Health Assessment Chapters 1&2

4. Mr. L presents to the clinic with severe groin pain and a history of kidney stones. Mr. L's son tells you that for religious reasons, his father wishes to keep any stone that is passed into the urine filter that he has been using. What is your most appropriate response? a. "With your father's permission, we will examine the stone and request that it be returned to him." b. "The stone must be sent to the lab for examination and therefore cannot be kept." c. "We cannot let him keep his stone because it violates our infection control policy." d. "We don't know yet if your father has another kidney stone, so we must analyze this one." e. "I have found it unwise to make these kinds of individual exceptions to hospital procedure."

ANS: A Health care providers should be willing to modify the delivery of health care in a manner that is respectful and in keeping with the patient's cultural background. It is better to mediate than to be coercive. The statement, "With your father's permission, we will examine the stone and request that it be returned to him" does this most effectively.

12. A 50-year-old man comes to the primary care clinic. He tells you he is worried because he has had severe chest pains for the past 2 weeks. Which initial history interview question is most appropriate? a. "Can you describe the pain?" b. "The pain doesn't radiate to your arm, does it?" c. "Have you been treated for anxiety before?" d. "Does your father have heart disease?" e. "Are the pains worse after you eat?"

ANS: A Initially, an open-ended question is a more appropriate response. "Can you describe the pain?" is an open-ended question that offers clues to the chief concern.

40. Which of the following is considered an IADL but not an ADL? a. Paying bills b. Toileting c. Walking around the house d. Dressing oneself e. Eating

ANS: A Paying bills is an instrumental activity of daily living but not an activity of daily living

11. Informing a patient that he or she has a terminal illness is most likely to be discouraged in which cultural group? a. Navajo Native Americans b. Dominant Americans c. First-generation African descendants d. First-generation European descendants e. Hispanics

ANS: A The Navajo culture believes that thought and language have the power to shape reality; the desire to avoid discussing negative information is particularly strong in this culture.

20. Information that is needed during the initial interview of a pregnant woman includes all of the following except a. the gender that the woman hopes the baby will be. b. her past medical history. c. her health care practices. d. the woman's knowledge about pregnancy. e. potential pregnancy risk factors.

ANS: A The initial interview for the pregnant woman should include information of about her past history, assessment of health practices, identification of potential risk factors, and assessment of her knowledge because it affects the pregnancy.

30. Direct questioning about intimate partner violence in the home should be a. a routine component of history taking with female patients. b. avoided for fear of offending the woman's partner. c. conducted only in cases in which there is a history of abuse. d. used only when the patient is obviously being victimized. e. used only when bruises are found on physical examination

ANS: A The presence of intimate partner violence should be routinely queried, and the questioning should be direct for all female patients

8. Mr. F. is speaking with you, the health care provider, about his respiratory problem. Mr. F. says, "I've had this cough for 3 days, and it's getting worse." You reply, "Tell me more about your cough." Mr. F. states, "I wish I could tell you more. That's why I'm here. You tell me what's wrong!" Which caregiver response would be most appropriate for enhancing communication? a. "After 3 days, you're tired of coughing. Have you had a fever?" b. "I'd like to hear more about your experiences. Where were you born?" c. "You may have a serious problem, and being confrontational will not help." d. "I'll examine you and figure out the problem later." e. "I don't know what's wrong. You could have almost any disease."

ANS: A This is the only response aimed at focusing on the chief concern to gather more data and does not digress from the issue

3. Which action would best promote accurate translations as well as confidentiality when the caregiver does not speak the patient's language? a. Ask a person unfamiliar with the patient to translate. b. Have a friend of the patient translate. c. Ask simple leading questions that the patient may understand. d. Use a neighbor as translator. e. Involve the family with the translation.

ANS: A When you do not speak the patient's language, family members or friends may pose a communication barrier and may have issues of confidentiality; a stranger as an interpreter is less biased.

14. A 36-year-old woman complains that she has had crushing chest pain for the past 2 days. She seems nervous as she speaks to you. An appropriate response is to a. continue to collect information regarding the chief concern in an unhurried manner. b. finish the interview as rapidly as possible. c. ask the patient to take a deep breath and calm down. d. ask the patient if she wants to wait until another day to talk to you. e. ignore her, because anxiety rarely accompanies physical disorders.

ANS: A With an anxious, vulnerable patient, it is best to not hurry; a calm demeanor communicates caring to the patient.

36. A survey of mobility and activities of daily living (ADLs) is part of a(n) a. ethnic assessment. b. functional assessment. c. genetic examination. d. social history. e. sexual history.

ANS: B A functional assessment is an assessment of a patient's mobility, upper extremity movement, household management, activities of daily living, and instrumental activities of daily living.

14. An aspect of traditional Western medicine that may be troublesome to many Hispanics, Native Americans, Asians, and Arabs is Western medicine's attempt to a. use a holistic approach that views a particular medical problem as part of a bigger picture. b. determine a specific cause for every problem in a precise way. c. establish harmony between a person and the entire cosmos. d. use herbal remedies and rituals. e. promote balance in an individual's life.

ANS: B A more scientific approach to health care problem solving, in which a cause can be determined for every problem in a precise way, is a Western approach. Hispanics, Native Americans, Asians, and Arabs embrace a more "holistic" approach.

37. Constitutional symptoms in the ROS refer to: a. height, visual acuity, and body mass index. b. fever, chills, fatigue, and malaise. c. hearing loss, tinnitus, and diplopia. d. rashes, skin turgor, and temperature. e. joint stiffness, redness, and swelling

ANS: B General constitutional symptoms refer to fever, chills, malaise, fatigability, night sweats, sleep patterns, and weight (average, preferred, present, change).

17. During an interview, you have the impression that a patient may be considering suicide. Which action is essential? a. Immediately begin proceedings for an involuntary commitment. b. Ask whether the patient has considered self-harm. c. Ask whether the patient would like to visit a psychiatrist. d. Record the impression in the patient's chart and refer the patient for hospitalization. e. Avoid directly confronting the patient regarding your impression.

ANS: B If you think the patient may be considering suicide, he or she probably is. Mentioning it gives permission to talk about it.

35. Pain is difficult to assess in older adults because a. their histories are usually unreliable. b. sharp pain may be felt as a dull ache. c. they tend to exaggerate symptoms. d. their language skills decline. e. drugs act more rapidly with age.

ANS: B Pain is often an unreliable symptom in older adults because they lose pain perception and experience pain in a different manner from those in other age groups.

2. Which statement is true regarding the relationship of physical characteristics and culture? a. Physical characteristics should be used to identify members of cultural groups. b. There is a difference between distinguishing cultural characteristics and distinguishing physical characteristics. c. To be a member of a specific culture, an individual must have certain identifiable physical characteristics. d. Gender and race are the two essential physical characteristics used to identify cultural groups. e. Whereas all cultural traits can be viewed as static, physical traits are dynamic.

ANS: B Physical characteristics do not symbolize cultural groups; there is a difference between the two, and they are considered separately. Cultures are dynamic in their evolution.

7. Which statement is true regarding impoverished people? a. In the United States, socioeconomic status does not influence the delivery of health care. b. The morbidity and mortality rates of impoverished people are greater than those of the middle class. c. The morbidity and mortality rates of impoverished people are less than those of the middle class. d. No reliable statistics exist regarding the relationship of poverty to morbidity and mortality. e. The morbidity and mortality rates of impoverished people are similar to those of the middle class.

ANS: B Poorly educated people and people in poverty die at higher rates than those who are advantaged; the same is true for morbidity.

13. As you explain your patient's condition to her husband, you notice that he is leaning toward you and pointedly blinking his eyes. Knowing that he is from England, your most appropriate response to this behavior is to a. tell him that you understand his need to be alone. b. ask whether he has any questions. c. ask whether he would prefer to speak to the clinician. d. tell him that it is all right to be angry. e. stop questioning the patient immediately

ANS: B The English worry about being overheard and tend to speak in modulated voices, so when they lean in toward you, they are probably ready with a question.

25. A brief statement of the reason the patient is seeking health care is called the a. medical history. b. chief concern c. assessment. d. diagnosis. e. review of systems.

ANS: B The chief concern is a brief statement of the reason the patient is seeking health care.

1.Which question would be considered a "leading question?" a. "Please describe any associated symptoms with your headaches?" b. "You don't get headaches often, do you?" c. "What activities affect the severity of your headaches?" d. "What times of the day are your headaches the most severe?" e. "What worries you most about your headache."

ANS: B This question would limit the information in the patient's answer. The other choices allow the patient more discretion about the extent of an answer.

13. After you ask a patient about her family history, she says, "Tell me about your family now." Which response is generally most appropriate? a. Ignore the patient's comment and continue with the interview. b. Give a brief, undetailed answer. c. Ask a direct question that refocuses the patient on the chief concern. d. Tell the patient that you do not discuss your family with patients. e. Ask the patient why she needs to know.

ANS: B This response will satisfy the patient's curiosity about yourself without invading your private life

7. Which technique is most likely to result in the patient's understanding of questions? a. Use phrases that are commonly used by other patients in the area. b. Use the patient's own terms if possible. c. Use language that keeps the patient from being expansive in his or her answer. d. Use proper medical and technical terminology. e. Use the simplest language possible.

ANS: B To ensure that your questions have been correctly understood, be clear and explicit while using the patient's idiom and level of understanding.

5. Behaviors that diffuse anxiety during the interview include a. trying to limit the patient to simple "yes" or "no" answers. b. providing forthright answers to questions. c. providing all necessary information before the patient has to ask for it. d. completing the interview as quickly as possible. e. avoiding the wearing of uniforms and laboratory coats

ANS: B To relieve anxiety, the health care professional should answer patient questions in a forthright manner, avoiding overload of information and without hurrying the conversation

27. When questioning the patient regarding his or her sexual history, which question should be asked initially? a. "Do you have any particular sexual likes or dislikes?" b. "Do you have any worries or concerns regarding your sex life?" c. "How often do you have intercourse and with whom?" d. "Do you have any reason to think you may have been exposed to a sexually transmitted infection?" e. "What sexually transmitted diseases have you had in the past?"

ANS: B When approaching questioning about a sensitive area, it is recommended that the provider first ask open-ended questions that explore the patient's feelings about the issue

16. An example of a "cold" condition would be a. a fever. b. a rash. c. tuberculosis. d. an ulcer. e. a sore throat.

ANS: C A cold condition among cultures with a holistic approach is tuberculosis.

15. In a naturalistic or holistic approach to health, an example of a "hot" condition would be a. teething. b. joint pain. c. diarrhea. d. a nasal cold. e. a headache

ANS: C A hot condition among cultures with a holistic approach is diarrhea

18. A naturalistic or holistic approach to health care often assumes a. that hot conditions require treatment with a hot remedy. b. a reductionist view that looks to a very narrow cause and effect. c. there are external factors that must be kept in balance. d. that there are hot and cold conditions but not hot and cold remedies. e. that hot and cold conditions are the same among different cultures

ANS: C A naturalistic or holistic approach often assumes that there are external factors—some good, some bad—that must be kept in balance if we are to remain well.

19. You are collecting a history from an 11-year-old girl. Her mother is sitting next to her in the examination room. When collecting history from older children or adolescents, they should a. never be interviewed alone because this may alienate the parent. b. be mailed a questionnaire in advance to avoid the need for her to talk. c. be given the opportunity to be interviewed without the parent at some point d. be allowed to direct the flow of the interview. e. be ignored while you address all questions to the parent.

ANS: C An older child should be given the opportunity to give information directly. This enhances the probability that the child will follow your advice

6. Your new patient is a 40-year-old Middle Eastern man with a complaint of new abdominal pain. You are concerned about violating a cultural prohibition when you prepare to do his rectal examination. The best tactic would be to a. do the examination because it is a necessary part of the physical examination. b. ask a colleague from the same geographic area if this examination is acceptable. c. inform the patient of the reason for the examination and ask if it is acceptable to him. d. refer the patient to a provider more knowledgeable about cultural differences. e. forego the examination for fear of violating cultural norms.

ANS: C Asking, if you are not sure, is far better than making a damaging mistake

41. A pedigree diagram is drafted for the purpose of obtaining a. sexual orientation and history. b. growth and developmental status. c. genetic and familial health problems. d. ethnic and cultural backgrounds. e. the past medical history.

ANS: C Drafting a pedigree diagram, or genogram, is a method to determine consanguinity of health problems.

28. A guideline for history taking is for caregivers to a. ask direct questions before open-ended questions so that the data move from simple to complex. b. use a previous diagnosis as a chief concern whenever possible. c. make notes sparingly so that patients can be observed during the history taking. d. write detailed information as stated by patients so their priorities are reflected. e. ask for a complete history at once so that data are not forgotten between meetings.

ANS: C During an interview, you should maintain eye contact with the patients, observing body language and proceeding from open-ended to direct questions.

38. J.M. has been seen in your clinic for 5 years. She presents today with signs and symptoms of acute sinusitis. The type of history that is warranted is a(n) _____ history. a. complete b. inventory c. problem or focused d. interim e. family

ANS: C If the patient is well known or if you have been seeing the patient for the same problem over time, a focused history is appropriate.

8. In terms of cultural communication differences, Americans are more likely to _____ than other groups of patients. a. emphasize attitudes and feelings b. maintain eye contact c. come quickly to the point d. use silence comfortably e. speak more softly than other cultures

ANS: C In the United States, individuals are very direct in conversation and come to the point quickly. They also tend to talk more loudly and to worry less about being overheard.

12. A 22-year-old female nurse is interviewing an 86-year-old male patient. The patient avoids eye contact and answers questions only by saying, "Yeah," "No," or "I guess so." Which of the following is appropriate for the interviewer to say or ask? a. "Why are you so depressed?" b. "It's hard for me to gather useful information because your answers are so short." c. "Are you uncomfortable talking with me?" d. "Does your religion make it hard for you to answer my questions?" e. "We will be able to communicate better if you will look at me."

ANS: C It is all right to ask if the patient is uncomfortable with any aspect of your person and to talk about it; the other choices are less respectful

19. Because of common cultural food preferences, avoidance of monosodium glutamate (MSG) is likely to be most problematic for the hypertensive patient of which group? a. Native Americans b. Hispanics c. Chinese d. Italians e. Orthodox Jews

ANS: C Of all the choices, the Chinese are more likely to use MSG and soy sauce in their diet.

1. Which of the following describes a physical, not a cultural, differentiator? a. Ritual b. Rite c. Race d. Norm e. Ethos

ANS: C Race is a physical, not a cultural, differentiator

2. To prevent personal appearance from becoming an obstacle in patient care, the health care professional should a. wear a uniform. b. always wear a white coat. c. avoid extremes in dress. d. avoid wearing any jewelry. e. avoid wearing white.

ANS: C Sensible personal habits, along with avoidance of extremes in behavior and dress, contribute to establishing a trusting relationship between the provider of care and the patient. Uniforms help identify roles rather than relationships

6. Periods of silence during the interview can serve important purposes, such as a. allowing the clinician to catch up on documentation. b. giving you a clue that you should speed up the interview. c. providing time for reflection. d. increasing the length of the visit. e. promoting calm.

ANS: C Silence is a useful tool during interviews for the purposes of reflection, summoning of courage, and displaying compassion. It is usually a clue for you to go slower and not to push too hard.

31. Mrs. G. reports an increase in her alcohol intake over the past 5 years. To screen her for problem drinking, you would use the a. Miller Analogies Test. b. PACE Assessment Instrument. c. CAGE questionnaire. d. Glasgow Coma Scale. e. HITS questionnaire.

ANS: C The CAGE questionnaire is a model for approaching a discussion of the use of alcohol.

10. A person's definition of illness is likely to be most influenced by: a. race. b. ritual. c. enculturation. d. age group. e. socioeconomic class.

ANS: C The definition of "ill" is determined in large part by the individual's —the process whereby an individual assumes the traits and behaviors of a given culture.

22. When interviewing older adults, the examiner should a. speak extremely loudly because most older adults have significant hearing impairment. b. provide a written questionnaire in place of an interview. c. position himself- or herself face to face with the patient. d. ask questions containing double negatives. e. dim the lights to decrease anxiety.

ANS: C The health care provider should position himself- or herself so that the older patient can see his or her face. Shouting distorts vocalizations, dimming the lights impairs vision; a written interview may be necessary if all else fails. The provider's language should be uncomplicated and free from double negatives.

10. When questioning a patient regarding alcohol intake, she tells you that she is "only a social drinker." Which initial response is appropriate? a. "I'm glad that you are a responsible drinker." b. "Many people who are really alcoholic say they are social drinkers." c. "What amount and what kind of alcohol do you drink in a week?" d. "If you only drink socially, you won't need to worry about always having a designated driver." e. "Do the other people in your household consume alcohol?"

ANS: C This answer clarifies the patient's own term without asking a leading question or being judgmental.

3. A fixed image of any group that rejects its potential for originality or individuality is known as a(n) a. acculturation. b. norm. c. stereotype. d. ethnos. e. custom.

ANS: C This definition describes a stereotype. A norm, on the other hand, is a standard of allowable behavior within a group, ethnos implies the same race or nationality, and acculturation is a process of adopting another culture's behaviors. A custom refers to a habitual activity of a group in a given situation.

5. To develop cultural competence, one should a. ignore one's own cultural beliefs. b. attempt to convince the patient to accept institutional mores. c. realize that cultural values are difficult to change and must be respected. d. realize that all members of a cultural group behave the same way. e. understand that an individual's culture has no effect on the delivery of health carein this country.

ANS: C To develop cultural competence, health care providers should examine their own beliefs, respect the unfamiliar, appreciate that cultural values are difficult to change, and do not expect all members of a cultural group to behave exactly the same. Differences in culture can sometimes have an overpowering effect on the delivery of health and medical care.

26. When taking a history, you should a. ask patients to give you any information they can recall about their health. b. start the interview with the patient's family history. c. use a chronologic and sequential framework. d. use a holistic and eclectic structure. e. start the interview with the social history.

ANS: C To give structure to the present problem or chief concern, the provider should proceed in a chronologic and sequential framework. Asking patients to give you any information they can recall about their health and using a holistic and eclectic structure do not provide for structure. Starting the interview with the patient's family history and with the social history are incorrect because gathering data about the chief concern is the initial step.

24. Being sensitive to cultural differences that may exist between you and the patient is most useful in the avoidance of a. prejudice. b. stereotypic judgment. c. miscommunication. d. opinion formation. e. preaching to the patient.

ANS: C When you determine that cultural differences may exist, you must first use culturally sensitive communication modes to grasp what the patient means correctly or else prejudice, stereotypic judgment, tendency to preach, and you forming an opinion may inadvertently be perceived by the patient.

34. Tom is a 16-year-old young man with diabetes who does not follow his diet. He enjoys his dirt bike and seems unconcerned about any consequences of his activities. Which factor is typical of adolescence and pertinent to Tom's health? a. Attachment to parents b. Tendency to give too much information c. Low peer support needs d. Propensity for risk taking e. High self-esteem

ANS: D Adolescents tend to experiment with risky behaviors that lead to a high incidence of morbidity and mortality. Adolescents may be reluctant to provide information.

21. Adolescents most likely to smoke, abuse substances, perform poorly in school, and be depressed are those who are a. from dual-income families. b. from families that emphasize strong religious beliefs. c. from deprived socioeconomic groups. d. unsupervised after school. e. involved in athletics after school.

ANS: D Adolescents who are unsupervised after school are more likely to smoke, abuse substances, perform poorly in school, and be depressed than adolescents in any other situation.

39. Mary Jane has brought in her 16-year-old son, Kyle. She states that he has been sleeping more and doesn't hang around his friends, and recently his girlfriend broke up with him. Your most immediate question is to ask Kyle a. "Do you want to see a counselor today?" b. "Is your father out of jail yet?" c. "Are you taking any illegal drugs?" d. "Have you made plans to harm yourself?" e. "What sexual practices did you have with your girlfriend?"

ANS: D If you sense that a patient is contemplating suicide, you should ask about suicidal ideation directly

24. To what extent should the patient with a physical disability or emotional disorder be involved in providing health history information to the health professional? a. All information should be obtained from family members. WWW.TESTBANKTANK.COM b. All information should be collected from past records while the patient is in another room. c. The patient should be involved only when you sense that he or she may feel ignored. d. The patient should be fully involved to the limit of his or her ability. e. The patient should be present during information collection but should not be addressed directly

ANS: D Patients with disabilities may not give an effective history, but they must be respected, and the history must be obtained from them to the greatest extent possible. Family members may help provide a more complete history but not at the exclusion of the patient.

23. The attitudes of the health care professional are largely a. acculturated and cannot be changed. b. uninfluenced by patient behavior. c. difficult for the patient to sense. d. culturally derived. e. irrelevant to the success of relationships with the patient.

ANS: D The attitude of a health care provider is foundationally derived from his or her own culture but cannot cause stereotypical judgments to be made; understanding this is relevant to the success of patient relationships. Attitudes of the health care professional are easily detected by others, and they influence patient behavior.

22. Knowledge of the culture(s) of the patient should be used to a. form a standard practice procedure for that culture. b. draw conclusions regarding individual patient needs. c. form stereotypical categories. d. help make the interview questions more pertinent. e. form a sense of the patient based on prior knowledge.

ANS: D The purpose of understanding the patient's culture(s) is to help the provider construct pertinent questioning and avoid stereotyping.

11. Ms. T. is crying and states that her mother couldn't possibly have a tumor. "No one else in the family has ever had cancer!" exclaims the daughter. The most appropriate response to Ms. T. would be a. "Has anyone explained hospice care to your mother?" b. "I'm so sorry that your mother was diagnosed with cancer." c. "Didn't you know that all tumors are not cancerous?" d. "Why do you think that your mother's tumor is cancerous?" e. "That is odd because cancer usually runs in families."

ANS: D This is the only answer that is a direct exploration of the daughter's concern. The health care provider can explain and clarify the concerns of the daughter.

9. A patient becomes restless during the history and says, "I don't have time for all of this conversation. I've got to get back to work." Your most appropriate response would be to a. stop using open-ended questions and become more direct. b. ask another open-ended question and insist on an answer. c. ask questions about his anger and move closer to him. d. acknowledge his anger and proceed with the history and examination. e. ignore his displeasure and become more assertive about getting answers.

ANS: D This is the only that resists the tendency for patient manipulation, pursues the information, and confronts the patient's anger.

9. Which question has the most potential for exploring a patient's cultural beliefs related to a health problem? a. "How often do you have a medical examinations?" b. "What are your age, race, and educational level?" c. "What types of symptoms have you been having?" d. "Why do you think you are having these symptoms?" e. "Do you take herbal remedies?"

ANS: D This open-ended question avoids stereotyping, is sensitive and respectful toward the individual, and allows for cultural data to be exchanged.

23. When you suspect that your 81-year-old patient has short-term memory loss because he cannot remember what he had for breakfast, you should a. order a neurology consult. b. stop all of his medications. c. continue to press the patient for appropriate answers. d. validate the concern with his family or caregivers. e. dismiss the finding as a normal age-related change.

ANS: D When older adults experience memory loss for recent events, consult other family members to clarify discrepancies or to fill in the gaps.

16. During an interview, tears appear in the patient's eyes, and his voice becomes shaky. Initially, you should a. ask the patient what he is upset about. b. offer a tissue and let him know it is all right to cry. c. explain to the patient that you will be able to help him more if he can control his emotions. d. keep the interview moving to distract the patient. e. ask him if he would like some time alone

ANS: D When patients cry, it is best to allow the moment to pass at the patient's pace. If you suspect a need to cry but the patient is suppressing it, give permission

18. During a history-taking session, Mr. B. appears to be avoiding certain questions. He keeps looking out the window. What should the caregiver do? a. Ask direct questions and insist on a "yes" or "no" answer to each question. b. Continue to ask questions until Mr. B. responds appropriately. c. Let the patient know all relevant information should be revealed in one interview. d. Stop the interview until the patient is ready to cooperate. e. Make a note to pursue sensitive issues later in the interview.

ANS: D When the patient dissembles, do not push too hard for an answer. Allow the interview to go on and come back to it later. Learning all that you may need to know about a patient may not happen in one interview.

4. When are open-ended questions generally most useful? a. During the physical examination b. After several close-ended questions have been asked c. While designing the genogram d. During the review of systems e. During the initial part of the interview

ANS: E Asking open-ended questions at the beginning of an interview allows you to gather more information and establishes yourself as an empathic listener, which is the first step of effective communication. Interviewing for the purpose of conducting a genogram or review of systems requires more focused data that can be more easily gathered with direct questioning

33. When you enter the examination room of a 3-year-old girl, you find her sitting on her father's lap. She turns away from you when you greet her. Initially, your best response is to a. screen the child for sexual abuse. b. ask the child to be seated on the examination table so you can talk to her father. c. explain to the child that you will not hurt her and that she will have to trust you. d. ask the father to persuade the child to cooperate with you. e. leave the child sitting in the father's lap while you talk to the father

ANS: E Interaction with children must be modified according to age and in a manner that promotes trust

20. Which maternal factor is most predictive of whether an infant will receive inoculations? a. The mother has family support. b. The mother is divorced. c. The mother breastfeeds. d. The mother uses drugs. e. The mother received prenatal care.

ANS: E Mothers who take advantage of appropriate prenatal care generally take advantage of other infant care practices as well.

15. Ms. A. states, "My life is just too painful. It isn't worth it." She appears depressed. Which one of the following statements is the most appropriate caregiver response? a. "Try to think about the good things in life." b. "You shouldn't feel that way; look at all the good things in your life." c. "You can't mean what you're saying." d. "If you think about it, nothing is worth getting this upset about." e. "What in life is causing you such pain?"

ANS: E Specific yet open-ended questions are best used when the patient has feelings of loss of self-worth and depression. The other responses hurry the patient and offer superficial assurance.

32. A tool used to screen adolescents for alcoholism is the a. CAGE questionnaire. b. CRAFFT. c. PACE Assessment Instrument. d. HITS questionnaire. e. Glasgow Coma Scale

ANS: B The CRAFFT tool is used to screen for alcoholism in adolescents.

29. Mr. D. complains of a headache. During the history, he mentions his use of alcohol and illicit drugs. This information would most likely belong in the a. chief concern. b. family history. c. personal and social history. d. review of systems. e. past medical history.

ANS: C Habits are included within the personal and social history

21. When communicating with older children and teenagers, you should be sensitive to their a. parent's needs. b. natural urge to communicate. c. need for verbal instructions. d. typical reluctance to talk. e. desire for adult companionship

ANS: D Adolescents are usually reluctant to talk; therefore, the provider should clearly communicate a respect for their confidentiality.

17. An example of a cold food is a. chocolate. b. hard liquor. c. oil. d. onions. e. a dairy product.

ANS: E Dairy products are an example of a cold food; the others are hot.