,✅ Test Bank – Chapter 1: The Patient Interview
Themes: Patient-centered communication, respiratory symptom
assessment (cough, dyspnea, chest pain), occupational/smoking history,
therapeutic interviewing techniques.
1. A 54-year-old patient arrives for a follow-up visit and begins
describing a new, unrelated concern. What is the most appropriate
patient-centered response?
A. "Let's first finish reviewing your lab results before addressing new
concerns."
B. "We'll have to reschedule to discuss that issue in a different visit."
C. "Tell me more about this new concern. We’ll figure out how to
prioritize everything."
D. "You should have mentioned that earlier so we could prepare."
✅ Correct Answer: C
Rationale: This reflects flexibility and patient-centered care. It allows
prioritization and shared decision-making, essential during respiratory
follow-ups where new symptoms may indicate disease progression or a
separate pathology.
2. Which of the following techniques best promotes accurate history-
taking in a dyspneic patient with limited breath support?
A. Use of rapid-fire questioning
B. Open-ended questions without interruption
C. Use of short, focused questions with pauses
D. Avoiding questions until symptoms improve
✅ Correct Answer: C
Rationale: Dyspneic patients may not tolerate long verbal exchanges.
,Short, directed questions with adequate pauses allow meaningful
history-taking while minimizing respiratory effort.
3. A patient describes a productive cough for 3 months each year for
the past 2 years. Which diagnostic label is most supported?
A. Recurrent pneumonia
B. Emphysema
C. Chronic bronchitis
D. Asthma
✅ Correct Answer: C
Rationale: Chronic bronchitis is defined clinically by a productive
cough lasting ≥3 months for at least 2 consecutive years. History-taking
is essential for this diagnosis.
4. A patient reports dyspnea only when climbing stairs. What is the
best follow-up question to assess severity?
A. "Is it worse in the morning or at night?"
B. "Can you still walk on level ground without shortness of breath?"
C. "Do you smoke?"
D. "Have you ever fainted with it?"
✅ Correct Answer: B
Rationale: Functional limitation helps quantify dyspnea severity. This
question determines if the dyspnea is exertional or progressing to
everyday activities, key in staging conditions like heart failure or COPD.
5. In evaluating chronic cough, which historical question most
directly screens for gastroesophageal reflux-related etiology?
A. "Do you smoke or live with smokers?"
, B. "Do you wake up with heartburn or a sour taste?"
C. "Do you have sinus problems or postnasal drip?"
D. "Do you use a humidifier?"
✅ Correct Answer: B
Rationale: GERD-related cough may occur at night or upon awakening,
often with sour taste or heartburn. Identifying triggers is essential in
tailoring therapy.
6. Which question most directly identifies occupational exposure as
a risk for chronic respiratory disease?
A. "Do you work full-time?"
B. "What do you do for a living and how long have you done it?"
C. "Have you been around smokers at work?"
D. "What is your education level?"
✅ Correct Answer: B
Rationale: Asking about occupation and duration directly screens for
exposure to dusts, fumes, asbestos, or chemicals, all relevant to diseases
like pneumoconiosis or asthma.
7. A patient reports sudden-onset dyspnea. What historical feature
most urgently points toward pulmonary embolism?
A. History of asthma
B. Use of beta-blockers
C. Recent immobilization or surgery
D. Wheezing on previous exams
✅ Correct Answer: C
Rationale: Recent immobility, surgery, or trauma strongly suggests
thromboembolic risk. Acute dyspnea in this context warrants high
suspicion for PE.
Themes: Patient-centered communication, respiratory symptom
assessment (cough, dyspnea, chest pain), occupational/smoking history,
therapeutic interviewing techniques.
1. A 54-year-old patient arrives for a follow-up visit and begins
describing a new, unrelated concern. What is the most appropriate
patient-centered response?
A. "Let's first finish reviewing your lab results before addressing new
concerns."
B. "We'll have to reschedule to discuss that issue in a different visit."
C. "Tell me more about this new concern. We’ll figure out how to
prioritize everything."
D. "You should have mentioned that earlier so we could prepare."
✅ Correct Answer: C
Rationale: This reflects flexibility and patient-centered care. It allows
prioritization and shared decision-making, essential during respiratory
follow-ups where new symptoms may indicate disease progression or a
separate pathology.
2. Which of the following techniques best promotes accurate history-
taking in a dyspneic patient with limited breath support?
A. Use of rapid-fire questioning
B. Open-ended questions without interruption
C. Use of short, focused questions with pauses
D. Avoiding questions until symptoms improve
✅ Correct Answer: C
Rationale: Dyspneic patients may not tolerate long verbal exchanges.
,Short, directed questions with adequate pauses allow meaningful
history-taking while minimizing respiratory effort.
3. A patient describes a productive cough for 3 months each year for
the past 2 years. Which diagnostic label is most supported?
A. Recurrent pneumonia
B. Emphysema
C. Chronic bronchitis
D. Asthma
✅ Correct Answer: C
Rationale: Chronic bronchitis is defined clinically by a productive
cough lasting ≥3 months for at least 2 consecutive years. History-taking
is essential for this diagnosis.
4. A patient reports dyspnea only when climbing stairs. What is the
best follow-up question to assess severity?
A. "Is it worse in the morning or at night?"
B. "Can you still walk on level ground without shortness of breath?"
C. "Do you smoke?"
D. "Have you ever fainted with it?"
✅ Correct Answer: B
Rationale: Functional limitation helps quantify dyspnea severity. This
question determines if the dyspnea is exertional or progressing to
everyday activities, key in staging conditions like heart failure or COPD.
5. In evaluating chronic cough, which historical question most
directly screens for gastroesophageal reflux-related etiology?
A. "Do you smoke or live with smokers?"
, B. "Do you wake up with heartburn or a sour taste?"
C. "Do you have sinus problems or postnasal drip?"
D. "Do you use a humidifier?"
✅ Correct Answer: B
Rationale: GERD-related cough may occur at night or upon awakening,
often with sour taste or heartburn. Identifying triggers is essential in
tailoring therapy.
6. Which question most directly identifies occupational exposure as
a risk for chronic respiratory disease?
A. "Do you work full-time?"
B. "What do you do for a living and how long have you done it?"
C. "Have you been around smokers at work?"
D. "What is your education level?"
✅ Correct Answer: B
Rationale: Asking about occupation and duration directly screens for
exposure to dusts, fumes, asbestos, or chemicals, all relevant to diseases
like pneumoconiosis or asthma.
7. A patient reports sudden-onset dyspnea. What historical feature
most urgently points toward pulmonary embolism?
A. History of asthma
B. Use of beta-blockers
C. Recent immobilization or surgery
D. Wheezing on previous exams
✅ Correct Answer: C
Rationale: Recent immobility, surgery, or trauma strongly suggests
thromboembolic risk. Acute dyspnea in this context warrants high
suspicion for PE.
