,Chapter 01: The History and Interviewing Process
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Ball: Seidel’s Guide to Physical Examination, 10th Edition
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MULTIPLE CHOICE ,Y
1. Which question would be considered a “leading question?”
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a. “Please describe any associated symptoms with your headaches?”
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b. “You don't get headaches often, do you?”
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c. “What activities affect the severity of your headaches?”
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d. “What times of the day are your headaches the most severe?”
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e. “What worries you most about your headache?”
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ANS: B ,Y
This question would limit the information in the patient's answer. The other choices allow
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the patient more discretion about the extent of an answer.
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TOP: , Y Discipline: Behavioral Science ,Y ,Y MSC: Organ System: General , Y ,Y ,Y
2. Which action would best promote accurate translations as well as confidentiality when
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the caregiver does not speak the patient's language?
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a. Ask a person unfamiliar with the patient to translate.
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b. Have a friend of the patient translate.
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c. Ask simple leading questions that the patient may understand.
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d. Use a neighbor as translator.
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e. Involve the family with the translation. ,Y ,Y ,Y ,Y ,Y
ANS: , Y A
When you do not speak the patient's language, family members or friends may pose a
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communication barrier and may have issues of confidentiality; a stranger as an interpreter
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is less biased.
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TOP: , Y Discipline: Behavioral Science ,Y ,Y MSC: Organ System: General , Y ,Y ,Y
3. Periods of silence during the interview can serve important purposes, such as:
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a. allowing the clinician to catch up on documentation. ,Y ,Y ,Y ,Y ,Y ,Y ,Y
b. giving you a clue that you should speed up the interview.
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c. providing time for reflection. ,Y ,Y ,Y
d. increasing the length of the visit. ,Y ,Y ,Y ,Y ,Y
e. promoting a calm environment. ,Y ,Y ,Y
ANS: C ,Y
Silence is a useful tool during interviews for the purposes of reflection, summoning of
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courage, and displaying compassion. It is usually a clue for you to go slower and not to
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push too hard.
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TOP: , Y Discipline: Behavioral Science ,Y ,Y MSC: Organ System: General , Y ,Y ,Y
4. Which technique is most likely to result in the patient's understanding of questions?
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a. Use phrases that are commonly used by other patients in the area.
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b. Use the patient's own terms if possible.
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, c. Use language that keeps the patient from being expansive in his or her answer.
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d. Use proper medical and technical terminology.
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e. Use the simplest language possible.
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ANS: B ,Y
To ensure that your questions have been correctly understood, be clear, and explicit while
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using the patient's idiom and level of understanding.
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TOP: , Y Discipline: Behavioral Science ,Y ,Y MSC: Organ System: General , Y ,Y ,Y
5. A patient becomes restless during the history and says, “I don't have time for all of
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this conversation. I've got to get back to work.” Your most appropriate response
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would be to:
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a. stop using open-ended questions and become more direct.
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b. ask another open-ended question and insist on an answer.
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c. ask questions about his anger and move closer to him.
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d. acknowledge his anger and proceed with the history and examination. ,Y ,Y ,Y ,Y ,Y ,Y ,Y ,Y ,Y
e. ignore his displeasure and become more assertive about getting answers.
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ANS: D ,Y
This is the only answer that resists the tendency for patient manipulation, pursues the
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information, and confronts the patient's anger.
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TOP: , Y Discipline: Behavioral Science ,Y ,Y MSC: Organ System: General , Y ,Y ,Y
6. When questioning a patient regarding alcohol intake, she tells you that she is “only a
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social drinker.” Which initial response is appropriate?
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a. “I'm glad that you are a responsible drinker.”
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b. “Many people who are reN allyRalcI
ohoGlic sBay.tCheyMare social drinkers.”
U S ofNT
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c. “What amount and what kind alcohol do you drink in a week?”
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d. “If you only drink socially, you won't need to worry about always
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having a designated driver.”
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e. “Do the other people in your household consume alcohol?”
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ANS: C ,Y
This answer clarifies the patient's own term without asking a leading question or being
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judgmental.
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TOP: , Y Discipline: Behavioral Science ,Y ,Y MSC: Organ System: General , Y ,Y ,Y
7. A 50-year-old man comes to the primary care clinic. He tells you he is worried because
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he has had severe chest pains for the past 2 weeks. Which initial history interview
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question is most appropriate?
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a. “Can you describe the pain?” ,Y ,Y ,Y ,Y
b. “The pain doesn't radiate to your arm, does it?”
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c. “Have you been treated for anxiety before?” ,Y ,Y ,Y ,Y ,Y ,Y
d. “Does your father have heart disease?” ,Y ,Y ,Y ,Y ,Y
e. “Are the pains worse after you eat?” ,Y ,Y ,Y ,Y ,Y ,Y
ANS: A ,Y
Initially, an open-ended question is a more appropriate response. “Can you describe the
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pain?” is an open-ended question that offers clues to the chief concern.
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, TOP: , Y Discipline: Behavioral Science ,Y ,Y MSC: Organ System: General , Y ,Y ,Y
8. Ms. A. states, “My life is just too painful. It isn't worth it.” She appears depressed.
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,Y Which one of the following statements is the most appropriate caregiver response?
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a. “Try to think about the good things in life.”
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b. “You shouldn't feel that way; look at all the good things in your life.”
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c. “You can't mean what you're saying.” ,Y ,Y ,Y ,Y ,Y
d. “If you think about it, nothing is worth getting this upset about.”
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e. “What in life is causing you such pain?” ,Y ,Y ,Y ,Y ,Y ,Y ,Y
ANS: E ,Y
Specific yet open-ended questions are best used when the patient has feelings of
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loss of self-worth and depression. The other responses hurry the patient and offer
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superficial assurance.
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TOP: , Y Discipline: Behavioral Science ,Y ,Y MSC: Organ System: General , Y ,Y ,Y
9. During an interview, you have the impression that a patient may be considering
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suicide. Which action is essential?
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a. Immediately begin proceedings for an involuntary commitment. ,Y ,Y ,Y ,Y ,Y ,Y
b. Ask whether the patient has considered self-harm.
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c. Ask whether the patient would like to visit a psychiatrist.
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d. Record the impression in the patient's chart and refer the patient
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for hospitalization.
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e. Avoid directly confronting the patient regarding your impression.
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ANS: B ,Y
If you think the patient may bNe c R
o n s iId e r iGn g B
su.
icC
ide,Mhe or she probably is. Mentioning it
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gives permission to talk about it.
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TOP: , Y Discipline: Behavioral Science ,Y ,Y MSC: Organ System: General , Y ,Y ,Y
10. You are collecting a history from an 11-year-old girl. Her mother is sitting next to her
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in the examination room. When collecting history from older children or adolescents,
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they should:
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a. never be interviewed alone because this may alienate the parent.
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b. be mailed a questionnaire in advance to avoid the need for her to talk.
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c. be given the opportunity to be interviewed without the parent at some point.
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d. be allowed to direct the flow of the interview.
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e. be ignored while you address all questions to the parent.
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ANS: C ,Y
An older child should be given the opportunity to give information directly. This enhances
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the probability that the child will follow your advice.
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TOP: , Y Discipline: Behavioral Science ,Y ,Y MSC: Organ System: General , Y ,Y ,Y
11. When communicating with older children and teenagers, you should be sensitive to their:
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a. parent's needs. ,Y
b. natural urge to communicate. ,Y ,Y ,Y
c. need for verbal instructions. ,Y ,Y ,Y
d. typical reluctance to talk. ,Y ,Y ,Y
