Test bank for Advanced Health Assessment and Diagnostic Reasoning 5th Edition
Advanced Health Assessment and Diagnostic Reasoning 5th Edition Rhoads
Test bank
Chapter 1: Interview and History Taking Strategies
MULTIPLE CHOICE
• 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,
which statement does the nurse know to be most accurate? The
woman is:
N
Excited about her pregnancy but nervous
a.
about the labor.
Exhibiting verbal and nonverbal behaviors
b.
ur
that do not match.
Excited about her pregnancy, but her husband
c.
is not and this is upsetting to her.
Not excited about her pregnancy but believes
se
d. the nurse will negatively respond to her if she
states this.
ANS: B
Communication is all behaviors, conscious and unconscious, verbal and
nonverbal. All behaviors have meaning. Her behavior does not imply that
do
she is nervous about labor, upset by her husband, or worried about the
nurses response.
• Receiving is a part of the communication process.
Which receiver is most likely to misinterpret a
message sent by a health care professional?
cs
Well-adjusted adolescent who came in for a
a.
sports physical
Recovering alcoholic who came in for a basic
b.
physical examination
Man whose wife has just been diagnosed with
c.
lung cancer
Man with a hearing impairment who uses sign
d. language to communicate and who has an
interpreter with him
ANS: C
The receiver attaches meaning determined by his or her experiences,
culture, self-concept, and current physical and emotional states. The
man whose wife has just been diagnosed with lung cancer may be
, Test bank for Advanced Health Assessment and Diagnostic Reasoning 5th Edition
experiencing emotions that affect his receiving.
• The nurse makes which adjustment in the physical environment
to promote the success of an interview?
Reduces noise by turning off televisions and
a.
radios
Reduces the distance between the interviewer
b.
and the patient to 2 feet or less
Provides a dim light that makes the room
c.
cozy and helps the patient relax
Arranges seating across a desk or table to
d.
allow the patient some personal space
ANS: A
The nurse should reduce noise by turning off the television, radio, and
N
other unnecessary equipment, because multiple stimuli are confusing.
The interviewer and patient should be approximately 4 to 5 feet apart; the
room should be well-lit, enabling the interviewer and patient to see each
ur
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.
• In an interview, the nurse may find it necessary to take notes to
aid his or her memory later. Which statement is trueregarding
se
note-taking?
Note-taking may impede the nurses
a. observation of the patients nonverbal
behaviors.
do
Note-taking allows the patient to continue at
b. his or her own pace as the nurse records what
is said.
Note-taking allows the nurse to shift attention
c. away from the patient, resulting in an
cs
increased comfort level.
Note-taking allows the nurse to break eye
d. contact with the patient, which may
increase his or her level of comfort.
ANS: A
The use of history forms and note-taking may be unavoidable. However,
the nurse must be aware that note-taking during the interview has
disadvantages. It breaks eye contact too often and shifts the attention away
from the patient, which diminishes his or her sense of importance. Note-
taking may also interrupt the patients narrative flow, and it impedes the
observation of the patients nonverbal behavior.
• 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
, Test bank for Advanced Health Assessment and Diagnostic Reasoning 5th Edition
interview process.
a. Summary
b. Closing
c. Body
d. Opening or introduction
ANS: D
When gathering a complete history, the nurse should give the reason for
the interview during the opening or introduction phase of the interview,
not during or at the end of the interview.
• 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 phase of the interview with this patient?
a. Hello, Nancy, my name is Mrs. C.
N
Hello, Mrs. H., my name is Mrs. C. It sure is
b.
cold today!
c. Mrs. H., my name is Mrs. C. How are you?
ur
Mrs. H., my name is Mrs. C. Ill need to ask
d.
you a few questions about what happened.
ANS: D
se
Address the person by using his or her surname. The nurse should
introduce him or herself and give the reason for the interview. Friendly
small talk is not needed to build rapport.
• During an interview, the nurse states, You mentioned having
do
shortness of breath. Tellme more about that. Which verbal
skill is used with this statement?
a. Reflection
b. Facilitation
c. Direct question
cs
d. Open-ended question
ANS: D
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.
• 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?
Mr. Y., at your age, surely you have been
a.
hospitalized before!
, Test bank for Advanced Health Assessment and Diagnostic Reasoning 5th Edition
Mr. Y., I just need permission to get your
b.
medical records from County Medical.
Mr. Y., you mentioned that you have been
c. hospitalized on several occasions. Would you
tell me more about that?
Mr. Y., I just need to get some additional
information about your past hospitalizations.
d. When was the last time you were admitted for
chest pain?
ANS: D
The nurse should use direct questions after the persons 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.
N
• In using verbal responses to assist the patients narrative, some
responses focus on the patients frame of reference and some focus
on the health care providers perspective. An example of a verbal
ur
response that focuses on the health care providers perspective
would be:
a. Empathy.
b. Reflection.
se
c. Facilitation.
d. Confrontation.
ANS: D
When the health care provider uses the response of confrontation, the
do
frame of reference shifts from the patients perspective to the
perspective of the health care provider, and the health care provider
starts to express his or her own thoughts and feelings. Empathy,
reflection, and facilitation responses focus on the patients frame of
reference.
cs
• When taking a history from a newly admitted patient, the nurse
notices that he often pauses and expectantly looks at the nurse.
What would be the nurses best response to this behavior?
Be silent, and allow him to continue when he
a.
is ready.
Smile at him and say, Dont worry about all of
b. this. Im sure we can find out why
youre having these pains.
Lean back in the chair and ask, You are
c. looking at me kind of funny; there isnt
anything wrong, is ther
