b b b b b b
Ball: Seidel’s Guide to Physical Examination, 9th Edition
b b b b b b b
MULTIPLEbCHOICE
1. Whichbquestionbwouldbbebconsideredbab“leadingbquestion?”
a. “Whatbdobyoubthinkbisbcausingbyourbheadaches?”
b. “Youbdon’tbgetbheadachesboften,bdobyou?”
c. “Onbabscalebofb1btob10,bhowbwouldbyoubratebthebseveritybofbyourbheadaches?”
d. “Atbwhatbtimebofbthebdaybarebyourbheadachesbthebmostbsevere?”
ANS:b B
Statingbtobthebpatientbthatbheborbshebdoesbnotbgetbheadachesbwouldblimitbthebinformationbinbthebp
atient’sbanswer.bAskingbthebpatientbwhatbheborbshebthinksbisbcausingbthebheadachesbisbanbopen-
endedbquestion.bAskingbthebpatientbhowbheborbshebwouldbratebthebseveritybofbthebheadachesband
baskingbwhatbtimebofbthebdaybthebheadachesbarebthebmostbseverebarebdirectbquestions.
DIF: CognitivebLevel:bApplyingb(Application)
OBJ:b b Nursingbprocess—assessment MSC:b PhysiologicbIntegrity:bPhysiologicbAdaptation
2. Whenbarebopen-endedbquestionsbgenerallybmostbuseful?
a. Duringbsensitivebareabpartbofbthebinterview
b. Afterbseveralbclosed-endedbquestionsbhavebbeenbasked
c. Whilebdesigningbthebgenogram
d. Duringbthebreviewbofbsyst ems
N RIGbB.CbM
USNT O
b
b b b
ANS:b A
Askingbopen-
endedbquestionsbduringbthebsensitivebpartbofbthebinterviewballowsbyoubtobgatherbmorebinformati
onbandbestablishesbyoubasbanbempathicblistener,bwhichbisbthebfirstbstepbofbeffectivebcommunicati
on.bAskingbclosed-
endedbquestionsbmaybstiflebthebpatient’sbdesirebtobdiscussbthebhistorybofbthebillness.bInterviewin
gbforbthebpurposebofbdesigningbabgenogramborbconductingbabreviewbofbsystemsbrequiresbmorebfo
cusedbdatabthanbcanbbebmorebeasilybgatheredbwithbdirectbquestioning.
DIF: CognitivebLevel:bUnderstandingb(Comprehension)
OBJ:b b Nursingbprocess—assessment MSC:b PhysiologicbIntegrity:bPhysiologicbAdaptation
3. Periodsbofbsilencebduringbthebinterviewbcanbservebimportantbpurposes,bsuchbas:
a. allowingbthebclinicianbtobcatchbupbonbdocumentation.
b. promotingbcalm.
c. providingbtimebforbreflection.
d. increasingbtheblengthbofbthebvisit.
ANS:b C
Silencebisbabusefulbtoolbduringbinterviewsbforbthebpurposesbofbreflection,bsummoningbcourage,ba
ndbdisplayingbcompassion.bThisbisbnotbabtimebtobdocumentbinbthebchart,bbutbratherbtobfocusbonbth
ebpatient.bPeriodsbofbsilencebmaybcausebanxietybratherbthanbpromotebcalm.bTheblengthbofbthebvis
itbisblessbimportantbthanbgettingbcriticalbinformation.
, DIF: CognitivebLevel:bUnderstandingb(Comprehension)
OBJ:b b Nursingbprocess—assessment MSC:b PhysiologicbIntegrity:bPhysiologicbAdaptation
4. Mr.bFranklinbisbspeakingbwithbyou,bthebhealthcarebprovider,baboutbhisbrespiratorybproblem.bMr.
Franklinbsays,b“I’vebhadbthisbcoughbforb3bdays,bandbit’sbgettingbworse.”bYoubreply,b“Tellbmeb
morebaboutbyourbcough.”bMr.bFranklinbstates,b“IbwishbIbcouldbtellbyoubmore.bThat’sbwhybI’mbh
ere.bYoubtellbmebwhat’sbwrong!”bWhichbcaregiverbresponsebwouldbbebmostbappropriatebforben
hancingbcommunication?
a. “Afterb3bdays,byou’rebtiredbofbcoughing.bHavebyoubhadbabfever?”
b. “I’dblikebtobhearbmorebaboutbyourbexperiences.bWherebwerebyoubborn?”
c. “Ibdon’tbknowbwhat’sbwrong.bYoubcouldbhavebalmostbanybdisease.”
d. “I’llbexaminebyoubandbfigureboutblaterbwhatbthebproblembis.”
ANS:b A
“Afterb3bdays,byou’rebtiredbofbcoughing.bHavebyoubhadbabfever?”bisbthebonlybresponsebaimedbat
focusingbonbthebchiefbcompliantbtobgatherbmorebdatabandbdoesbnotbdigressbfrombthebissue.
DIF: CognitivebLevel:bAnalyzingb(Analysis)
OBJ:b b Nursingbprocess—assessment MSC:b PhysiologicbIntegrity:bPhysiologicbAdaptation
5. Afterbyoubaskbabpatientbaboutbherbfamilybhistory,bshebsays,b“Tellbmebaboutbyourbfamilybnow.”
Whichbresponsebisbgenerallybmostbappropriate?
a. Ignorebthebpatient’sbcommentbandbcontinuebwithbthebinterview.
b. Givebabbrief,bundetailedbanswer.
c. Askbthebpatientbwhybshebneedsbtobknow.
d. Tellbthebpatientbthatbyoubdobnotbdiscussbyourbfamilybwithbpatients.
ANS:b B NURSINGTB.COM
Givingbabbrief,bundetailedbanswerbwillbsatisfybthebpatient’sbcuriositybaboutbyourselfbwithoutbinvadi
ngbyourbprivateblife.bIgnoringbthebpatient’sbcomment,bcontinuingbwithbthebinterview,bandbtellingbth
ebpatientbthatbyoubdobnotbdiscussbyourbfamilybwithbpatientsbwillbpotentiallybangerborbfrustratebherba
ndbkeepbherbfrombsharingbopenly.bAskingbthebpatientbwhybshebneedsbtobknowbwillbdistractbfrombtheb
realbreasonbshebisbseekingbcarebandbinsteadbmovebthebinterviewbconversationbawaybfrombthebtopicsb
thatbshouldbbebdiscussed.
DIF: CognitivebLevel:bApplyingb(Application)
OBJ:b b Nursingbprocess—assessment MSC:b PhysiologicbIntegrity:bPhysiologicbAdaptation
6. Ab36-year-
oldbwomanbcomplainsbthatbshebhasbhadbcrushingbchestbpainbforbthebpastb2bdays.bShebseemsbnervo
usbasbshebspeaksbtobyou.bAnbappropriatebresponsebisbto:
a. continuebtobcollectbinformationbregardingbthebchiefbcomplaintbinbanbunhurriedb
manner.
b. finishbthebinterviewbasbrapidlybasbpossible.
c. askbthebpatientbtobtakebabdeepbbreathbandbcalmbdown.
d. askbthebpatientbifbshebwantsbtobwaitbuntilbanotherbdaybtobtalkbtobyou.
ANS:b A
, Withbanbanxious,bvulnerablebpatient,bitbisbbestbtobnotbhurry;babcalmbdemeanorbwillbcommunicatebc
aringbtobthebpatient.bIfbyoubasbabhealthcarebproviderbarebhurried,bthebpatientbwillbbebmorebanxious.
bThebbestbwaybtobassistbanbanxiousbpatientbisbtobnotbhurrybandbremainbcalm,bbecausebthisbwillbcom
municatebcaringbtobthebpatient.bAskingbthebpatientbifbshebwantsbtobwaitbuntilbanotherbdaybtobtalkbt
obyoubdelaysbthebneededbhealthbcare.
DIF: CognitivebLevel:bApplyingb(Application)
OBJ:b b Nursingbprocess—assessment MSC:b PhysiologicbIntegrity:bPhysiologicbAdaptation
7. Ms.bAbstates,b“Myblifebisbjustbtoobpainful.bItbisn’tbworthbit.”bShebappearsbdepressed.bWhichbone
ofbthebfollowingbstatementsbisbthebmostbappropriatebcaregiverbresponse?
a. “Trybtobthinkbaboutbthebgoodbthingsbinblife.”
b. “Whatbinblifebisbcausingbyoubsuchbpain?”
c. “Youbcan’tbmeanbwhatbyou’rebsaying.”
d. “Ifbyoubthinkbaboutbit,bnothingbisbworthbgettingbthisbupsetbabout.”
ANS:b B
Specificbbutbopen-endedbquestionsbarebbestbusedbwhenbthebpatientbhasbfeelingsbofblossbof
self-
worthbandbdepression.b“Trybtobthinkbaboutbthebgoodbthingsbinblife,”b“Youbcan’tbmeanbwhatbyou’r
ebsaying,”bandb“Ifbyoubthinkbaboutbit,bnothingbisbworthbgettingbthisbupsetbabout”barebstatementsbt
hatbwillbhurrybthebpatientbandbofferbonlybsuperficialbassurance.
DIF: CognitivebLevel:bAnalyzingb(Analysis)
OBJ:b b Nursingbprocess—assessment MSC:b PhysiologicbIntegrity:bPhysiologicbAdaptation
8. Youbarebcollectingbabhistorybfrombab16-year-
oldbgirl.bHerbmotherbisbsittingbnextbtobherbinbthebexaminationbroom.bWhenbcollectingbhistorybf
rombolderbchildrenborbadolescents,btheybshould
be: NURSINGTB.COM
a. givenbthebopportunitybtobbebinterviewedbwithoutbthebparentbatbsomebpointbduringbthebi
nterview.
b. mailedbabquestionnairebinbadvancebtobavoidbthebneedbforbthembtobtalk.
c. ignoredbwhilebyoubaddressballbquestionsbtobthebparent.
d. allowedbtobdirectbthebflowbofbthebinterview.
ANS:b A
Thebadolescentbshouldbbebgivenbthebopportunitybtobgivebinformationbdirectly.bThisbenhancesbtheb
probabilitybthatbthebadolescentbwillbfollowbyourbadvice.bMailingbabquestionnairebinbadvancebtoba
voidbthebneedbforbherbtobtalkbdoesbnotbassistbthebadolescentbinblearningbtobrespondbtobanswersbreg
ardingbherbhealth.bThebparentbcanbhelpbfillbinbgapsbatbthebend.bIfbshebisbignoredbwhilebyoubaddress
ballbquestionsbtobthebparent,bthebpatientbwillbfeelbasbthoughbshebisbjustbbeingbdiscussedbandbisbnotb
partbofbthebprocessbforbthebhealthbcare.bThebhealthcarebproviderbshould
alwaysbdirectbthebflowbofbthebinterviewbaccordingbtobthebpatient’sbresponses.
DIF: CognitivebLevel:bApplyingb(Application)
OBJ:b b Nursingbprocess—assessment MSC:b PhysiologicbIntegrity:bPhysiologicbAdaptation
9. Informationbthatbisbneededbduringbthebinitialbinterviewbofbabpregnantbwomanbincludesballbthebf
ollowingbexcept:
a. thebgenderbthatbthebwomanbhopesbthebbabybwillbbe.
b. pastbmedicalbhistory.
c. healthcarebpractices.
, d. thebwoman’sbrememberingb(knowledge)baboutbpregnancy.
ANS:b A
Thebinitialbinterviewbforbthebpregnantbwomanbshouldbincludebinformationbaboutbherbpastbmedical
bhistory,bassessmentbofbhealthbpractices,bidentificationbofbpotentialbriskbfactors,bandbassessmentbo
fbrememberingb(knowledge)basbitbaffectsbthebpregnancy.bThebgenderbofbthebfetusbisbnotbasbimporta
ntbasbthebinformationbaboutbherbpastbmedicalbhistory,bhealthcarebpractices,band
thebwoman’sbrememberingb(knowledge)baboutbherbpregnancy.
DIF: CognitivebLevel:bUnderstandingb(Comprehension)
OBJ:b b Nursingbprocess—assessment MSC:b PhysiologicbIntegrity:bPhysiologicbAdaptation
10. Whenbinterviewingbolderbadults,bthebexaminerbshould:
a. speakbextremelybloudly,bbecausebmostbolderbadultsbhavebsignificantbhearingbi
mpairment.
b. providebabwrittenbquestionnairebinbplacebofbanbinterview.
c. positionbhimselfborbherselfbfacingbthebpatient.
d. dimbtheblightsbtobdecreasebanxiety.
ANS:b C
Thebhealthcarebproviderbshouldbpositionbhimselfborbherselfbsobthatbthebolderbpatientbcanbseebhisbor
bherbface.bShoutingbdistortsbspeech,bdimmingbtheblightsbimpairsbvision,bandbabwrittenbinterviewb
maybbebnecessarybifballbelsebfails.
DIF: CognitivebLevel:bUnderstandingb(Comprehension)
OBJ:b b Nursingbprocess—assessment MSC:b PhysiologicbIntegrity:bPhysiologicbAdaptation
11. Tobwhatbextentbshouldbthebp aN
t i e nR
t bw iI
t h baGphyBsi.
caClbdiM
sability borbemotionalbdisorderbbebinvolvedbi
UbSbNbTbtobthebhealthObprofessional?
nbprovidingbhealthbhistorybinformation
a. Thebpatientbshouldbbebpresentbduringbinformationbcollectionbbutbshouldbnotbbeba
ddressedbdirectly.
b. Allbinformationbshouldbbebcollectedbfrombpastbrecordsbandbfamilybmembersbwhilebt
hebpatientbisbinbanotherbroom.
c. Thebpatientbshouldbbebinvolvedbonlybwhenbyoubsensebthatbheborbshebmaybfeelbi
gnored.
d. Thebpatientbshouldbbebfullybinvolvedbtobtheblimitbofbhisborbherbability.
ANS:b D
Patientsbwhobarebdisabledbmaybnotbgivebanbeffectivebhistory,bbutbtheybmustbbebrespected,bandbth
ebhistorybmustbbebobtainedbfrombthembtobthebgreatestbextentbpossible.bPatientsbshouldbbebaddres
sedbdirectlybandbparticipatebinbthebinterviewbtobthebextentbofbtheirbability.
DIF: CognitivebLevel:bUnderstandingb(Comprehension)
OBJ:b b Nursingbprocess—assessment MSC:b PhysiologicbIntegrity:bPhysiologicbAdaptation
12. Whenbtakingbabhistory,bthebnursebshould:
a. askbthebpatientbtobgivebyoubanybinformationbheborbshebcanbrecallbaboutbhisborbherbh
ealth.
b. startbthebinterviewbwithbthebpatient’sbfamilybhistory.
c. usebabchronologicbandbsequentialbframework.
d. usebabholisticbandbeclecticbstructure.