Chapter 03: The Interview
Jarvis: Physical Examination and Health Assessment, 8th Edition
MULTIPLE CHOICE
1. The nurse is conducting an interview with a woman who has recently learned that she is
pregnant and who has come to the clinic today to begin prenatal care. The woman states that
she and her husband are excited about the pregnancy but have a few questions. She looks
nervously at her hands during the interview and sighs loudly. Considering the concept of
communication, which statement does the nurse know to be most accurate when describing
this woman?
a.
Excited about her pregnancy but nervous about the labor
b.
Exhibiting verbal and nonverbal behaviors that do not match
c.
Excited about her pregnancy, but her husband is not and this is upsetting to her
d.
Not excited about her pregnancy but believes the nurse will negatively respond to
her if she states this
2. Receiving is a part of the communication process. Which receiver is most likely to
misinterpret a message sent by a health care professional?
a.
Well-adjusted adolescent who came in for a sports physical
b.
Recovering alcoholic who came in for a basic physical examination
c.
Man who came in with his wife who was just diagnosed with lung cancer
d.
Man with a hearing impairment who has an interpreter with him who came in for a
follow-up blood pressure check
3. Which adjustment in the physical environment should the nurse make to promote the success
of an interview?
a.
Arrange seating across a desk or table.
b.
Reduce noise by turning off televisions and radios.
c.
Reduce the distance between the interviewer and the patient to 2 feet or less.
d.
Provide dim lighting to make the room cozy and help the patient relax.
4. In an interview, the nurse may find it necessary to take notes to aid his or her memory later.
Which statement is true regarding note-taking?
a.
Note-taking may impede the nurse’s observation of the patient’s nonverbal
behaviors.
b.
Note-taking allows the patient to continue at his or her own pace as the nurse
records what is said.
c.
Note-taking allows the nurse to shift attention away from the patient, resulting in
an increased comfort level.
d.
Note-taking allows the nurse to break eye contact with the patient, which may
increase his or her level of comfort.
5. The nurse asks, “I would like to ask you some questions about your health and your usual
daily activities so that we can better plan your stay here.” Based on this question, the nurse is
at which phase of the interview process?
a.
Summary
b.
Closing
c.
Working
d.
Opening or introduction
6. A woman has just entered the emergency department after being battered by her husband. The
nurse needs to get some information from her to begin treatment. What is the best choice for
an opening phase of the interview with this patient?
a.
“Hello, Nancy, my name is Nurse C.”
b.
“Mrs. H., my name is Nurse C. How are you?”
c.
“Hello, Mrs. H., my name is Nurse C. It sure is cold today!”
d.
“Mrs. H., my name is Nurse C. I’ll need to ask you a few questions about what
happened.”
7. During an interview, the nurse states, “You mentioned having shortness of breath. Tell me
more about that.” Which verbal skill is used with this statement?
a.
Reflection
b.
Facilitation
c.
Direct question
d.
Open-ended question
8. A patient has finished giving the nurse information about the reason he is seeking care. When
reviewing the data, the nurse finds that some information about past hospitalizations is
missing. At this point, which statement by the nurse would be most appropriate to gather these
data?
a.
“Mr. Y., at your age, surely you have been hospitalized before!”
b.
“Mr. Y., I just need permission to get your medical records from County Medical.”
c.
“Mr. Y., you mentioned that you have been hospitalized on several occasions.
Would you tell me more about that?”
d.
“Mr. Y., I just need to get some additional information about your past
hospitalizations. When was the last time you were admitted for chest pain?”
9. In using verbal responses to assist the patient’s narrative, some responses focus on the
patient’s frame of reference and some focus on the health care provider’s perspective. Which
is an example of a verbal response that focuses on the health care provider’s perspective?
a.
Empathy
b.
Reflection
c.
Facilitation
d.
Confrontation
10. When taking a history from a newly admitted patient, the nurse notices that he often pauses
and expectantly looks at the nurse. What would be the nurse’s best response to this behavior?
a.
Lean forward slightly and making eye contact ask “Is there anything else?”
b.
Smile at him and say, “Don’t worry about all of this. I’m sure we can get to the
bottom of your symptoms.”
c.
Lean back in the chair and ask, “You are looking at me kind of funny; there isn’t
anything wrong, is there?”
d.
Stand up and say, “I can see that this interview is uncomfortable for you. We can
continue it another time.”
11. A woman is discussing the problems she is having with her 2-year-old son. She says, “He
won’t go to sleep at night, and during the day he has several fits. I get so upset when that
happens.” Which is the best response by the nurse to gain a better understanding of the
problem?
a.
“Go on, I’m listening.”
b.
“Fits? Tell me what you mean by this.”
c.
“Yes, it can be upsetting when a child has a fit.”
d.
“Don’t be upset when he has a fit; every 2 year old has fits.”
12. A 17-year-old single mother is describing how difficult it is to raise a 3-year-old child by
herself. During the course of the interview she states, “I can’t believe my boyfriend left me to
do this by myself! What a terrible thing to do to me!” Which of these responses by the nurse
uses empathy?
a.
“You feel alone.”
b.
“You can’t believe he left you alone?”
c.
“It must be so hard to care for a child all alone.”
d.
“I would be angry, too; raising a child alone is no picnic.”
13. The nurse has used interpretation regarding a patient’s statement or actions. What should the
nurse do after using this technique?
a.
Apologize, because using interpretation can be demeaning for the patient.
b.
Allow time for the patient to confirm or correct the inference.
c.
Continue with the interview as though nothing has happened.
d.
Immediately restate the nurse’s conclusion on the basis of the patient’s nonverbal
response.
14. During an interview, a woman says, “I have decided that I can no longer allow my children to
live with their father’s violence, but I just can’t seem to leave him.” Using interpretation,
which would be the best response by the nurse?
a.
“You are going to leave him?”
b.
“If you are afraid for your children, then why can’t you leave?”
c.
“It sounds as if you might be afraid of how your husband will respond.”
d.
“It sounds as though you have made your decision. I think it is a good one.”
15. A pregnant woman states, “I just know labor will be so painful that I won’t be able to stand it.
I know it sounds awful, but I really dread going into labor.” The nurse responds by stating,
“Oh, don’t worry about labor so much. I have been through it, and although it is painful, many
good medications are available to decrease the pain.” Which statement is true regarding the
nurse’s response?
a.
Therapeutic response. By sharing something personal, the nurse gives hope to this
woman.
b.
Nontherapeutic response. By providing false reassurance, the nurse actually cut off
further discussion of the woman’s fears.
c.
Therapeutic response. By providing information about the medications available,
the nurse is giving information to the woman.
d.
Nontherapeutic response. The nurse is essentially giving the message to the
woman that labor cannot be tolerated without medication.
16. During a visit to the clinic, a patient states, “The doctor just told me he thought I ought to stop
smoking. He doesn’t understand how hard I’ve tried. I just don’t know the best way to do it.
What should I do?” What is the most appropriate response by the nurse?
a.
“I’d quit if I were you. The doctor really knows what he is talking about.”
b.
“Would you like some information about the different ways a person can quit
smoking?”
c.
“Stopping your dependence on cigarettes can be very difficult. I understand how
you feel.”
d.
“Why are you confused? Didn’t the doctor give you the information about the
smoking cessation program we offer?”
17. As the nurse enters a patient’s room, the nurse finds the patient crying. The patient states that
she has just found out that the lump in her breast is cancer and says, “I’m so afraid of, um, you
know.” Which would be the most therapeutic response by the nurse when said in a gentle
manner?
a.
“You’re afraid you might lose your breast?”
b.
“No, I’m not sure what you are talking about.”
c.
“I’ll wait here until you get yourself under control, and then we can talk.”
d.
“I can see that you are very upset. Perhaps we should discuss this later.”
18. A nurse is taking complete health histories on all of the patients attending a wellness
workshop. On the history form, one of the written questions asks, “You don’t smoke, drink, or
take drugs, do you?” This is an example of what type of question?
a.
Talking too much
b.
Using confrontation
c.
Using biased or leading questions
d.
Using blunt language to deal with distasteful topics
19. When observing a patient’s verbal and nonverbal communication, the nurse notices a
discrepancy. What action should the nurse take in this situation?
a.
Ask someone who knows the patient well to help interpret this discrepancy.
b.
Focus on the patient’s verbal message, and try to ignore the nonverbal behaviors.
c.
Try to integrate the verbal and nonverbal messages and then interpret them as an
average.
d.
Focus on the patient’s nonverbal behaviors, because these are often more reflective
of a patient’s true feelings.
20. During an interview, a parent of a hospitalized child is sitting in a recliner with his legs
extended and his arms at his sides. As the interviewer begins to discuss his son’s treatment,
however, he suddenly changes positions and crosses his arms against his chest and crosses his
legs. What does this change in posture suggest?
a.
Simply changing positions
b.
More comfortable in this position
c.
Tired and needs a break from the interview
d.
Uncomfortable talking about his son’s treatment
21. A mother brings her 28-month-old daughter into the clinic for a well-child visit. At the
beginning of the visit, the nurse focuses attention away from the toddler, but as the interview
progresses, the toddler begins to “warm up” and is smiling shyly at the nurse. The nurse will
be most successful in interacting with the toddler if which is done next?
a.
Tickle the toddler, and get her to laugh.
b.
Stoop down to her level, and ask her about the toy she is holding.
c.
Continue to ignore her until it is time for the physical examination.
d.
Ask the mother to leave during the examination of the toddler, because toddlers
often fuss less if their parent is not in view.
22. During an examination of a preschool child, the nurse will need to take her blood pressure.
What might the nurse do to try to gain the child’s full cooperation?
a.
Tell the child that the blood pressure cuff is going to give her arm a big hug.
b.
Tell the child that the blood pressure cuff is asleep and cannot wake up.
c.
Give the blood pressure cuff a name and refer to it by this name during the
assessment.
d.
Tell the child that by using the blood pressure cuff, we can see how strong her
muscles are.
23. A 16-year-old boy has just been admitted to the hospital for overnight observation after being
in an automobile accident. What is the best approach for the nurse to use to communicate with
him?
a.
Use periods of silence to communicate respect for him.
b.
Be totally honest with him, even if the information is unpleasant.
c.
Tell him that everything that is discussed will be kept totally confidential.
d.
Use slang language when possible to help him open up.
24. A 75-year-old woman is at the office for a preoperative interview. The nurse is aware that the
interview may take longer than interviews with younger people. What is the reason for this?
a.
An aged person has a longer story to tell.
b.
An aged person is usually lonely and likes to have someone with whom to talk.
c.
Aged people lose much of their mental abilities and require longer time to
complete an interview.
d.
As a person ages, he or she is unable to hear; thus the interviewer usually needs to
repeat much of what is said.
25. The nurse is interviewing a male patient who has a hearing impairment and came in because
of a cold. What techniques would be most beneficial in communicating with this patient?
a.
Determine the communication method he prefers.
b.
Avoid using facial and hand gestures because most hearing-impaired people find
this degrading.
c.
Request a sign language interpreter before meeting with him to help facilitate the
communication.
d.
Speak loudly and with exaggerated facial movement when talking with him
because doing so will help him lip read.
26. During a prenatal check, a patient begins to cry as the nurse asks her about previous
pregnancies. She states that she is remembering her last pregnancy, which ended in
miscarriage. Which is the best response by the nurse?
a.
“I’m so sorry for making you cry!”
b.
“I can see that you are sad remembering this. It is all right to cry.”
c.
“Why don’t I step out for a few minutes until you’re feeling better?”
d.
“I can see that you feel sad about this; why don’t we talk about something else?”
27. The nurse is performing a health interview on a patient who has a language barrier, and no
interpreter is available. Which is the best example of an appropriate question for the nurse to
ask in this situation?
a.
“Do you take medicine?”
b.
“Are you in any discomfort?”
c.
“Do you have nausea and vomiting?”
d.
“You have been following your doctor’s orders, haven’t you?”
28. A man arrives at the clinic for his annual wellness physical. He is experiencing no acute
health problems. Which question or statement by the nurse is most appropriate when
beginning the interview?
a.
“How is your family?”
b.
“How is your job?”
c.
“Tell me about your hypertension.”
d.
“How has your health been since your last visit?”
29. The nurse says to a patient, “I know it may be hard, but you should do what the doctor ordered
because she is the expert in this field.” Which statement is correct about the nurse’s comment?
a.
It is inappropriate because it shows the nurse’s bias.
b.
It is appropriate because members of the health care team are experts in their area
of patient care.
c.
This type of comment promotes dependency and inferiority on the part of the
patient and is best avoided in an interview situation.
d.
Using authority statements when dealing with patients, especially when they are
undecided about an issue, is necessary at times.
30. A female patient does not speak English well, and the nurse needs to choose an interpreter.
Which of the following would be the most appropriate choice?
a.
Trained interpreter
b.
Male family member
c.
Female family member
d.
Volunteer college student from the foreign language studies department
31. During a follow-up visit, the nurse discovers that a patient has not been taking his insulin on a
regular basis. The nurse asks, “Why haven’t you taken your insulin?” Which statement is an
appropriate evaluation of this situation?
a.
This question may place the patient on the defensive.
b.
This question is an effective way to search for information.
c.
Discussing his behavior with his wife would have been better.
d.
A direct question is the best way to discover the reasons for his behavior.
32. The nurse is nearing the end of an interview. Which statement is appropriate at this time?
a.
“Did we forget something?”
b.
“Is there anything else you would like to mention?”
c.
“I need to go on to the next patient. I’ll be back.”
d.
“While I’m here, let’s talk about your upcoming surgery.”
33. What data should the nurse collect during the interview portion of a health assessment.
a.
Physical
b.
Historical
c.
Objective
d.
Subjective
34. During an interview, the nurse would expect that most of the interview will take place at what
distance?
a.
Intimate zone
b.
Personal distance
c.
Social distance
d.
Public distance
35. A female nurse is interviewing a male patient who is near the same age as the nurse. During
the interview, the patient makes an overtly sexual comment. Which is the best response by the
nurse?
a.
“Stop that immediately!”
b.
“Oh, you are too funny. Let’s keep going with the interview.”
c.
“Do you really think I would be interested?”
d.
“It makes me uncomfortable when you talk that way. Please stop.”
MULTIPLE RESPONSE
1. The nurse is conducting an interview. Which of these statements is true regarding open-ended
questions? (Select all that apply.)
a.
Elicit hard facts.
b.
Allow for self-expression.
c.
Build and enhance rapport.
d.
Call for short one- to two-word answers.
e.
Are used when narrative information is needed.
2. The nurse is conducting an interview in an outpatient clinic and is using a computer to record
data. Which are the best uses of the computer in this situation? (Select all that apply.)
a.
Collect the patient’s data in a direct, face–to-face manner.
b.
Enter all the data as the patient states them.
c.
Ask the patient to wait as the nurse enters the data.
d.
Type the data into the computer after the narrative is fully explored.
e.
Allow the patient to see the monitor during typing.