the nurse says something that "makes the person cry," the nurse should not think he or she has hurt the person. The nurse has simply hit on an important topic. The nurse should not apologize, leave the person alone, or change the topic, but rather allow the person to cry and express his or her feelings fully. The nurse can offer a tissue and wait until the crying subsides to talk.

Question 16

During a follow-up visit, the nurse discovers that a patient has not been taking his insulin on a regular basis. The nurse asks, "Why haven't you taken your insulin?" Which statement is an appropriate evaluation of this situation?

Accepted Answer

This is a "why" question and the adult's use of "why" questions usually implies blame and condemnation and places the person on the defensive. The other statements are not correct. The question, "Why haven't you taken your insulin?" is not an effective way to search for information as it often puts the person on the defensive. Discussing his behavior with his wife could be a breach in confidentiality and asking a direct question is not the best way to discover reasons for his behavior as they elicit yes or no answers.

Question 17

A 75-year-old woman is at the office for a preoperative interview. The nurse is aware that the interview may take longer than interviews with younger people. What is the reason for this?

Accepted Answer

The interview usually takes longer with older adults because they have a longer story to tell. It is not necessarily true that all older adults are lonely, have lost mental abilities, or are hard of hearing. Not all older adults are lonely, have lost mental abilities, or are hard of hearing. Instead, the interview usually takes longer because older adults have a longer story to tell.

Quiz 3: The Interview