NR 302 - Chapter 3 The Interview, NR 302 - Chapter 3 Practice Questions

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 confrontation, 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."

"Mr. K., you have said that you don't smoke, but I see that you have an open pack of cigarettes in your pocket."

Ten Traps of Interviewing

1. Providing false assurance of reassurance 2. Giving unwanted advice 3. Using authority 4. Using avoidance language 5. Engaging in distancing 6. using professional jargon 7. using leading or biased questions 8. talking too much 9. interrupting 10. using "why" questions

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. "Do you sterilize the bottles?" C. "Do you have nausea and vomiting?" D. "You have been taking your medicine, haven't you?"

A. "Do you take medicine?"

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."

A. "You're afraid you might lose your breast?"

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 with whom to talk. 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.

A. An aged person has a longer story to tell

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. 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 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."

A. Be silent, and allow him to continue when he is ready

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.

A. Collect the patient's data in direct, face-to-face manner. D. Type the data into the computer after the narrative is fully explored E. Allow the patient to see the monitor during typing

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.

A. Determine the communication method he prefers

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.

A. Note-taking may impede the nurse's observation of the patient's nonverbal behaviors

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 2 feet 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

A. Reduces noise by turning off televisions and radios

A female nurse is interviewing a man who has recently immigrated. 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 behaviors 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. These behaviors are indicative of sexual aggression, and the nurse should confront this person about his behaviors. D. The nurse should laugh but tell him that he or she is uncomfortable with his proximity and ask him to move away.

A. The nurse should try to relax; these behaviors are culturally appropriate for this person

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 behavior with his wife would have been better. D. A direct question is the best way to discover the reasons for his behavior.

A. This question may place the patient on the defensive

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

A. Trained interpreter

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."

B. "Fits? Tell me what you mean by this."

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: 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?"

B. "I can see that you are sad remembering this. It is all right to cry."

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."

B. "Is there anything else you would like to mention?"

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?"

B. "Would you like some information about the different ways a person can quit smoking?"

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.

B. Allow time for the patient to confirm or correct the inference

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.

B. Be totally honest with him, even if the information is unpleasant

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? The woman is: A. Excited about her pregnancy but nervous about her 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 her D. Not excited about her pregnancy but believes the nurse will negatively respond to her if she states this

B. Exhibiting verbal and nonverbal behaviors that do not match

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 this response? 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 labor cannot be tolerated without medication.

B. Nontherapeutic response. By providing false reassurance, the nurse actually cut off further discussion of the woman's fears

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,

B. Stoop down to her level, and ask her about the toy she is holding

The nurse is conducting an interview. Which of these statements is true regarding open-ended questions? 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.

B. They allow for self-expression C. Open-ended questions build and enhance rapport F. They are used when narrative information is needed

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 face this all alone." D. "I would be angry, too; raising a child alone is no picnic."

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

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, 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."

C. "It sounds as if you might be afraid of how your husband will respond."

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

C. Man whose wife has just been diagnosed with lung cancer

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

C. Social distance

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.

C. This type of comment promotes dependency and inferiority on the part of the patient and is best avoided in an interview situation

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.

C. Using biased or leading questions

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?"

D. "How has your health been since your last visit?"

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: 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."

D. "It makes me uncomfortable when you talk that way. Please stop."

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?"

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?"

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 Mrs. C." B. "Hello, Mrs. H., my name is Mrs. C. It sure is cold today!" C. "Mrs. H., my name is Mrs. C. How are you?" D. "Mrs. H., my name is Mrs. C. I'll need to ask you a few questions about what happened."

D. "Mrs. H., my name is Mrs. C. I'll need to ask you a few questions about what happened."

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. Confrontation.

D. Confrontation

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 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.

D. Focus on the patient's nonverbal behaviors, because these are often more relective of a patient's true feelings

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

D. Open-ended question

A female American Indian has come to the clinic for follow-up diabetic teaching. During the interview, the nurse notices that she never makes eye contact and speaks mostly to 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 behaviors. D. She is showing that she is carefully listening to what the nurse is saying.

D. She is showing that she is carefully listening to what the nurse is saying

During the interview portion of data collection, the nurse collects __________ data. A. Physical B. Historical C. Objective D. Subjective

D. Subjective

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? 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.

D. Tell the child that by using the blood pressure cuff, we can see how strong her muscles are

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 changed posture would suggest that the parent is: 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.

D. Uncomfortable talking about his son's treatment

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

Opening or introduction

Open Ended Questions

ask for narrative responses state topic only in general terms use in the following situations: to begin interview to introduce a new section of questions whenever the patient introduces a new topic

Closed or Direct Questions

ask for specific information elicit short one or two word answers: a yes or no answer, or a forced choice use in the following situations: after opening narrative to fill in details person may have left out when you need many specific facts about past health problems or during review of systems to move the interview along

Interpretation

based on your inference or conclusion it links events, makes associations, implies cause, ascribes feelings helps person understand his or her own feelings in relation to the verbal message if your inference is incorrect, the patient may correct it and thus prompt further discussion of topic

Gender

being aware of maintaining cultural norms during interview and examination process maintaining privacy and modesty

Challenges of Note Taking

breaks eye contact too often shifts attention away from person, diminishing his or her sense of importance interrupts patient's narrative flow may be threatening to patient's discussion of sensitive issues

Object Cues

clothing jewelry hairstyles

Interview Contract

consists of spoken and unspoken rules for behavior

Working Phase

data gathering phase verbal skills include questions to patient and your responses to what is said

Reflection

echoes patient's words, repeating what the person has just said, focuses further attention on a specific phase, and helps person continue in his or her own way

Communication External Factors

ensure privacy refuse interruptions physical environment dress note taking (may be unaviodable) tape and video recording

Assisting the Narrative

facilitation encourages patient to say more and shows you are interested and will listen further

Summary

final review of what person has said; it ocndenses facts and presents your view of health problem is a type of validation that person can agree with or correct; both you and patient should participate occurring at the end of the interview, it signals that temination of the interview is near

Confrontation

frame of reference shifts form patient's perspective to yours may focus on discrepancy or inconsistenc in person's narrative you have observed a certain action, feeling, or statement and now focus person's attention on it you give honest feedback about what you see or feel

Silent Attentiveness

gives patient time to think and organize what to say without interruption from you gives you a chance to observe person unobrtusively and note nonverbal cues

Health Literacy

includes understanding and following directions that lead to effective communication between the patient and the health care provider

Personal Space

interpersonal transactions and care of belongings

Touch

involves use of personal space and action

Communication

is behavior, conscious, and unconscious, verbal and nonverbal

Communication Internal Factors

liking others empathy ability to listen

Sexual Orientation

maintaining neutrality related to patient's presentation by being mindful of communication patterns being aware of your own personal bias baggage

Elements of the Interview Process

nonverbal skills physical appearance posture gestures facial expression eye contact voice touch closing the interview

Two Types of Questions

open ended closed

Techniques to Improve Health Literacy

oral teaching use of written materials based on standard education levels teach back or use return demonstration

Vocal Cues

pitch, tone, and quality of voice, including moaning, crying, and groaning

Action Cues

posture facial expression gestures

Empathy

recognizes a feeling and puts it into words names the feeling and allows expression of it

Interview

subjective data collection identify health strengths and problems as bridge to physical examination first and most important part of data collection

Explanation

these statements inform the person that you share factual and objective information, offering reasons for requirements or actions

Interview Contract Terms

time and place of interview and physica exam introduction and explaination of health care provider's role purpose of interview how long it will take expectation of participation for each person

Clarification

use when a person's words are confusing. used to summarize person's words and to simplify them to make them clearer you are asking for agreement and the person can then confirm or deny your understanding