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,Chapteri01:iTheiHistoryiandiInterviewingiProcess
Ball:iSeidel’siGuideitoiPhysicaliExamination,i9thiEdition
MULTIPLEiCHOICE
1. Whichiquestioniwouldibeiconsiderediai“leadingiquestion?”
a. “Whatidoiyouithinkiisicausingiyouriheadaches?”
b. “Youidon’tigetiheadachesioften,idoiyou?”
c. “Oniaiscaleiofi1itoi10,ihowiwouldiyouirateitheiseverityiofiyouriheadaches?”
d. “Atiwhatitimeiofitheidayiareiyouriheadachesitheimostisevere?”
ANS:i B
Statingitoitheipatientithatiheiorisheidoesinotigetiheadachesiwouldilimititheiinformationiinitheipa
tient’sianswer.iAskingitheipatientiwhatiheiorisheithinksiisicausingitheiheadachesiisianiopen-
endediquestion.iAskingitheipatientihowiheiorisheiwouldirateitheiseverityiofitheiheadachesiandi
askingiwhatitimeiofitheidayitheiheadachesiareitheimostisevereiareidirectiquestions.
DIF: CognitiveiLevel:iApplyingi(Application)
OBJ:iiiNursingiprocess—assessment MSC:i PhysiologiciIntegrity:iPhysiologiciAdaptation
2. Wheniareiopen-endediquestionsigenerallyimostiuseful?
a. Duringisensitiveiareaipartiofitheiinterview
b. Afteriseveraliclosed-endediquestionsihaveibeeniasked
c. Whileidesigningitheigenogram
d. Duringitheireviewiofisystems
N RiI
ANS:i A
Askingiopen-
endediquestionsiduringitheisensitiveipartiofitheiinterviewiallowsiyouitoigatherimoreiinformation
iandiestablishesiyouiasianiempathicilistener,iwhichiisitheifirstistepiofieffectiveicommunication.i
Askingiclosed-
endediquestionsimayistifleitheipatient’sidesireitoidiscussitheihistoryiofitheiillness.iInterviewingif
oritheipurposeiofidesigningiaigenogramioriconductingiaireviewiofisystemsirequiresimoreifocuse
didataithanicanibeimoreieasilyigatherediwithidirectiquestioning.
DIF: CognitiveiLevel:iUnderstandingi(Comprehension)
OBJ:iiiNursingiprocess—assessment MSC:i PhysiologiciIntegrity:iPhysiologiciAdaptation
3. Periodsiofisilenceiduringitheiinterviewicaniserveiimportantipurposes,isuchias:
a. allowingitheiclinicianitoicatchiupionidocumentation.
b. promotingicalm.
c. providingitimeiforireflection.
d. increasingitheilengthiofitheivisit.
ANS:i C
Silenceiisiaiusefulitooliduringiinterviewsiforitheipurposesiofireflection,isummoningicourage,ian
didisplayingicompassion.iThisiisinotiaitimeitoidocumentiinitheichart,ibutiratheritoifocusionitheip
atient.iPeriodsiofisilenceimayicauseianxietyiratherithanipromoteicalm.iTheilengthiofitheivisitiisil
essiimportantithanigettingicriticaliinformation.
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, DIF: CognitiveiLevel:iUnderstandingi(Comprehension)
OBJ:iiiNursingiprocess—assessment MSC:i PhysiologiciIntegrity:iPhysiologiciAdaptation
4. Mr.iFrankliniisispeakingiwithiyou,itheihealthcareiprovider,iaboutihisirespiratoryiproblem.iMr.iFr
anklinisays,i“I’veihadithisicoughifori3idays,iandiit’sigettingiworse.”iYouireply,i“Tellimeimoreia
boutiyouricough.”iMr.iFranklinistates,i“IiwishiIicoulditelliyouimore.iThat’siwhyiI’mihere.iYouit
ellimeiwhat’siwrong!”iWhichicaregiveriresponseiwouldibeimostiappropriateiforienhancingico
mmunication?
a. “Afteri3idays,iyou’reitiredioficoughing.iHaveiyouihadiaifever?”
b. “I’dilikeitoihearimoreiaboutiyouriexperiences.iWhereiwereiyouiborn?”
c. “Iidon’tiknowiwhat’siwrong.iYouicouldihaveialmostianyidisease.”
d. “I’lliexamineiyouiandifigureioutilateriwhatitheiproblemiis.”
ANS:i A
“Afteri3idays,iyou’reitiredioficoughing.iHaveiyouihadiaifever?”iisitheionlyiresponseiaimediatifo
cusingionitheichieficompliantitoigatherimoreidataiandidoesinotidigressifromitheiissue.
DIF: CognitiveiLevel:iAnalyzingi(Analysis)
OBJ:iiiNursingiprocess—assessment MSC:i PhysiologiciIntegrity:iPhysiologiciAdaptation
5. Afteriyouiaskiaipatientiaboutiherifamilyihistory,isheisays,i“Tellimeiaboutiyourifamilyinow.”iW
hichiresponseiisigenerallyimostiappropriate?
a. Ignoreitheipatient’sicommentiandicontinueiwithitheiinterview.
b. Giveiaibrief,iundetailedianswer.
c. Askitheipatientiwhyisheineedsitoiknow.
d. Tellitheipatientithatiyouidoinotidiscussiyourifamilyiwithipatients.
ANS:i B
Givingiaibrief,iundetailediansweriwillisatisfyitheipatient’sicuriosityiaboutiyourselfiwithout
invadingiyouriprivateilife.iIgnoringitheipatient’sicomment,icontinuingiwithitheiinterview,iandite
llingitheipatientithatiyouidoinotidiscussiyourifamilyiwithipatientsiwillipotentiallyiangeriorifrustr
ateiheriandikeepiherifromisharingiopenly.iAskingitheipatientiwhyisheineedsitoiknowiwillidistracti
fromitheirealireasonisheiisiseekingicareiandiinsteadimoveitheiinterviewiconversationiawayifromi
theitopicsithatishouldibeidiscussed.
DIF: CognitiveiLevel:iApplyingi(Application)
OBJ:iiiNursingiprocess—assessment MSC:i PhysiologiciIntegrity:iPhysiologiciAdaptation
6. Ai36-year-
oldiwomanicomplainsithatisheihasihadicrushingichestipainiforitheipasti2idays.iSheiseemsinervo
usiasisheispeaksitoiyou.iAniappropriateiresponseiisito:
a. continueitoicollectiinformationiregardingitheichieficomplaintiinianiunhurriedi
manner.
b. finishitheiinterviewiasirapidlyiasipossible.
c. askitheipatientitoitakeiaideepibreathiandicalmidown.
d. askitheipatientiifisheiwantsitoiwaitiuntilianotheridayitoitalkitoiyou.
ANS:i A
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, Withianianxious,ivulnerableipatient,iitiisibestitoinotihurry;iaicalmidemeanoriwillicommunicateica
ringitoitheipatient.iIfiyouiasiaihealthcareiprovideriareihurried,itheipatientiwillibeimoreianxious.iT
heibestiwayitoiassistianianxiousipatientiisitoinotihurryiandiremainicalm,ibecauseithisiwillicommu
nicateicaringitoitheipatient.iAskingitheipatientiifisheiwantsitoiwaitiuntilianotheridayitoitalkitoiyo
uidelaysitheineededihealthicare.
DIF: CognitiveiLevel:iApplyingi(Application)
OBJ:iiiNursingiprocess—assessment MSC:i PhysiologiciIntegrity:iPhysiologiciAdaptation
7. Ms.iAistates,i“Myilifeiisijustitooipainful.iItiisn’tiworthiit.”iSheiappearsidepressed.iWhichioneiofi
theifollowingistatementsiisitheimostiappropriateicaregiveriresponse?
a. “Tryitoithinkiaboutitheigoodithingsiinilife.”
b. “Whatiinilifeiisicausingiyouisuchipain?”
c. “Youican’timeaniwhatiyou’reisaying.”
d. “Ifiyouithinkiaboutiit,inothingiisiworthigettingithisiupsetiabout.”
ANS:i B
Specificibutiopen-endediquestionsiareibestiusediwhenitheipatientihasifeelingsiofilossiof
self-
worthiandidepression.i“Tryitoithinkiaboutitheigoodithingsiinilife,”i“Youican’timeaniwhatiyou’reis
aying,”iandi“Ifiyouithinkiaboutiit,inothingiisiworthigettingithisiupsetiabout”iareistatementsithati
willihurryitheipatientiandiofferionlyisuperficialiassurance.
DIF: CognitiveiLevel:iAnalyzingi(Analysis)
OBJ:iiiNursingiprocess—assessment MSC:i PhysiologiciIntegrity:iPhysiologiciAdaptation
8. Youiareicollectingiaihistoryifromiai16-year-
oldigirl.iHerimotheriisisittinginextitoiheriinitheiexaminationiroom.iWhenicollectingihistoryifr
omiolderichildrenioriadolescents,itheyishouldibe:
a. givenitheiopportunityitoibeiinterviewediwithoutitheiparentiatisomeipointiduringithe
interview.
b. mailediaiquestionnaireiiniadvanceitoiavoiditheineediforithemitoitalk.
c. ignorediwhileiyouiaddressialliquestionsitoitheiparent.
d. alloweditoidirectitheiflowiofitheiinterview.
ANS:i A
Theiadolescentishouldibeigivenitheiopportunityitoigiveiinformationidirectly.iThisienhancesithei
probabilityithatitheiadolescentiwillifollowiyouriadvice.iMailingiaiquestionnaireiiniadvanceitoiav
oiditheineediforiheritoitalkidoesinotiassistitheiadolescentiinilearningitoiresponditoianswersiregar
dingiherihealth.iTheiparenticanihelpifilliinigapsiatitheiend.iIfisheiisiignorediwhileiyouiaddressiall
iquestionsitoitheiparent,itheipatientiwillifeeliasithoughisheiisijustibeingidiscussediandiisinotiparti
ofitheiprocessiforitheihealthicare.iTheihealthcareiproviderishouldialwaysidirectitheiflowiofitheiin
terviewiaccordingitoitheipatient’siresponses.
DIF: CognitiveiLevel:iApplyingi(Application)
OBJ:iiiNursingiprocess—assessment MSC:i PhysiologiciIntegrity:iPhysiologiciAdaptation
9. Informationithatiisineedediduringitheiinitialiinterviewiofiaipregnantiwomaniincludesiallitheifo
llowingiexcept:
a. theigenderithatitheiwomanihopesitheibabyiwillibe.
b. pastimedicalihistory.
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