Chapter 01: The History and Interviewing Process

1.The primary objective of the initial encounter is to: e the advice and care for the patient. lish the tone of a successful partnership. ize your ability to help. the patient the limits of care. ANS: B The first meeting with the patient sets the tone for a successful partnership. It is to discover the details about patients’ concerns, explore expectations for the encounter, display genuine interest, and develop a partnership. 2.If language is a barrier, the interpreter should be: a.a family member. b.a language board. c.a professional interpreter d.a staff person. ANS: C Someone other than a family member should act as an interpreter to bridge the language difference between a health care provider and the patient. A professional interpreter rather than a family member should be used. 3.Mary Jane has brought in her 16-year-old son, Kyle. She states that he has been sleeping more and does not hang around his friends, and recently his girlfriend broke up with him. Your most immediate question is to ask Kyle: a.“Do you want to see a counselor today?” b.“Is your father out of jail yet?” c.“Are you taking any illegal drugs?” d.“Have you made plans to harm yourself?” ANS: D If you sense that a patient is contemplating suicide, you should ask about suicidal ideation directly. The most important area to address is the potential for suicide. The question “Is your father out of jail yet?” may be relevant to the history, but is not an immediate concern. 4.Ms. Yale is a 52-year-old patient who presents to the office for evaluation. During the interview, you say “Tell me what you do when you have knee pain.” The health care provider is asking information about: h promotion. description and character of the complaint. location and duration of the complaint. vating and relieving factors of the complaint. ANS: D The health care provider is asking a symptom-analysis question to obtain more information about the aggravating and alleviating factors of the knee pain. Asking the patient to describe a typical attack of pain would help obtain information about the description and character of the complaint. The question “When did you last feel well?” would help define the time of onset and duration of the complaint. A question about health promotion would be directed toward improving patient health. 5.Which question would be considered a “leading question?” a.“What do you think is causing your headaches?” b.“You don’t get headaches often, do you?” c.“On a scale of 1 to 10, how would you rate the severity of your headaches?” d.“At what time of the day are your headaches the most severe?” ANS: B Stating to the patient that he or she does not get headaches would limit the information in the patient’s answer. Asking the patient what he or she thinks is causing the headaches is an open-ended question. Asking the patient how he or she would rate the severity of the headaches and asking what time of the day the headaches are the most severe are direct questions. 6.To prevent personal appearance from becoming an obstacle in patient care, the health care professional should: a uniform. wearing white. extremes in dress. wearing any jewelry. ANS: C Sensible personal habits, along with avoidance of extremes in behavior and dress, contribute to establishing a trusting relationship between the care provider and the patient. 7.Which action would best promote accurate translation and confidentiality when the caregiver does not speak the patient’s language? a.Ask a person unfamiliar with the patient to translate. b.Have a friend of the patient translate. c.Involve the family with the translation. d.Use a neighbor as translator. ANS: A When you do not speak the patient’s language, family members or friends may pose a communication barrier and may have issues of confidentiality; a stranger will be a less biased interpreter. You should ask a person unfamiliar with the patient to translate. 8.When are open-ended questions generally most useful? a.During the initial part of the interview. b.After several closed-ended questions have been asked. c.While designing the genogram. d.During the review of systems. ANS: A Asking open-ended questions at the beginning of an interview allows you to gather more information and establishes you as an empathic listener, which is the first step of effective communication. Interviewing for the purpose of designing a genogram or conducting a review of systems requires more focused data than can be more easily gathered with direct questioning. Asking closed-ended questions may stifle the patient’s desire to discuss the history of the illness. 9.Behaviors that diffuse anxiety during the interview include: ing wearing uniforms or laboratory coats. ding forthright answers to questions. ding all necessary information before the patient has to ask for it. eting the interview as quickly as possible. ANS: B To relieve anxiety, the health care professional shoul