Question 1

When observing a patient's verbal and nonverbal communication,the nurse notices a discrepancy.Which statement is true regarding this situation? The nurse should:

Accepted Answer

When nonverbal and verbal messages are congruent,the verbal message is reinforced.When they are incongruent,the nonverbal message tends to be the true one because it is under less conscious control.Thus it is important to study the nonverbal messages of patients and examiners and to understand their meanings.The other statements are not true.

Question 2

A woman has just entered the emergency department after being battered by her husband.The nurse needs to get some information from her to begin treatment.What is the best choice for an opening with this patient ?

Accepted Answer

Address the person by using his or her surname.The nurse should introduce himself or herself and give the reason for the interview.Friendly small talk is not needed to build rapport.

Question 3

A 17-year-old single mother is describing how difficult it is to raise a 3-year-old child by herself.During the course of the interview she states,"I can't believe my boyfriend left me to do this by myself! What a terrible thing to do to me!" Which of these responses by the nurse uses empathy?

Accepted Answer

An empathetic response recognizes the feeling and puts it into words.It names the feeling and allows the expression of it.It strengthens rapport.Other empathetic responses are,"This must be very hard for you," "I understand," or just placing your hand on the person's arm.Simply reflecting the person's words is not an empathetic response,nor is agreeing with the person.

Question 4

During an interview,a woman says,"I have decided that I can no longer allow my children to live with their father's violence,but I just can't seem to leave him." Using interpretation,the nurse's best response would be:

Accepted Answer

This statement is not based on one's inference or conclusion.It links events,makes associations,or implies cause.Interpretation also ascribes feelings and helps the person understand his or her own feelings in relation to the verbal message.The other statements do not reflect interpretation.

Question 5

The nurse makes which adjustment in the physical environment in order to promote the success of an interview?

Accepted Answer

The nurse should reduce noise by turning off the television,radio,and other unnecessary equipment because multiple stimuli are confusing.The interviewer and patient should be about 4 to 5 feet apart;the room should be well-lit so that the interviewer and patient can see each other clearly.Having a table or desk in between the two people creates the idea of a barrier;equal-status seating,at eye level,is better.

Question 6

A patient has finished giving the nurse information about the reason he is seeking care.When reviewing the data,the nurse finds that some information about past hospitalizations is missing.At this point,which statement by the nurse would be most appropriate to gather these data?

Accepted Answer

The nurse should use direct questions after the person's opening narrative to fill in any details he or she left out.The nurse also should use direct questions when specific facts are needed,such as when asking about past health problems or during the review of systems.

Question 7

A woman is discussing the problems she is having with her 2-year-old son.She says,"He won't go to sleep at night,and during the day he has several fits.I get so upset when that happens." The nurse's best verbal response would be:

Accepted Answer

Use clarification when the person's word choice is ambiguous or confusing (e.g.,"Tell me what you mean by 'fits.'").Clarification is also used to summarize the person's words,simplify the words to make them clearer,and then ask if you are on the right track.

Question 8

As the nurse enters a patient's room,the nurse finds her crying.The patient states that she has just found out that the lump in her breast is cancer and says,"I'm so afraid of,um,you know." The nurse's most therapeutic response would be to say,in a gentle manner:

Accepted Answer

Reflection echoes the patient's words,repeating part of what the person just said.Reflection also can help express the feeling behind a person's words.

Question 9

A nurse is taking complete health histories on all of the patients attending a wellness workshop.On the history form,one of the written questions asks,"You don't smoke,drink,or take drugs,do you?" This question is an example of:

Accepted Answer

This is an example of using leading or biased questions.Asking,"You don't smoke,do you?" implies that one answer is "better" than another.If the person wants to please someone,he or she is either forced to answer in a way corresponding to their implied values or is made to feel guilty when admitting the other answer.

Question 10

The nurse has used interpretation regarding a patient's statement or actions.After using this technique,it would be best for the nurse to:

Accepted Answer

Interpretation is not based on direct observation as is confrontation,but it is based on one's inference or conclusion.The nurse risks making the wrong inference.If this is the case,the patient will correct it.But even if the inference is corrected,interpretation helps to prompt further discussion of the topic.

Question 11

Receiving is a part of the communication process.Which receiver is most likely to misinterpret a message sent by a health care professional?

Accepted Answer

The receiver attaches meaning determined by his or her past experiences,culture,self-concept,and current physical and emotional states.The man whose wife has just been diagnosed with lung cancer may be experiencing emotions that affect his receiving.

Question 12

During a clinic visit a patient states,"The doctor just told me he thought I ought to stop smoking.He doesn't understand how hard I've tried.I just don't know the best way to do it.What should I do?" The nurse's most appropriate response in this case would be:

Accepted Answer

Use clarification when the person's word choice is ambiguous or confusing.Clarification is also used to summarize the person's words,simplify the words to make them clearer,and then ask if you are on the right track.The other responses give unwanted advice or do not offer a helpful response.

Question 13

When taking a history from a newly admitted patient,the nurse notices that he is pausing often and looking at the nurse expectantly.What would be the nurse's best response to this behavior?

Accepted Answer

Silent attentiveness communicates that the person has time to think,to organize what he or she wishes to say without interruption from the nurse.This "thinking silence" is the one health professionals interrupt most often.The other responses are not conducive to ideal communication.

Question 14

A pregnant woman states,"I just know labor will be so painful that I won't be able to stand it.I know it sounds awful,but I really dread going into labor." The nurse responds by stating,"Oh,don't worry about labor so much.I have been through it,and although it is painful there are many good medications to decrease the pain." Which statement is true regarding this response? It was a:

Accepted Answer

By providing false assurance or reassurance,this "courage builder" relieves one's anxiety and gives the nurse the false sense of having provided comfort.But for the woman,it actually closes off communication.It trivializes her anxiety and effectively denies any further talk of it.

Question 15

A man has been admitted to the observation unit for observation after being treated for a large cut on his forehead.As the nurse works through the interview,one of the standard questions has to do with alcohol,tobacco,and drug use.When the nurse asks him about tobacco use,he states,"I quit smoking after my wife died 7 years ago." However,the nurse notices an open package of cigarettes in his shirt pocket.Using confrontation,the nurse could say:

Accepted Answer

In the case of confrontation,a certain action,feeling,or statement has been observed,and the nurse now focuses the patient's attention on it.The nurse should give honest feedback about what is seen or felt.This may focus on a discrepancy.Or the nurse may confront the patient when parts of the story are inconsistent.The other statements are not appropriate.

Question 16

In using verbal responses to assist the patient's narrative,some responses focus on the patient's frame of reference and some focus on the health care provider's perspective.An example of a verbal response that focuses on the health care provider's perspective would be:

Accepted Answer

When the health care provider uses the response of confrontation,the frame of reference shifts from the patient's perspective to the health care provider's,and the health care provider starts to express his or her own thoughts and feelings.Empathy,reflection,and facilitation responses focus on the patient's frame of reference.

Question 17

The nurse asks,"I would like to ask you some questions about your health and your usual daily activities so that we can better plan your stay here." This question is found at the _____ phase of the interview process.

Accepted Answer

When gathering a complete history,the nurse should give the reason for the interview during the opening or introduction of the interview,not during or at the end of the interview.

Question 18

During an interview,the nurse states,"You mentioned shortness of breath.Tell me more about that." Which verbal skill is used with this statement?

Accepted Answer

The open-ended question asks for narrative information.It states the topic to be discussed but only in general terms.The nurse should use it to begin the interview,to introduce a new section of questions,and whenever the person introduces a new topic.

Question 19

The nurse is conducting an interview with a woman who has recently learned that she is pregnant and who has come to the clinic today to begin prenatal care.The woman states that she and her husband are excited about the pregnancy but have a few questions.She looks nervously at her hands during the interview and sighs loudly.Considering the concept of communication,the nurse knows that which statement is most accurate? The woman is:

Accepted Answer

Communication is all behavior,conscious and unconscious,verbal and nonverbal.All behavior has meaning.Her behavior does not specify that she is nervous about labor,upset by her husband,or worried about the nurse's response.

Question 20

In an interview,the nurse may find it necessary to take notes to aid his or her memory later.Which statement is true regarding note-taking?

Accepted Answer

Some use of history forms and note-taking may be unavoidable.But be aware that note-taking during the interview has disadvantages.It breaks eye contact too often,and it shifts attention away from the patient,which diminishes his or her sense of importance.It also may interrupt the patient's narrative flow,and it impedes the observation of the patient's nonverbal behavior.

Quiz 3: The Interview