HAP MIDTERM QUESTIONS AND ACCURATE
ANSWERS
During an interview, the nurse states, "You mentioned having shortness of breath. Tell
me more about that." Which verbal skill is used with this statement?
a.
Reflection
b.
Facilitation
c.
Direct question
d.
Open-ended question - Answers - 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?
a.
"Mr. Y., at your age, surely you have been hospitalized before!"
b.
"Mr. Y., I just need permission to get your medical records from County Medical."
c.
,"Mr. Y., you mentioned that you have been hospitalized on several occasions. Would
you tell me more about that?"
d.
"Mr. Y., I just need to get some additional information about your past hospitalizations.
When was the last time you were admitted for chest pain?" - Answers - ANS: D
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.
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:
a.
Empathy.
b.
Reflection.
c.
Facilitation.
d.
Confrontation. - Answers - ANS: D
When the health care provider uses the response of confrontation, the frame of
reference shifts from the patient's 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 patient's frame of
reference.
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?
a.
,"You feel alone."
b.
"You can't believe he left you alone?"
c.
"It must be so hard to face this all alone."
d.
"I would be angry, too; raising a child alone is no picnic." - Answers - ANS: C
An empathetic response recognizes the feeling and puts it into words. It names the
feeling, allows its expression, and strengthens rapport. Other empathetic responses are,
"This must be very hard for you," "I understand," or simply placing your hand on the
person's arm. Simply reflecting the person's words or agreeing with the person is not an
empathetic response.
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 pack of cigarettes in his shirt pocket. Using
confrontation, the nurse could say:
a.
"Mr. K., I know that you are lying."
b.
"Mr. K., come on, tell me how much you smoke."
c.
"Mr. K., I didn't realize your wife had died. It must be difficult for you at this time. Please
tell me more about that."
d.
"Mr. K., you have said that you don't smoke, but I see that you have an open pack of
cigarettes in your pocket." - Answers - ANS: D
, 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. Confrontation 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.
The nurse has used interpretation regarding a patient's statement or actions. After using
this technique, it would be best for the nurse to:
a.
Apologize, because using interpretation can be demeaning for the patient.
b.
Allow time for the patient to confirm or correct the inference.
c.
Continue with the interview as though nothing has happened.
d.
Immediately restate the nurse's conclusion on the basis of the patient's nonverbal
response. - Answers - ANS: B
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, then the patient will correct it. However, even if the inference is correct,
interpretation helps prompt further discussion of the topic.
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:
a.
"You are going to leave him?"
b.
"If you are afraid for your children, then why can't you leave?"
c.
"It sounds as if you might be afraid of how your husband will respond."
ANSWERS
During an interview, the nurse states, "You mentioned having shortness of breath. Tell
me more about that." Which verbal skill is used with this statement?
a.
Reflection
b.
Facilitation
c.
Direct question
d.
Open-ended question - Answers - 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?
a.
"Mr. Y., at your age, surely you have been hospitalized before!"
b.
"Mr. Y., I just need permission to get your medical records from County Medical."
c.
,"Mr. Y., you mentioned that you have been hospitalized on several occasions. Would
you tell me more about that?"
d.
"Mr. Y., I just need to get some additional information about your past hospitalizations.
When was the last time you were admitted for chest pain?" - Answers - ANS: D
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.
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:
a.
Empathy.
b.
Reflection.
c.
Facilitation.
d.
Confrontation. - Answers - ANS: D
When the health care provider uses the response of confrontation, the frame of
reference shifts from the patient's 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 patient's frame of
reference.
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?
a.
,"You feel alone."
b.
"You can't believe he left you alone?"
c.
"It must be so hard to face this all alone."
d.
"I would be angry, too; raising a child alone is no picnic." - Answers - ANS: C
An empathetic response recognizes the feeling and puts it into words. It names the
feeling, allows its expression, and strengthens rapport. Other empathetic responses are,
"This must be very hard for you," "I understand," or simply placing your hand on the
person's arm. Simply reflecting the person's words or agreeing with the person is not an
empathetic response.
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 pack of cigarettes in his shirt pocket. Using
confrontation, the nurse could say:
a.
"Mr. K., I know that you are lying."
b.
"Mr. K., come on, tell me how much you smoke."
c.
"Mr. K., I didn't realize your wife had died. It must be difficult for you at this time. Please
tell me more about that."
d.
"Mr. K., you have said that you don't smoke, but I see that you have an open pack of
cigarettes in your pocket." - Answers - ANS: D
, 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. Confrontation 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.
The nurse has used interpretation regarding a patient's statement or actions. After using
this technique, it would be best for the nurse to:
a.
Apologize, because using interpretation can be demeaning for the patient.
b.
Allow time for the patient to confirm or correct the inference.
c.
Continue with the interview as though nothing has happened.
d.
Immediately restate the nurse's conclusion on the basis of the patient's nonverbal
response. - Answers - ANS: B
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, then the patient will correct it. However, even if the inference is correct,
interpretation helps prompt further discussion of the topic.
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:
a.
"You are going to leave him?"
b.
"If you are afraid for your children, then why can't you leave?"
c.
"It sounds as if you might be afraid of how your husband will respond."
