Chapter 01: The History and Interviewing Process
Ball: Seidel’s Guide to Physical Examination, 9th Edition
MULTIPLE CHOICE
1. 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.
DIF: Cognitive Level: Applying (Application)
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
2. When are open-ended questions generally most useful?
a. During sensitive area 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 during the sensitive part of the interview allows you to gather more
information and establishes you
as an empathic listener, which is the first step of effective communication. Asking closed-ended
questions may stifle the patient’s
desire to discuss the history of the illness. 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.
DIF: Cognitive Level: Understanding (Comprehension)
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
3. Periods of silence during the interview can serve important purposes, such as:
a. allowing the clinician to catch up on documentation.
b. promoting calm.
c. providing time for reflection.
d. increasing the length of the visit.
ANS: C
Silence is a useful tool during interviews for the purposes of reflection, summoning courage, and
displaying compassion. This is
, not a time to document in the chart, but rather to focus on the patient. Periods of silence may
cause anxiety rather than promote
calm. The length of the visit is less important than getting critical information.
DIF: Cognitive Level: Understanding (Comprehension)
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
4. Mr. Franklin is speaking with you, the healthcare provider, about his respiratory problem. Mr.
Franklin says, “I’ve had this cough
for 3 days, and it’s getting worse.” You reply, “Tell me more about your cough.” Mr. Franklin
states, “I wish I could tell you more.
That’s why I’m here. You tell me what’s wrong!” Which caregiver response would be most
appropriate for enhancing
communication?
a. “After 3 days, you’re tired of coughing. Have you had a fever?”
b. “I’d like to hear more about your experiences. Where were you born?”
c. “I don’t know what’s wrong. You could have almost any disease.”
d. “I’ll examine you and figure out later what the problem is.”
ANS: A
“After 3 days, you’re tired of coughing. Have you had a fever?” is the only response aimed at
focusing on the chief compliant to
gather more data and does not digress from the issue.
DIF: Cognitive Level: Analyzing (Analysis)
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
5. After you ask a patient about her family history, she says, “Tell me about your family now.”
Which response is generally most
appropriate?
a. Ignore the patient’s comment and continue with the interview.
b. Give a brief, undetailed answer.
c. Ask the patient why she needs to know.
d. Tell the patient that you do not discuss your family with patients.
ANS: B
Giving a brief, undetailed answer will satisfy the patient’s curiosity about yourself without
invading your private life. Ignoring the
patient’s comment, continuing with the interview, and telling the patient that you do not discuss
your family with patients will
potentially anger or frustrate her and keep her from sharing openly. Asking the patient why she
needs to know will distract from the
real reason she is seeking care and instead move the interview conversation away from the topics
that should be discussed.
DIF: Cognitive Level: Applying (Application)
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
6. A 36-year-old woman complains that she has had crushing chest pain for the past 2 days. She
seems nervous as she speaks to you.
An appropriate response is to:
Ball: Seidel’s Guide to Physical Examination, 9th Edition
MULTIPLE CHOICE
1. 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.
DIF: Cognitive Level: Applying (Application)
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
2. When are open-ended questions generally most useful?
a. During sensitive area 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 during the sensitive part of the interview allows you to gather more
information and establishes you
as an empathic listener, which is the first step of effective communication. Asking closed-ended
questions may stifle the patient’s
desire to discuss the history of the illness. 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.
DIF: Cognitive Level: Understanding (Comprehension)
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
3. Periods of silence during the interview can serve important purposes, such as:
a. allowing the clinician to catch up on documentation.
b. promoting calm.
c. providing time for reflection.
d. increasing the length of the visit.
ANS: C
Silence is a useful tool during interviews for the purposes of reflection, summoning courage, and
displaying compassion. This is
, not a time to document in the chart, but rather to focus on the patient. Periods of silence may
cause anxiety rather than promote
calm. The length of the visit is less important than getting critical information.
DIF: Cognitive Level: Understanding (Comprehension)
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
4. Mr. Franklin is speaking with you, the healthcare provider, about his respiratory problem. Mr.
Franklin says, “I’ve had this cough
for 3 days, and it’s getting worse.” You reply, “Tell me more about your cough.” Mr. Franklin
states, “I wish I could tell you more.
That’s why I’m here. You tell me what’s wrong!” Which caregiver response would be most
appropriate for enhancing
communication?
a. “After 3 days, you’re tired of coughing. Have you had a fever?”
b. “I’d like to hear more about your experiences. Where were you born?”
c. “I don’t know what’s wrong. You could have almost any disease.”
d. “I’ll examine you and figure out later what the problem is.”
ANS: A
“After 3 days, you’re tired of coughing. Have you had a fever?” is the only response aimed at
focusing on the chief compliant to
gather more data and does not digress from the issue.
DIF: Cognitive Level: Analyzing (Analysis)
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
5. After you ask a patient about her family history, she says, “Tell me about your family now.”
Which response is generally most
appropriate?
a. Ignore the patient’s comment and continue with the interview.
b. Give a brief, undetailed answer.
c. Ask the patient why she needs to know.
d. Tell the patient that you do not discuss your family with patients.
ANS: B
Giving a brief, undetailed answer will satisfy the patient’s curiosity about yourself without
invading your private life. Ignoring the
patient’s comment, continuing with the interview, and telling the patient that you do not discuss
your family with patients will
potentially anger or frustrate her and keep her from sharing openly. Asking the patient why she
needs to know will distract from the
real reason she is seeking care and instead move the interview conversation away from the topics
that should be discussed.
DIF: Cognitive Level: Applying (Application)
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
6. A 36-year-old woman complains that she has had crushing chest pain for the past 2 days. She
seems nervous as she speaks to you.
An appropriate response is to:
