Deck 4: The Interview

Question 1

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.An example of a verbal response that focuses on the health care provider's perspective would be:

A)Empathy
B)Reflection
C)Facilitation
D)Explanation

Answer 1

Explanation

Question 2

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 question is an example of:

A)Talking too much
B)Using confrontation
C)Using biased or leading questions
D)Using blunt language to deal with distasteful topics

Answer 2

Using biased or leading questions

Question 3

A 17-year-old woman, who is a lone parent, 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 face this all alone."
D)"I would be angry, too; raising a child alone is no picnic."

Answer 3

"It must be so hard to face this all alone."

Question 4

As the nurse enters a patient's room, the nurse finds her 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." The nurse's most therapeutic response would be to say 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."

Question 5

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 whose wife has just been diagnosed with lung cancer
D)Man with a hearing impairment, who uses sign language to communicate and who has an interpreter with him

Question 6

A man has been admitted to the observation unit for observation after being treated for a large cut on his forehead.As the nurse works through the interview, one of the standard questions has to do with alcohol, tobacco, and drug use.When the nurse asks him about tobacco use, he states, "I quit smoking after my wife died 7 years ago." However, the nurse notices an open pack of cigarettes in his shirt pocket.Using clarification, the nurse could say:

A)"Mr.K., I know that you are lying."
B)"Mr.K., come on, tell me how much you smoke."
C)"Mr.K., I didn't realize your wife had died.It must be difficult for you at this time.Please tell me more about that."
D)"Mr.K., you have said that you don't smoke, but I see that you have an open pack of cigarettes in your pocket."

Question 7

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 don't seem to be able to leave him." Using interpretation, the nurse's best response would be:

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."

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?"

Question 9

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." This question is found at the __________ phase of the interview process.

A)Summary
B)Closing
C)Body
D)Opening or introduction

Question 10

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?" The nurse's most appropriate response in this case would be:

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?"

Question 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." The nurse's best verbal response would be:

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."

Question 12

The nurse makes which adjustment in the physical environment to promote the success of an interview?

A)Reduces noise by turning off televisions and radios
B)Reduces the distance between the interviewer and the patient to 1 m or less
C)Provides a dim light that makes the room cozy and helps the patient relax
D)Arranges seating across a desk or table to allow the patient some personal space

Question 13

When taking 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 behaviour?

A)Be silent, and allow him to continue when he is ready.
B)Smile at him, and say, "Don't worry about all of this.I'm sure we can find out why you're having these pains."
C)Lean back in the chair, and say, "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."

Question 14

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 Carol."
B)"Hello, Mrs.Smith, my name is Carol; I am one of the nurses working here.It sure is cold today!"
C)"Mrs.Smith my name is Carol.How are you?"
D)"Hello, Mrs.Smith.My name is Carol.I am a nurse, and I need to ask you a few questions about what happened."

Question 15

When observing a patient's verbal and nonverbal communication, the nurse notices a discrepancy.Which statement is true regarding this situation? The nurse should:

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 behaviours
C)Try to integrate the verbal and nonverbal messages and then interpret them as an average
D)Focus on the patient's nonverbal behaviours because these are often more reflective of a patient's true feelings

Question 16

The nurse is conducting an interview with a woman who has recently learned that she is pregnant and 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? The woman is:

A)Excited about her pregnancy but nervous about the labour
B)Exhibiting verbal and nonverbal behaviours 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 respond to her negatively if she states this

Question 17

In an interview, the nurse may find it necessary to take notes to aid memory later.Which statement regarding note taking is true?

A)Note taking may impede the nurse's observation of the patient's nonverbal behaviours.
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.

Question 18

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

Question 19

A pregnant woman states, "I just know labour will be so painful that I won't be able to stand it.I know it sounds awful, but I really dread going into labour." The nurse responds by stating, "Oh, don't worry about labour so much.I have been through it, and although it is painful, many good medications are available to decrease the pain." Which statement regarding this response is true? The nurse's reply was a:

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 labour cannot be tolerated without medication.

Question 20

The nurse has used interpretation regarding a patient's statement or actions.After using this technique, it would be best for the nurse to:

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

Question 21

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 question?

A)This question may place the patient on the defensive.
B)This question is an innocent search for information.
C)Discussing his behaviour with his wife would have been better.
D)A direct question is the best way to discover the reasons for his behaviour.

Question 22

A 16-year-old boy has just been admitted to the unit for overnight observation after being in an automobile accident.What is the nurse's best approach to communicating 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

Question 23

The nurse is conducting an interview in an outpatient clinic and is using a computer to record data.Which is the best use of the computer in this situation? (Select all that apply.)

A)Collecting the patient's data in a direct, face-to-face manner
B)Entering all of the data as the patient states them
C)Asking the patient to wait as the nurse enters the data
D)Typing the data into the computer after the narrative is fully explored
E)Allowing the patient to type in the information

Question 24

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)Get down to her eye 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 the parent is not in view.

Question 25

The nurse is performing a health interview with 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 medicines?"
B)"Do you sterilize the bottles?"
C)"Do you have nausea and vomiting?"
D)"You have been taking your medicine, haven't you?"

Question 26

During her prenatal checkup, the patient begins to cry as the nurse asks her about previous pregnancies.The patient states that she is remembering her last pregnancy, which had ended in a miscarriage.The nurse's best response to her crying would be:

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?"

Question 27

The nurse is interviewing a male patient who has a hearing impairment.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

Question 28

During an interview, a parent of a hospitalized child is sitting in an open position.As the interviewer begins to discuss the son's treatment, he suddenly crosses his arms against his chest and crosses his legs.This changed posture would suggest that the parent is:

A)Simply changing posture
B)More comfortable in this position
C)Tired and needs a break from the interview
D)Uncomfortable talking about his son's treatment

Question 29

The nurse is conducting an interview.Which of these statements regarding open-ended questions is true? (Select all that apply.)

A)Open-ended questions elicit cold facts.
B)They allow for self-expression.
C)Open-ended questions build and enhance rapport.
D)They leave interactions neutral.
E)Open-ended questions call for short one- to two-word answers.
F)They are used when narrative information is needed.

Question 30

During an examination of a 3-year-old child, the nurse needs to take the 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, it will be possible to see how strong the heart is pumping blood through the body

Question 31

A female nurse is interviewing a male patient who is close in age to the nurse.During the interview, the patient makes an overtly sexual comment.The nurse's best reaction would be:

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."

Question 32

A female Métis patient has come to the clinic for follow-up diabetes teaching.During the interview, the nurse notices that the patient never makes eye contact and speaks mostly looking at the floor.Which statement is true regarding this situation?

A)The woman is nervous and embarrassed.
B)She has something to hide and is ashamed.
C)The woman is showing inconsistent verbal and nonverbal behaviours.
D)She is showing that she is listening carefully to what the nurse is saying.

Question 33

During the interview portion of data collection, the nurse collects __________ data.

A)Physical
B)Historical
C)Objective
D)Subjective

Question 34

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 discuss?"
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."

Question 35

To ensure privacy while assessing a patient in a shared hospital room, the nurse needs to use curtains to achieve:

A)Geographical privacy
B)Physical privacy
C)Psychological privacy
D)Social privacy

Question 36

A female nurse is interviewing a man who is a recent immigrant.During the course of the interview, he leans forward and then finally moves his chair close enough that his knees are nearly touching the nurse's knees.The nurse begins to feel uncomfortable with his proximity.Which statement most closely reflects what the nurse should do next?

A)The nurse should try to relax; these behaviours are culturally appropriate for this person.
B)The nurse should discreetly move his or her chair back until the distance is more comfortable, and then continue with the interview.
C)Such behaviour is indicative of sexual aggression, and the nurse should confront this person about it.
D)The nurse should laugh but say that he or she is uncomfortable with the person's proximity and ask him to move away.

Question 37

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?"

Question 38

A female patient does not speak English fluently, 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

Question 39

The nurse makes this comment 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)This comment is inappropriate because it shows the nurse's bias.
B)This comment 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.

Question 40

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 persons.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 to talk to.
C)Aged persons 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.