Deck 4: The Interview

Question 1

A nurse is taking complete health histories on all the patients attending a wellness workshop.On the history form,one of the written question asks,"You don't smoke,drink,or take drugs,do you?" This question is an example of:
1)talking too much.
2)using confrontation.
3)using biased or leading questions.
4)using blunt language to deal with distasteful topics.

Answer 1

3
Using leading or biased questions.Asking,"You don't smoke,do you?" implies that one answer is "better" than another.If the person wants to please you,he or she is either forced to answer in a way corresponding to your values or is made to feel guilty when admitting the other answer.

Question 2

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:
1)empathy.
2)reflection.
3)facilitation.
4)confrontation.

Answer 2

4
When using the response of confrontation,the frame or reference shifts from the patient's perspective to yours,and you start to express your own thoughts and feelings.

Question 3

The following statement could be found at which phase of the interview? "Mr.S. ,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."
1)During the summary
2)Closing the interview
3)During the body of the interview
4)Opening/introducing the interview

Answer 3

4
When gathering a complete history,give the reason for the interview during the opening or introduction of the interview.

Question 4

Receiving is a part of the communication process.Which receiver is most likely to misinterpret a message sent by a health care professional?
1)A well-adjusted adolescent in for a sports physical
2)A recovering alcoholic in for a basic physical examination
3)A man whose wife has just been diagnosed with lung cancer
4)A hearing-impaired man who uses sign language to communicate and has an interpreter with him

Question 5

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?
1)An aged person has a longer story to tell.
2)An aged person is usually lonely and likes to have someone to talk to.
3)Aged persons lose much of their mental abilities and require greater time to complete an interview.
4)As a person ages,they are unable to hear and thus interviewers usually need to repeat much of what is said.

Question 6

During an interview,the nurse states: "You mentioned shortness of breath.Tell me more about that." Identify the verbal skill used with this statement.
1)Reflection
2)Facilitation
3)Direct question
4)Open-ended question

Question 7

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:
1)"You're afraid you might lose your breast?"
2)"No,I'm not sure what you are talking about."
3)"I'll wait here until you get yourself under control and then we can talk."
4)"I can see that you are very upset.Perhaps we should discuss this later."

Question 8

The nurse is interviewing a patient who has a hearing impairment.What techniques would be most beneficial in communicating with this patient?
1)Assess the communication method he prefers.
2)Avoid using facial and hand gestures because most hearing-impaired people find this degrading.
3)Request a sign language interpreter before meeting with him to help facilitate the communication.
4)Speak loudly and with exaggerated facial movement when talking with him because this helps with lip reading.

Question 9

During an examination of a 3-year-old child,the nurse will need to take her blood pressure.What might the nurse do to try to gain the child's full cooperation?
1)Tell the child that the blood pressure cuff is going to give her arm a big hug.
2)Tell the child that the blood pressure cuff is asleep and cannot wake up.
3)Give the blood pressure cuff a name and refer to it by this name during the assessment.
4)Tell the child that by using the blood pressure cuff,we can see how strong her muscles are.

Question 10

When taking a history from a newly admitted patient,the nurse notices that he is pausing often and looking at the nurse expectantly.What would be the nurse's best response to this behavior?
1)Be silent and allow him to continue when he is ready.
2)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."
3)Lean back in the chair and ask,"Mr.J. ,you are looking at me kind of funny;there isn't anything wrong,is there?"
4)Stand up and say,"I can see that this interview is uncomfortable for you.We can continue it another time."

Question 11

A woman is discussing the problems she is having with her 2-year-old son."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:
1)"Go on,I'm listening."
2)"Fits? Tell me what you mean by this."
3)"Yes,it can be upsetting when a child has a fit."
4)"Don't be upset when he has a fit;every 2-year-old has fits."

Question 12

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.Which statement by the nurse would be most appropriate to gather these data?
1)"Mr.Y. ,at your age,surely you have been hospitalized before!"
2)"Mr.Y. ,I just need permission to get your medical records from County Medical."
3)"Mr.Y. ,you mentioned that you have been hospitalized on several occasions.Would you tell me more about that?"
4)"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 13

When observing a patient's verbal and nonverbal communication,the nurse notices a discrepancy.Which statement is true regarding this situation?
1)The nurse should ask someone who knows the patient well to help interpret this discrepancy.
2)The nurse should focus on the patient's verbal message and try to ignore the nonverbal behaviors.
3)The nurse should try to integrate the verbal and nonverbal messages and then interpret them as an "average."
4)The nurse should focus on the patient's nonverbal behaviors because these are often more reflective of a patient's true feelings.

Question 14

During an interview,a parent of a hospitalized child is sitting in an open position.As the interviewer begins to discuss his son's treatment,however,he suddenly crosses his arms against his chest and crosses his legs.This would suggest that the parent is:
1)just changing positions.
2)more comfortable in this position.
3)tired and needs a break in the interview.
4)uncomfortable talking about his son's treatment.

Question 15

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?
1)Use periods of silence to communicate respect for him.
2)Be totally honest with him,even if the information is unpleasant.
3)Tell him that everything that is discussed will be kept totally confidential.
4)Use slang language when possible to help him open up.

Question 16

A 17-year-old single mother is describing how difficult it is to raise a 2-year-old 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 the following responses by the nurse uses empathy?
1)"You feel alone?"
2)"You can't believe he left you alone."
3)"It must be so hard to face this all alone."
4)"I would be angry,too;raising a child alone is no picnic."

Question 17

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?
1)Tickle the toddler and get her to laugh.
2)Stoop down to her level and ask her about the toy she is holding.
3)Continue to ignore her until it is time for the physical examination.
4)Ask the mother.to leave during the examination of the toddler because toddlers often fuss less if their parents aren't in view.

Question 18

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 there are many good medications to decrease the pain." Which statement is true regarding this response?
1)It was a therapeutic response.By sharing something personal,the nurse gives hope to this woman.
2)It was a nontherapeutic response.By providing false reassurance,the nurse actually cut off further discussion of the woman's fears.
3)It was a therapeutic response.By providing information about the medications available,the nurse is giving information to the woman.
4)It was a nontherapeutic response.The nurse is essentially giving the message to the woman that labor cannot be tolerated without medication.

Question 19

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,the nurse knows that which statement is most accurate? The woman:
1)is excited about her pregnancy but nervous about labor.
2)is exhibiting verbal and nonverbal behavior that does not match.
3)is excited about her pregnancy but her husband is not and this is upsetting to her.
4)is not excited about her pregnancy but believes the nurse will respond negatively to her if she states this.

Question 20

Because the physical environment in which an interview takes place is an important consideration for the success of an interview,the interviewer should:
1)reduce noise by turning off televisions and radios.
2)place the distance between the interviewer and the patient about 2 feet or closer.
3)provide a dim light that makes a room cozier and will help the patient relax.
4)arrange seating across a desk or table to allow the patient some personal space.

Question 21

The interview portion of data collection collects:
1)physical data.
2)historical data.
3)objective data.
4)subjective data.

Question 22

The nurse is performing a health interview on a patient,named Salil,who has a language barrier,and no interpreter is available.Which of the following is the best example of an appropriate question for the nurse to ask in this situation?
1)"Does Salil take medicine?"
2)"Do you sterilize the bottles?"
3)"Do you have nausea and vomiting?"
4)"He has been taking his medicine,hasn't he?"

Question 23

A man arrives at the clinic for an annual wellness physical.He is experiencing no acute health problems.Which of the following statements by the nurse is most appropriate when beginning the interview?
1)"How is your family?"
2)"Why are you here today?"
3)"Tell me about your hypertension?"
4)"How has your health been since your last visit?"

Question 24

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.The nurse's best reaction would be:
1)"Stop that immediately!"
2)"Oh,you are too funny.Let's keep going with the interview."
3)"Do you really think I'd be interested?"
4)"It makes me uncomfortable when you talk that way.Please don't."

Question 25

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?
1)A trained interpreter
2)A male family member
3)A female family member
4)A volunteer college student from the foreign language studies department.

Question 26

During an interview,the nurse would expect that most of the interview will take place at which distance?
1)Intimate zone
2)Personal distance
3)Social distance
4)Public distance

Question 27

The nurse is interviewing a recent male immigrant from Mexico.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 begins to feel uncomfortable with his proximity.Which statement most closely reflects what the nurse should do next?
1)Try to relax-these behaviors are culturally appropriate for this person.
2)Discreetly move one's chair back until the distance is more comfortable and then continue with the interview.
3)These behaviors are indicative of sexual aggression,and the nurse should confront this person about them.
4)The nurse should laugh but tell him that he or she is uncomfortable with his proximity and ask him to move away.

Question 28

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 of the following is an appropriate evaluation of this question?
1)It may put the patient on the defensive.
2)It is an innocent search for information.
3)It would have been better to discuss this with his wife.
4)It is the best way to discover the reasons for his behavior.

Question 29

Which of the following is appropriate for the nurse to say near the end of the interview?
1)"Did we forget something?"
2)"Is there anything else you would like to mention?"
3)"I need to go on to the next patient.I'll be back."
4)"While I'm here,let's talk about your upcoming surgery."

Question 30

Which of the following statements illustrate the use of open-ended questions? Select all that apply.
1)Elicits cold facts
2)Elicits feelings,opinions,and ideas
3)Builds and enhances rapport
4)Leaves interactions neutral
5)Calls for short one- to two-word answers
6)Used when narrative information is needed.

Question 31

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.The nurse's best response to her crying would be:
1)"I'm so sorry for making you cry!"
2)"I can see that you are sad remembering this.It is all right to cry."
3)"Why don't I step out for a few minutes until you're feeling better?"
4)"I can see that you feel sad about this;why don't we talk about something else?"