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