Deck 2: Interviewing the Patient for the Health History

Question 1

The nursing instructor is teaching a group of students the components of the health history interview. Which principles of behavior should the student remember when conducting a health assessment history? Select all that apply.

A) Remain sensitive.
B) Be nonjudgmental.
C) Give the appearance only of being genuine.
D) Demonstrate professional behaviors.
E) Show indifference.

Answer 1

Remain sensitive.
Be nonjudgmental.
Demonstrate professional behaviors.

Question 2

In order to conduct effective assessments and health histories, the nurse must use a patient-centered approach using therapeutic communication. Which dimensions of patient-centered care should the nurse include? Select all that apply.

A) Empathy and compassion
B) Conditional regard
C) Genuineness
D) Respect
E) Caring

Answer 2

Empathy and compassion
Genuineness
Respect
Caring

Question 3

A patient comes to the clinic for an annual examination. To prepare for the health history interview the nurse knows to include all of the following components EXCEPT (Select all that apply):

A) Reading the patient record as the health history is being conducted
B) Leaving the patient dressed until it is time to perform the physical assessment
C) Conducting the interview in a private place away from noise
D) Allowing a short, limited amount of time to conduct the interview
E) Standing at all times when talking to the patient.

Answer 3

Reading the patient record as the health history is being conducted
Allowing a short, limited amount of time to conduct the interview
Standing at all times when talking to the patient.

Question 4

The nurse is preparing to conduct a complete health history on a new patient who has just arrived at the walk-in clinic. The nurse is going to use the CLEAR mnemonic to collect information. What does CLEAR stand for? Select all that apply.

A) Center
B) Communicate
C) Listen
D) Empathy
E) Empower
F) Attention
G) Advocate
H) Respect

Question 5

You are taking a health history on a patient who has not seen a health-care provider in many years. He states, "I do not want to be here, but my wife is forcing me to see this doctor. All doctors want to do is put patients on drugs!" You know that communication skills will be very important during this patient encounter. What is the purpose of communication? Select all that apply.

A) Share information.
B) Share and exchange thoughts and feelings.
C) Send data only.
D) Confirm patient complaints.
E) Make a diagnosis.

Question 6

Communication is both verbal and nonverbal. The following are nonverbal visual cues to be aware of during an interview. Select all that apply.

A) Slouching in the chair
B) Frowning
C) No eye contact
D) Gestures
E) Age-appropriate appearance
F) Tone of voice
G) Crying and moaning

Question 7

A patient and her husband arrive at the community health center for a follow-up assessment. The patient has recently had a stroke and is aphasiac. She understands what you are saying but is unable to talk. Which of the following nursing interventions should be followed? Select all that apply.

A) Ask the husband the best way to communicate with his wife.
B) Find a large blackboard to write your questions on.
C) Offer the patient a white board or paper and pen.
D) Speak slowly and loudly so the patient understands.
E) Communicate one question or sentence at a time.

Question 8

As the nurse prepares for a patient interview he or she recalls that effective communication includes which of the following? Select all that apply.

A) Avoid medical jargon.
B) Be authoritative.
C) Keep questions simple and clear.
D) Stand over the patient.
E) Avoid excessive note taking.

Question 9

The mnemonic CLEAR is foundational for successful interviewing. The student nurse recognizes that this stands for which of the following terms?

A) Center, Listen, Empathy, Attention, and Respect
B) Calm, Listen, Empathy, Attention, and Respect
C) Center, Listen, Eye Contact, Attention, and Respect
D) Calm, Listen, Eye Contact, Attention, and Respect

Question 10

The nurse is conducting a health history interview and suspects that the patient may have a hearing deficit. Which consideration is most appropriate for the nurse to make?

A) Write down all questions for the patient.
B) Reduce any background noise in the room.
C) Speak quickly and use short, simple sentences.
D) Complete the health history as quickly as possible to reduce stress.

Question 11

The patient has disclosed a visual impairment to the nurse. Which is the priority action for the nurse to remember before starting the physical assessment?

A) Speak clearly and loudly at all times during the assessment.
B) Acknowledge the patient by putting a hand on his or her shoulder.
C) Give short directions throughout the assessment.
D) Ask the patient how much he or she can see.

Question 12

A patient's culture can influence the interview process. The nursing student recognizes that which of the following is true about how culture can influence the interview process?

A) A patient may have different definitions and perceptions of health and illness.
B) A patient cannot refuse to discuss personal matters out of concern for privacy.
C) A patient may project his or her own cultural beliefs on the nurse.
D) A patient may try to portray the cultural beliefs of the nurse.

Question 13

When conducting the interview, the nurse needs to determine the reliability of the data collected. Which primary source would be considered the most reliable for the health history information?

A) The patient who is alert and oriented to person, place, and time
B) The significant other who is answering all the questions
C) The patient's medical record from the primary care provider
D) An interpreter who speaks the patient's native language

Question 14

The nurse is preparing to conduct a health history on a patient and organizes the interview in a head-to-toe sequence. Which type of health history is the nurse going to conduct?

A) Comprehensive
B) Focused
C) Problem-based
D) Follow-up

Question 15

The nurse is preparing to conduct a health history on a patient seen in the health clinic 2 days ago. Which type of health history is the nurse going to conduct?

A) Comprehensive
B) Focused
C) Problem-based
D) Follow-up

Question 16

The nurse is preparing to conduct a health history on a patient being seen in the emergency room. Which type of health history is the nurse going to conduct?

A) Comprehensive
B) Focused
C) Basic
D) Follow-up

Question 17

While conducting a health history during admission to the medical floor, the nurse asks the patient "Have you ever had surgery?" This question is an example of which type of communication technique?

A) Open-ended question
B) Closed question
C) Indirect question
D) Clarification question

Question 18

The nursing student is learning how to use various therapeutic communication techniques. The student recognizes which of these as an example of confrontation?

A) "You look angry."
B) "This must be very hard for you."
C) "Do you feel worried about your dog?"
D) "How can I help you?"

Question 19

You are completing a health history on a 32-year-old woman who is reporting that "she may have a problem using heroin and other drugs." You are being attentive to the patient's report and nonverbal cues. The patient is looking down as she is telling her story. What communication technique is the nurse demonstrating?

A) Silence
B) Respect
C) Active listening
D) Exploring

Question 20

A home health nurse is assessing a 94-year-old patient with a severe cognitive impairment. The daughter with whom the patient lives states that her mom only eats less than half of all her meals. What will you document?

A) Patient is reliable. Cared for by her daughter. Eating half of her meals.
B) Report by daughter. Eating 50% of her meals. Patient lives with her daughter.
C) Patient is unreliable. Report by daughter. Patient is only eating less than 50% of each meal.
D) Patient is unreliable. Eating about 50% of each meal.

Question 21

A nurse in the emergency department is completing an emergency assessment for a teenager just admitted for injuries from a motor vehicle accident. Which of the following documentations is a pertinent negative report?

A) "My leg hurts so bad. I can't stand it."
B) Denies headache and blurry vision.
C) Reports feeling nauseous and dizzy.
D) "It wasn't my fault. I couldn't stop."

Question 22

During the summarization phase of the interview it is important to

A) Encourage the patient to tell his or her history of present illness.
B) Complete documenting the data as told by the patient.
C) Clarify the patient's report, needs, feelings, and concerns.
D) Ask the patient if he or she has any questions.

Question 23

You are assessing a patient who does not seem to understand your questions and explanations. What should be your next action?

A) Continue on with the assessment.
B) Speak slowly and loudly so the patient can hear you.
C) Ask the patient if he or she understands what you are saying.
D) Omit the explanations and continue with the assessment.

Question 24

A patient is having his annual physical examination. You are doing a health history related to male breasts. You ask the patient if he has ever palpated his breasts. He responds, "I cannot believe that you asked me that question. I am not a woman and cannot get breast cancer." The nurse responds, "You sound surprised. You don't think that men can get breast cancer?" What type of communication technique is the nurse using?

A) Focusing
B) Facilitation
C) Reflecting
D) Exploring

Question 25

Your patient reports that he thinks that he may have a problem with drinking too much beer. The nurse states, "So, do you drink about two beers every day?" What type of communication technique is this question?

A) Leading the patient
B) Transitional statement
C) Clarification
D) Exploring

Question 26

You are about to start the health history. The patient is present with his daughter. Which of the following priority steps should you take before you start the health history?

A) Organize your thoughts prior to the assessment.
B) Wash your hands in front of the patient.
C) Obtain permission from the patient for the daughter to be present.
D) Assess your professional appearance and demeanor.

Question 27

The patient just had abdominal surgery and reports that she is feeling bloated and crampy. The nurse inspects her abdomen and finds it to be bloated. The nurse tells the patient, "You will feel better tomorrow." This is an example of which communication technique?

A) Respect
B) Using clichés
C) Giving opinions
D) Using patronizing language

Question 28

The visiting nurse is going to start an interview at a patient's home. The patient is watching television. The patient is hard of hearing and reports that her left ear is her good ear. Which nursing intervention should take highest priority?

A) Speak in simple, focused sentences.
B) Ask to have the television volume turned down.
C) Be descriptive when giving directions.
D) Use drawings and a white board to ask questions.

Question 29

You are about to start an interview with the husband and wife present. The husband tells the nurse that his wife may not tell her everything that she needs to know. He states that in his wife's culture, feelings are considered private and difficult to share. Sharing one's feelings with others often creates a sense of vulnerability or is looked on as evidence of weakness. What culture is his wife?

A) Chinese heritage
B) German heritage
C) American Eskimo
D) Italian heritage

Question 30

Which consideration should the nurse recognize as priority when interviewing the patient?

A) Gender
B) Socioeconomic status
C) Developmental level
D) Education

Question 31

The patient is telling you that she is very upset because her mother passed away last month. She states, "I do not know how I am going to survive without my mom. I loved her so much." The nurse says, "I am so sorry to hear about the passing of your mom. This must be a very difficult time for you." What communication technique is the nurse demonstrating?

A) Empathy
B) Facilitation
C) Reflecting
D) Clarification

Question 32

The hospital nurse is conducting the initial interview with a patient who does not speak the same language as the nurse. What is a general principle when finding an interpreter?

A) Direct all your questions to the interpreter without looking at the patient.
B) Use your resources to find a trained face-to-face interpreter.
C) If a family member is available, ask him or her to be the interpreter.
D) Ask all the questions first so the interpreter can then ask the patient all at once.

Question 33

As you enter the examination room to start the health history interview, the patient immediately starts yelling at you because he waited 45 minutes in the waiting room. He is angry and upset. You should:

A) Tell the patient to lower his voice and stop yelling.
B) Put your hand on the patient's shoulder and tell him it will never happen again.
C) Not argue with the patient and be empathetic.
D) Tell the patient that you will be right back and go get the health-care provider.

Question 34

The three phases of the interview, in order, are: 1) ____________________, 2) ____________________, and 3) ____________________.