ADVANCED mHEALTHmASSESSMENTmANDmDIAGNOSTIC mREASONINGm3RD mEDITION mRHOADSmTE
ST mBANK
Advanced Health Assessment and Diagnostic Reasoning 3
m m m m m m
rd edition Rhoads
m m
TEST BANK
m
Chapterm1mInterview mand mHistorymTakingmStrategies
MULTIPLEmCHOI CE
1. Themnursemismconductingmanminterview mwithmamwomanmwhomhasmrecentlymlearned mthat mshemismp
regnant mand mwhomhasmcomemtomthemclinicmtodaymtombeginmprenatalmcare.mThemwomanmstatesmthat ms
hemand mhermhusband maremexcited mabout mthempregnancymbut mhavemamfew mquestions.mShemlooksmnerv
ouslymat mhermhandsmduringmtheminterview mand msighsmloudly.mConsideringmthemconcept mof mcommu
nication,mwhichmstatement mdoesmthemnursemknow mtombemmost maccurate?mThemwomanmis:
a. Excited mabout mhermpregnancymbut mnervousmabout mthemlabor.
b. Exhibitingmverbalmand mnonverbalmbehaviorsmthat mdomnot mmatch.
c. Excited mabout mhermpregnancy,mbut mhermhusband mismnot mand mthismismupsettingmtomh
er.md.
Not mexcited mabout mhermpregnancymbut mbelievesmthemnursemwillmnegativelymresp
ond mtomhermif mshemstatesmthis.
ANS:mB
Communicationmismallmbehaviors,mconscious mand munconscious, mverbalmand mnonverbal.mAllmbehavio
rsmhavemmeaning.mHermbehaviormdoesmnot mimplymthat mshemismnervousmabout mlabor,mupset mbymhermh
usband,mormworried mabout mthemnursesmresponse.
2. Receivingmismampart mof mthemcommunicationmprocess. mWhichm receivermis mmost mlikelym
tommisinterpret mammessagemsent mbymamhealthmcaremprofessional?
a. Well-adjusted madolescent mwhomcameminmformamsportsmphysical
b. Recoveringmalcoholicmwhomcamemin mformambasicmphysicalmexamination
c. Manmwhosemwifemhasmjust mbeenmdiagnosed mwithmlungmcanc
ermd.
Manmwithmamhearingmimpairment mwhomusesmsignmlanguagemtomcommunicatemand mwhomhasmanminter
pretermwithmhim
ANS:mC
Themreceivermattachesmmeaningmdetermined mbymhismormhermexperiences, mculture, mself-
concept,mand mcurrent mphysicalmand memotionalmstates.mThemmanmwhosemwifemhasmjust mbeenmdiagnos
ed mwithmlungmcancermmaymbemexperiencingmemotionsmthat maffect mhismreceiving.
3. Themnursemmakesmwhichmadjustment minmthemphysicalmenvironment mtompromotemthemsuccessmof m
anminterview?
a. Reducesmnoisembymturningmoff mtelevisionsmand mradios
b. Reducesmthemdistancembetweenmtheminterviewermand mthempatient mtom2mfeet mormless
c. Providesmamdimmlight mthat mmakesmthemroommcozymand mhelpsmthempatient mrelax
d. Arrangesmseatingmacrossmamdeskmormtablemtomallow mthempatient msomempersonalmspa
cemANS:mA
Themnursemshould mreducemnoisembymturningmoff mthemtelevision,mradio,mand mothermunnecessarymequi
pment,mbecausemmultiplemstimulimaremconfusing.m Them interviewerm and mpatient mshould mbemapproxi
matelym4mtom5mfeet mapart;mthemroommshould mbemwell-
lit,menablingmtheminterviewermand mpatient mtomseemeachmothermclearly.mHavingmamtablemor mdeskminmbe
tweenmthemtwompeoplemcreatesmthemideamof mambarrier;mequal-statusmseating,mat meyemlevel,mismbetter.
,4. Inmanminterview,mthemnursemmaymfind mit mnecessarymtomtakemnotesmtomaid mhismormhermmemorymla
ter.mWhichmstatement mismtrueregardingmnote-taking?
a. Note-
takingmmaymimpedemthemnursesmobservationmof mthempatientsmnonverbalmbehaviors. mb.
Note-
takingmallowsmthempatient mtomcontinuemat mhismormhermownmpacemasmthemnursemre
cordsmwhat mismsaid.
c.
Note-
takingmallowsmthemnursemtomshift mattentionmawaymfrommthempatient,mresultingminma
nmincreased mcomfort mlevel.
d.
Note-
takingmallowsmthemnursemtombreakmeye mcontact mwithmthempatient,mwhichmmaym incr
easemhismormhermlevelmof mcomfort.
ANS:mA
Themusemof mhistorymforms mand mnote-
takingmmaymbemunavoidable.mHowever,mthemnurse mmust mbemawaremthat mnote-
takingmduringmtheminterview mhasmdisadvantages.mIt mbreaksmeyemcontact mtoomoftenmand mshiftsmthematt
entionmawaymfrommthempatient,mwhichmdiminishesmhismormhermsensemof mimportance.mNotetakingmma
ymalsominterrupt mthempatientsmnarrativemflow,mand mit mimpedesmthemobservationmof mthe
patientsmnonverbalmbehavior.
5. Themnursemasks,mI mwould mlikemtomaskmyoumsomemquestionsmabout myourmhealthmand myourmusualmd
ailymactivitiesmsomthat mwemcanmbettermplanmyourmstaymhere.mThismquestionmis mfound mat mthem
mphasemof mtheminterview mprocess.
a. Summary
b. Closing
c. Body
d. Openingmormintroductio
nmANS:mD
Whenmgatheringmamcompletemhistory,mthemnursemshould mgivemthemreasonmformtheminterview mduringmt
hemopeningmormintroductionmphasemof mtheminterview,mnot mduringmormat mthemend mof mtheminterview.
6. A mwomanmhasmjust mentered mthememergencymdepartment maftermbeingmbattered mbymhermhusband.mT
hemnursemneedsmtomget msomeminformationmfrommhermtombeginmtreatment.mWhat mismthembest mchoicem
formanmopeningmphasemof mtheminterview mwithmthismpatient?
a. Hello,mNancy,mmymnamemismMrs.mC.
b. Hello,mMrs.mH.,mmymnamemismMrs.mC.mIt msuremismcold mtoday!
c. Mrs.mH.,mmymnamemismMrs.mC.mHow maremyou?
d. Mrs.mH.,mmymnamemismMrs.mC.mIllmneed mtomaskmyoumamfew mquestionsmabout mwhat mhappen
ed.mANS:mD
Addressmthempersonmbymusingmhismormhermsurname.mThemnursemshould mintroducemhimmormherself man
d mgivemthemreasonmformtheminterview.mFriendlymsmallmtalkmismnot mneeded mtombuild mrapport.
7. Duringmanminterview,mthemnursemstates,mYoummentioned mhavingmshortness mof mbreath.mTellm
memmoremabout mthat.mWhichmverbalmskillmismused mwithmthismstatement?
a. Reflection
b. Facilitation
c. Direct mquestion
d. Open-
ended mquestionmANS:m
,D
, Themopen-
ended mquestionmasksmformnarrativeminformation.mIt mstatesmthemtopicmtombemdiscussed mbut monlyminm
generalmterms.mThemnursemshould musemit mtombeginmtheminterview,mtomintroducemamnew msectionmof mq
uestions,mand mwhenevermthempersonmintroducesmamnew mtopic.
8. A mpatient mhasmfinished mgivingmthemnurseminformationmabout mthemreasonmhemismseekingmcare.mWh
enmreviewingmthemdata,mthemnursemfindsmthat msomeminformationmabout mpast mhospitalizationsmismmi
ssing.mAt mthismpoint,mwhichmstatement mbymthemnursemwould mbemmost mappropriatemtomgathermthesem
data?
a. Mr.mY.,mat myourmage,msurelymyoumhavembeenmhospitalized mbefore!
b. Mr.mY.,mI mjust mneed mpermissionmtomget myourmmedicalmrecordsmfrom mCountymMedic
al.mc.
Mr.mY.,myoummentioned mthat myoumhavembeenmhospitalized monmseveralmoccasion
s.mWould myoumtellmmemmoremabout mthat?
d.
Mr.mY.,mI mjust mneed mtomget msomemadditionalminformationmabout myourmpast mhospitalization
s.mWhenmwasmthemlast mtimemyoumweremadmitted mformchest mpain?
ANS:mD
Themnursemshould musemdirect mquestionsmaftermthempersonsmopeningmnarrativemtomfillminmanymdetailsm
hemormshemleft mout.mThemnursemalsomshould musemdirect mquestionsmwhenmspecificmfactsmaremneeded,ms
uchmasmwhenmaskingmabout mpast mhealthmproblemsmormduringmthemreview mof msystems.
9. Inmusingmverbalmresponsesmtomassist mthempatientsmnarrative,msomemresponses mfocusmon mthempatie
ntsmframemof mreferencemand msomemfocusmonmthemhealthmcaremprovidersmperspective.mAnmexamplem
of mamverbalmresponsemthat mfocusesmonmthemhealthmcaremprovidersmperspectivemwould mbe:
a. Empathy.
b. Reflection.
c. Facilitation.
d. Confrontation.
mANS:mD
Whenmthemhealthmcaremprovidermusesmthemresponsemof mconfrontation,mthemframemof mreferencemshifts
mfrommthempatientsmperspectivemtomthemperspectivemof mthemhealthmcaremprovider,mand mthemhealthmcar
emprovidermstartsmtomexpressmhismormhermownmthoughtsmand mfeelings.mEmpathy,mreflection,mand mfac
ilitationmresponsesmfocusmonmthempatientsmframemof mreference.
10. Whenmtakingmamhistorymfrommamnewlymadmitted mpatient,mthemnursemnoticesmthat mhemoftenmpau
sesmand mexpectantlymlooksmat mthemnurse.mWhat mwould mbemthemnursesmbest mresponsemtomthismbeha
vior?
a. Bemsilent,mand mallow mhimmtomcontinuemwhenmhemismread
y.mb.
Smilemat mhimmand msay,mDont mworrymabout mallmof mthis.mImmsuremwemcanmfind mout mwhy
myouremhavingmthesempains.
c.mLeanmbackminmthemchairmand mask,mYoumaremlookingmat mmemkind mof mfunny;mtheremisnt manythingmwro
ng,mishere
d.
Stand mupmand msay,mI mcanmseemthat mthisminterview mismuncomfortablemformyou.m
Wemcanmcontinuemit manothermtime.
ANS:mA
Silent mattentivenessmcommunicatesmthat mthempersonmhasmtimemtomthinkmand mtomorganizemwhat mhemo
rmshemwishesmtomsaymwithout manminterruptionmfrommthemnurse.mHealthmprofessionalsmmost moftenmi
nterrupt mthismthinkingmsilence.mThemothermresponsesmaremnot mconducivemtomidealmcommunication.
ST mBANK
Advanced Health Assessment and Diagnostic Reasoning 3
m m m m m m
rd edition Rhoads
m m
TEST BANK
m
Chapterm1mInterview mand mHistorymTakingmStrategies
MULTIPLEmCHOI CE
1. Themnursemismconductingmanminterview mwithmamwomanmwhomhasmrecentlymlearned mthat mshemismp
regnant mand mwhomhasmcomemtomthemclinicmtodaymtombeginmprenatalmcare.mThemwomanmstatesmthat ms
hemand mhermhusband maremexcited mabout mthempregnancymbut mhavemamfew mquestions.mShemlooksmnerv
ouslymat mhermhandsmduringmtheminterview mand msighsmloudly.mConsideringmthemconcept mof mcommu
nication,mwhichmstatement mdoesmthemnursemknow mtombemmost maccurate?mThemwomanmis:
a. Excited mabout mhermpregnancymbut mnervousmabout mthemlabor.
b. Exhibitingmverbalmand mnonverbalmbehaviorsmthat mdomnot mmatch.
c. Excited mabout mhermpregnancy,mbut mhermhusband mismnot mand mthismismupsettingmtomh
er.md.
Not mexcited mabout mhermpregnancymbut mbelievesmthemnursemwillmnegativelymresp
ond mtomhermif mshemstatesmthis.
ANS:mB
Communicationmismallmbehaviors,mconscious mand munconscious, mverbalmand mnonverbal.mAllmbehavio
rsmhavemmeaning.mHermbehaviormdoesmnot mimplymthat mshemismnervousmabout mlabor,mupset mbymhermh
usband,mormworried mabout mthemnursesmresponse.
2. Receivingmismampart mof mthemcommunicationmprocess. mWhichm receivermis mmost mlikelym
tommisinterpret mammessagemsent mbymamhealthmcaremprofessional?
a. Well-adjusted madolescent mwhomcameminmformamsportsmphysical
b. Recoveringmalcoholicmwhomcamemin mformambasicmphysicalmexamination
c. Manmwhosemwifemhasmjust mbeenmdiagnosed mwithmlungmcanc
ermd.
Manmwithmamhearingmimpairment mwhomusesmsignmlanguagemtomcommunicatemand mwhomhasmanminter
pretermwithmhim
ANS:mC
Themreceivermattachesmmeaningmdetermined mbymhismormhermexperiences, mculture, mself-
concept,mand mcurrent mphysicalmand memotionalmstates.mThemmanmwhosemwifemhasmjust mbeenmdiagnos
ed mwithmlungmcancermmaymbemexperiencingmemotionsmthat maffect mhismreceiving.
3. Themnursemmakesmwhichmadjustment minmthemphysicalmenvironment mtompromotemthemsuccessmof m
anminterview?
a. Reducesmnoisembymturningmoff mtelevisionsmand mradios
b. Reducesmthemdistancembetweenmtheminterviewermand mthempatient mtom2mfeet mormless
c. Providesmamdimmlight mthat mmakesmthemroommcozymand mhelpsmthempatient mrelax
d. Arrangesmseatingmacrossmamdeskmormtablemtomallow mthempatient msomempersonalmspa
cemANS:mA
Themnursemshould mreducemnoisembymturningmoff mthemtelevision,mradio,mand mothermunnecessarymequi
pment,mbecausemmultiplemstimulimaremconfusing.m Them interviewerm and mpatient mshould mbemapproxi
matelym4mtom5mfeet mapart;mthemroommshould mbemwell-
lit,menablingmtheminterviewermand mpatient mtomseemeachmothermclearly.mHavingmamtablemor mdeskminmbe
tweenmthemtwompeoplemcreatesmthemideamof mambarrier;mequal-statusmseating,mat meyemlevel,mismbetter.
,4. Inmanminterview,mthemnursemmaymfind mit mnecessarymtomtakemnotesmtomaid mhismormhermmemorymla
ter.mWhichmstatement mismtrueregardingmnote-taking?
a. Note-
takingmmaymimpedemthemnursesmobservationmof mthempatientsmnonverbalmbehaviors. mb.
Note-
takingmallowsmthempatient mtomcontinuemat mhismormhermownmpacemasmthemnursemre
cordsmwhat mismsaid.
c.
Note-
takingmallowsmthemnursemtomshift mattentionmawaymfrommthempatient,mresultingminma
nmincreased mcomfort mlevel.
d.
Note-
takingmallowsmthemnursemtombreakmeye mcontact mwithmthempatient,mwhichmmaym incr
easemhismormhermlevelmof mcomfort.
ANS:mA
Themusemof mhistorymforms mand mnote-
takingmmaymbemunavoidable.mHowever,mthemnurse mmust mbemawaremthat mnote-
takingmduringmtheminterview mhasmdisadvantages.mIt mbreaksmeyemcontact mtoomoftenmand mshiftsmthematt
entionmawaymfrommthempatient,mwhichmdiminishesmhismormhermsensemof mimportance.mNotetakingmma
ymalsominterrupt mthempatientsmnarrativemflow,mand mit mimpedesmthemobservationmof mthe
patientsmnonverbalmbehavior.
5. Themnursemasks,mI mwould mlikemtomaskmyoumsomemquestionsmabout myourmhealthmand myourmusualmd
ailymactivitiesmsomthat mwemcanmbettermplanmyourmstaymhere.mThismquestionmis mfound mat mthem
mphasemof mtheminterview mprocess.
a. Summary
b. Closing
c. Body
d. Openingmormintroductio
nmANS:mD
Whenmgatheringmamcompletemhistory,mthemnursemshould mgivemthemreasonmformtheminterview mduringmt
hemopeningmormintroductionmphasemof mtheminterview,mnot mduringmormat mthemend mof mtheminterview.
6. A mwomanmhasmjust mentered mthememergencymdepartment maftermbeingmbattered mbymhermhusband.mT
hemnursemneedsmtomget msomeminformationmfrommhermtombeginmtreatment.mWhat mismthembest mchoicem
formanmopeningmphasemof mtheminterview mwithmthismpatient?
a. Hello,mNancy,mmymnamemismMrs.mC.
b. Hello,mMrs.mH.,mmymnamemismMrs.mC.mIt msuremismcold mtoday!
c. Mrs.mH.,mmymnamemismMrs.mC.mHow maremyou?
d. Mrs.mH.,mmymnamemismMrs.mC.mIllmneed mtomaskmyoumamfew mquestionsmabout mwhat mhappen
ed.mANS:mD
Addressmthempersonmbymusingmhismormhermsurname.mThemnursemshould mintroducemhimmormherself man
d mgivemthemreasonmformtheminterview.mFriendlymsmallmtalkmismnot mneeded mtombuild mrapport.
7. Duringmanminterview,mthemnursemstates,mYoummentioned mhavingmshortness mof mbreath.mTellm
memmoremabout mthat.mWhichmverbalmskillmismused mwithmthismstatement?
a. Reflection
b. Facilitation
c. Direct mquestion
d. Open-
ended mquestionmANS:m
,D
, Themopen-
ended mquestionmasksmformnarrativeminformation.mIt mstatesmthemtopicmtombemdiscussed mbut monlyminm
generalmterms.mThemnursemshould musemit mtombeginmtheminterview,mtomintroducemamnew msectionmof mq
uestions,mand mwhenevermthempersonmintroducesmamnew mtopic.
8. A mpatient mhasmfinished mgivingmthemnurseminformationmabout mthemreasonmhemismseekingmcare.mWh
enmreviewingmthemdata,mthemnursemfindsmthat msomeminformationmabout mpast mhospitalizationsmismmi
ssing.mAt mthismpoint,mwhichmstatement mbymthemnursemwould mbemmost mappropriatemtomgathermthesem
data?
a. Mr.mY.,mat myourmage,msurelymyoumhavembeenmhospitalized mbefore!
b. Mr.mY.,mI mjust mneed mpermissionmtomget myourmmedicalmrecordsmfrom mCountymMedic
al.mc.
Mr.mY.,myoummentioned mthat myoumhavembeenmhospitalized monmseveralmoccasion
s.mWould myoumtellmmemmoremabout mthat?
d.
Mr.mY.,mI mjust mneed mtomget msomemadditionalminformationmabout myourmpast mhospitalization
s.mWhenmwasmthemlast mtimemyoumweremadmitted mformchest mpain?
ANS:mD
Themnursemshould musemdirect mquestionsmaftermthempersonsmopeningmnarrativemtomfillminmanymdetailsm
hemormshemleft mout.mThemnursemalsomshould musemdirect mquestionsmwhenmspecificmfactsmaremneeded,ms
uchmasmwhenmaskingmabout mpast mhealthmproblemsmormduringmthemreview mof msystems.
9. Inmusingmverbalmresponsesmtomassist mthempatientsmnarrative,msomemresponses mfocusmon mthempatie
ntsmframemof mreferencemand msomemfocusmonmthemhealthmcaremprovidersmperspective.mAnmexamplem
of mamverbalmresponsemthat mfocusesmonmthemhealthmcaremprovidersmperspectivemwould mbe:
a. Empathy.
b. Reflection.
c. Facilitation.
d. Confrontation.
mANS:mD
Whenmthemhealthmcaremprovidermusesmthemresponsemof mconfrontation,mthemframemof mreferencemshifts
mfrommthempatientsmperspectivemtomthemperspectivemof mthemhealthmcaremprovider,mand mthemhealthmcar
emprovidermstartsmtomexpressmhismormhermownmthoughtsmand mfeelings.mEmpathy,mreflection,mand mfac
ilitationmresponsesmfocusmonmthempatientsmframemof mreference.
10. Whenmtakingmamhistorymfrommamnewlymadmitted mpatient,mthemnursemnoticesmthat mhemoftenmpau
sesmand mexpectantlymlooksmat mthemnurse.mWhat mwould mbemthemnursesmbest mresponsemtomthismbeha
vior?
a. Bemsilent,mand mallow mhimmtomcontinuemwhenmhemismread
y.mb.
Smilemat mhimmand msay,mDont mworrymabout mallmof mthis.mImmsuremwemcanmfind mout mwhy
myouremhavingmthesempains.
c.mLeanmbackminmthemchairmand mask,mYoumaremlookingmat mmemkind mof mfunny;mtheremisnt manythingmwro
ng,mishere
d.
Stand mupmand msay,mI mcanmseemthat mthisminterview mismuncomfortablemformyou.m
Wemcanmcontinuemit manothermtime.
ANS:mA
Silent mattentivenessmcommunicatesmthat mthempersonmhasmtimemtomthinkmand mtomorganizemwhat mhemo
rmshemwishesmtomsaymwithout manminterruptionmfrommthemnurse.mHealthmprofessionalsmmost moftenmi
nterrupt mthismthinkingmsilence.mThemothermresponsesmaremnot mconducivemtomidealmcommunication.
