Download Nursing Interviews: Obtaining a Health History - Exam Questions and Answers and more Exams History and Philosophy in PDF only on Docsity! Chapter 2 Obtaining a health history (TEST BANK) (EXAM 1) Questions And Answers Which statement or question does the nurse use during the introduction phase of the interview? a. "I'm here to learn more about the pain you're experiencing." b. "Can you describe the pain that you're experiencing?" c. "I heard you say that the pain is' all over' your body." d. "What relieves the pain you are having? The Answer Is a. "I'm here to learn more about the pain you're experiencing." "I'm here to learn more about the pain you're experiencing" is an example of the introduction phase a nurse may use to explain the purpose of the interview to a patient. "Can you describe the pain that you're experiencing?" is an example of part of a symptom analysis that occurs in the discussion phase. "I heard you say that the pain is 'all over' your body" is an example of a summary statement by the nurse that occurs in the summary phase. "What relieves the pain you are having?" is an example of part of a symptom analysis that occurs in the discussion phase. Which statement is appropriate to use when beginning an interview with a new patient? a. "Have you ever been a patient in this clinic before?" b. "What is your purpose for coming to the clinic today?" Chapter 2 Obtaining a health history (TEST BANK) (EXAM 1) Questions And Answers c. "Tell me a little about yourself and your family." d. "Did you have any difficulty finding the clinic?" The Answer Is b. "What is your purpose for coming to the clinic today?" "What is your purpose for coming to the clinic today?" is an open-ended question that focuses on the patient's reason for seeking care. "Have you ever been a patient in this clinic before?" is a close-ended question that yields a "yes" or "no" response. This question may be asked on the first visit, but not as an opening question for a health interview. "Tell me a little about yourself and your family" is an open-ended question, but it is too general, and it is at least two questions: one about the patient and another about the family. "Did you have any difficulty finding the clinic?" is a social question and does not focus on the patient's purpose for the visit. Which statement by the nurse demonstrates a patient- centered interview? a. "I need to complete this questionnaire about your medical and family history." b. "The hospital requires me to complete this assessment as soon as possible." c. "Tell me about the symptoms you've been having." Chapter 2 Obtaining a health history (TEST BANK) (EXAM 1) Questions And Answers a huge bruise on your face. Did your husband hit you?" assumes that domestic violence did occur, and the comment does not encourage the patient to divulge additional information. "That bruise looks tender. I don't know how people can do that to one another" assumes that domestic violence did occur, and the comment does not encourage the patient to divulge additional information. "If your boyfriend has hit you, you can get a restraining order against him" assumes that domestic violence did occur, and the comment does not encourage the patient to divulge additional information. Which technique used by the nurse encourages a patient to continue talking during an interview? a. Laughing and smiling during conversation b. Using phrases such as "Go on," and "Then?" c. Repeating what the patient said, but using different words d. Asking the patient to clarify a point The Answer Is b. Using phrases such as "Go on," and "Then? Using phrases such as "Go on" and "Then?" encourages the patient to continue talking. Laughing and smiling during conversation may show attentiveness during the interview, but does not encourage more talking. Rephrasing what the patient has said is restatement. It Chapter 2 Obtaining a health history (TEST BANK) (EXAM 1) Questions And Answers confirms your interpretation of what they said, but does not encourage additional talking. Asking the patient to clarify a point is done when the information is conflicting, vague, or ambiguous. During the history, the patient states that she does not use many drugs. What is the nurse's appropriate response to this statement? a. "Tell me about the drugs you are using currently." b. "To some people six or seven is not many." c. "Do you mean prescription drugs or illicit drugs?" d. "How often are you using these drugs? The Answer Is a. "Tell me about the drugs you are using currently." "Tell me about the drugs you are using currently" is an open-ended question that allows patients to provide further data. "To some people six or seven is not many" is a comment that does not ask a question or obtain useful data. "Do you mean prescription drugs or illicit street drugs?" is a closed-ended question that yields data about the type of drugs used only. "How often are you using these drugs?" asks about frequency of drug use, which is not useful until the drugs are known Chapter 2 Obtaining a health history (TEST BANK) (EXAM 1) Questions And Answers A nurse is interviewing a patient who was diagnosed with type 2 diabetes mellitus 6 months ago. Since that time, the patient has gained weight and her blood glucose levels remain high. The nurse suspects that the patient is noncompliant with her diet. Which response by the nurse enhances data collection in this situation? a. "Tell me about what foods you eat and the frequency of your meals." b. "What symptoms do you notice when your blood sugar levels are high?" c. "You need to follow what the doctor has prescribed to manage your disease." d. "Tell me what you know about the cause of type 2 diabetes." The Answer Is a. "Tell me about what foods you eat and the frequency of your meals." "Tell me about what foods you eat and the frequency of your meals" gathers more data from the patient to help the nurse confirm if noncompliance is the reason for the weight gain and high glucose levels. "What symptoms do you notice when your blood sugar levels are high?" does not help the nurse determine if the patient is noncompliant. It may be useful later when teaching the patient about her disease. "You need to follow what the doctor has prescribed to manage your disease" does not provide additional data for the nurse Chapter 2 Obtaining a health history (TEST BANK) (EXAM 1) Questions And Answers What does the nurse say to obtain more data about a patient's vague statement about diet such as, "My diet's okay"? a. "Eating a variety of meats, fruits, and vegetables each day is important." b. "Give me an example of the foods you eat in a typical day." c. "Go on." d. "Does your diet meet your needs or does it need improvement?" The Answer Is b. "Give me an example of the foods you eat in a typical day." "Give me an example of the foods you eat in a typical day." This statement asks the patient to clarify the vague statement, "My diet is okay." "Eating a variety of meats, fruits, and vegetables each day is important." While this statement is true, it does not obtain data about what foods the patient consumes. "Go on" encourages patients to continue talking, but does not help clarify what foods are consumed. "Does your diet meet your needs or does it need improvement?" This response does not help clarify what foods the patient eats. Also it contains two questions rather than asking one question at a time While giving a history, a male patient describes several events out of order that occurred in different decades in Chapter 2 Obtaining a health history (TEST BANK) (EXAM 1) Questions And Answers his life. What technique does the nurse use to understand the timeline of these events? a. State the order of events as understood and ask the patient to verify the order. b. Draw conclusions about the order of events from data given. c. Ask the patient to elaborate about these events. d. Ask the patient to repeat what he said about these events The Answer Is a. State the order of events as understood and ask the patient to verify the order. State the order of events as understood and ask patient to verify the order is correct. This therapeutic technique is useful when interviewing a patient who rambles or does not provide sequential data. Drawing conclusions about the order of events is interpretation. In this example, the sequence of events is more relevant than an interpretation. The nurse may have difficulty interpreting an unclear sequence of events. Asking the patient to elaborate about these events will not provide order to the sequence of events. Asking the patient to repeat what he said about these events will not necessarily provide a sequence of events. A male patient is very talkative and shares much information that is not relevant to his history or the Chapter 2 Obtaining a health history (TEST BANK) (EXAM 1) Questions And Answers reason for his admission. Which action by the nurse improves data collection in this situation? a. Terminate the interview. b. Use closed-ended questions. c. Ask the patient to stay on the subject. d. Ask another nurse to complete the interview The Answer Is b. Use closed-ended questions. Using closed-ended questions is useful to obtain specific data when open-ended questions are not obtaining the needed data. Terminating the interview is not beneficial to the patient and does not allow data collection. Asking the patient to stay on the subject is not therapeutic and may result in less data collection. Asking another nurse to complete the interview may not be practical and interrupts the nurse-patient relationship that has been established. A patient answers questions quietly and appears sad. While answering questions about her marriage, she begins to cry. Which response by the nurse is appropriate in this situation? a. "Don't cry! I'll come back when you've settled down." b. "I only have a few more questions to ask, and then I'll leave you alone for a while." Chapter 2 Obtaining a health history (TEST BANK) (EXAM 1) Questions And Answers c. When encouraging a patient to elaborate on details of his or her history d. When collecting data about the current health problem The Answer Is b. When obtaining a history from an overly talkative patient When obtaining a history from an overly talkative patient, a nurse can resort to closedended questions to complete the data collection in a timely manner. When clarifying vague and conflicting data, the nurse needs to use open- ended questions to obtain data. When encouraging the patient to elaborate on details of his or her history, the nurse needs to use open-ended questions to obtain the details. When collecting data about the current problem, the patient needs to describe the symptoms that brought him or her to seek help. These details are not collected with closed-ended questions. The nurse is interviewing a woman with her husband present. The husband answers the questions for the wife most of the time. What is the most appropriate therapeutic nursing action to hear the patient's viewpoint? a. Continue the interview. b. Ask the husband to step out of the room. c. Ask another nurse to complete the interview. Chapter 2 Obtaining a health history (TEST BANK) (EXAM 1) Questions And Answers d. Tell the woman to speak up for herself The Answer Is b. Ask the husband to step out of the room. Asking the husband to step out of the room will allow the patient to answer questions in her own way. Continuing the interview is not a therapeutic action because the nurse needs to obtain the patient's answers to the questions. Asking another nurse to complete the interview does not solve the problem that the husband is answering questions for his wife. Telling the woman to speak up for herself does not solve the problem and may interfere with the therapeutic relationship between the patient and the nurse. A female Korean patient accompanied by her husband and son comes to the emergency department (ED) complaining of abdominal pain. The patient speaks and understands Korean only. Which person is the appropriate choice for the nurse to use to get a history from this patient? a. The patient's husband who speaks Korean and English b. The patient's son who speaks Korean and English c. A male technician who works in the ED who speaks Korean and English d. A female interpreter who speaks Korean and English and is available by phone Chapter 2 Obtaining a health history (TEST BANK) (EXAM 1) Questions And Answers The Answer Is d. A female interpreter who speaks Korean and English and is available by phone A female interpreter who speaks Korean and English and is available by phone is the best choice because she can communicate with the patient and is the same gender as the patient. The patient's husband who speaks Korean and English is not the best choice because he is a family member and may alter the meaning of what is said. The patient's son who speaks Korean and English is not the best choice because he is a family member and may alter the meaning of what is said. A male technician working in the ED who speaks Korean and English is not a good choice because the patient may feel uncomfortable giving a history to a stranger who is male. Which nurse demonstrates culturally competent care for a female patient from Russia? a. Nurse A who asks the patient about cultural factors that influence health care b. Nurse B who interacts with every patient from Russia in the same manner c. Nurse C who learns the cultural variables of every culture, including Russia d. Nurse D who relies on her previous experience with patients from Russia Chapter 2 Obtaining a health history (TEST BANK) (EXAM 1) Questions And Answers d. Subjective assessment data The Answer Is c. Reason for seeking care (chief complaint) The reason for seeking care (chief complaint) is the patient's reason for seeking care (also called the presenting problem). The patient's reason for seeking care is often recorded as a direct quote. The past health history includes data about immunizations, surgeries, accidents, and childhood illnesses. The present health status includes data the nurse obtains from the patient, often using a symptom analysis in which more data are collected about the patient's reason for seeking care. Subjective assessment data include information from the patient. In this example, the patient expresses the reason for seeking care, which is directly quoted and placed in quotation marks in the chief complaint section of the data sheet so that the patient's reason for seeking care can be easily identified. A patient comes to the ambulatory surgery center for an elective procedure this morning. While giving the admission history, the patient states she is allergic to latex. a. Removing all latex products from the patient's room b. Using powdered gloves when providing care to this patient Chapter 2 Obtaining a health history (TEST BANK) (EXAM 1) Questions And Answers c. Informing the surgeon that the patient has type I hypersensitivity to latex d. Questioning the patient about symptoms experienced in the past with latex The Answer Is d. Questioning the patient about symptoms experienced in the past with latex Questioning the patient about symptoms experienced in the past with latex is the appropriate response. When patients indicate an allergy to a medication or substance, ask them to describe what happens with exposure to determine whether the reaction is a side effect or an allergic reaction. Removing all latex products from the patient's room is unnecessary at this time because the latex allergy has not been confirmed. Using powdered gloves when providing care to this patient is unnecessary at this time because the latex allergy has not been confirmed. Informing the surgeon that the patient has type I hypersensitivity to latex is unnecessary at this time because the latex allergy has not been confirmed. A nurse is interviewing a male patient who reports he has not had a tetanus immunization in about 15 years because he had a "bad reaction" to the last tetanus immunization. What is the most appropriate response by the nurse in this case? a. Notify the health care provider that this immunization cannot be given. Chapter 2 Obtaining a health history (TEST BANK) (EXAM 1) Questions And Answers b. Document that the patient is allergic to the tetanus vaccine. c. Give the vaccine after explaining that adverse reactions are rare. d. Ask the patient to describe the "bad reaction" to the vaccine in more detail The Answer Is d. Ask the patient to describe the "bad reaction" to the vaccine in more detail The nurse needs to collect more data about the reaction from the patient to determine the type of reaction experienced. The nurse is trying to assess the relationship between the "reaction" reported by the patient and an allergic reaction. The immunization should not be eliminated at this time. Additional facts are needed to determine the type of reaction the patient experienced. Documenting an allergy to the tetanus vaccine may be an error because there are insufficient data to make that determination at this time. Giving the vaccine may be an error if the patient is allergic to the vaccine and additional data indicates that may be the case A patient admitted with pneumonia reports that she takes insulin for diabetes mellitus. In which section of the history does the nurse document the insulin and diabetes? Chapter 2 Obtaining a health history (TEST BANK) (EXAM 1) Questions And Answers "How often are you exercising?" is a question about activities patients regularly perform to maintain health. "Do you have any allergies?" is a question for the present health status rather than health promotion. "What are you doing to relieve your leg pain?" is a question that is part of the symptom analysis. "What kind of herbs are you using?" is a question for the present health status rather than health promotion. The patient reports having a persistent cough for the past 2 weeks and that the cough disrupts sleep and has not been helped by over-the-counter cough medicines. Which question is most appropriate for the nurse to ask next? a. "So what do you think is causing this persistent cough?" b. "Have you tried taking sleeping pills to help you sleep?" c. "Did you think this will just go away on its own?" d. "What other symptoms have you noticed related to this cough?" The Answer Is d. "What other symptoms have you noticed related to this cough?" "What other symptoms have you noticed related to this cough?" is part of a symptom analysis to provide more data. The answer to the question "So what do you think is causing this persistent cough?" is a guess by the patient Chapter 2 Obtaining a health history (TEST BANK) (EXAM 1) Questions And Answers and does not provide useful data. "Have you tried taking sleeping pills to help you sleep?" does not focus on the cough, which is what is disturbing the patient's sleep. "Did you think this will just go away on its own?" does not provide useful data and criticizes the patient's lack of action Which data do nurses document under the heading of Past Health History? (Select all that apply.) a. Father has Alzheimer disease. b. Last tetanus in 2009 c. Had chicken pox as a child d. Drinks three to four beers each day e. Had a dental examination 6 months ago The Answer Is B,C,E Which data do nurses document under the heading of Personal and Psychosocial History? (Select all that apply.) a. Walks for 45 minutes each day b. Eats meats, vegetables, and fruit at two meals daily c. Is allergic to milk and milk products d. Is married and has two daughters whom he is close to Chapter 2 Obtaining a health history (TEST BANK) (EXAM 1) Questions And Answers e. Smokes marijuana once a week f. Grandfather died from prostate cancer The Answer Is A,B,D,E Which questions are pertinent to ask when obtaining a symptom analysis from a patient who reports breathing problems? (Select all that apply.) a. How long have you had this problem with your breathing? b. Do you have a family history of breathing problems? c. Does this breathing problem come and go or isit constant? d. What do you do to make your breathing better? e. How does this breathing problem affect your work or daily activities? f. How many packs of cigarettes do you smoke a day? The Answer Is A,C,D,E Which questions are pertinent to ask when obtaining a symptom analysis from a patient who reports a headache? (Select all that apply.) a. Describe what the headache feels like. b. When was your last eye examination? c. What makes the headaches worse?