Advanced Health Assessment and Diagnostic Reasoning 4th Edition Rhoads – Test Bank

Complete Test Bank With Answers

 

Sample Questions Posted Below

 

 

Chapter 1: Interview and History Taking Strategies

 

MULTIPLE CHOICE

• 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:

1. Excited about her pregnancy but nervous

about the labor.

1. Exhibiting verbal and nonverbal behaviors

that do not match.

1. Excited about her pregnancy, but her husband

is not and this is upsetting to her.

d.

Not excited about her pregnancy but believes

the nurse will negatively respond to her if she

states this.

 

• Receiving is a part of the communication process.

Which receiver is most likely to misinterpret a

message sent by a health care professional?

1. Well-adjusted adolescent who came in for a

sports physical

1. Recovering alcoholic who came in for a basic

physical examination

1. 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

 

• The nurse makes which adjustment in the physical environment

to promote the success of an interview?

1. Reduces noise by turning off televisions and

radios

1. Reduces the distance between the interviewer

and the patient to 2 feet or less

1. Provides a dim light that makes the room

cozy and helps the patient relax

1. Arranges seating across a desk or table to

allow the patient some personal space

 

• In an interview, the nurse may find it necessary to take notes to

aid his or her memory later. Which statement is trueregarding

note-taking?

a.

Note-taking may impede the nurses

observation of the patients 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.

 

• 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.

1. Summary
2. Closing
3. Body
4. Opening or introduction

 

• 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?

1. Hello, Nancy, my name is Mrs. C.
2. Hello, Mrs. H., my name is Mrs. C. It sure is

cold today!

1. Mrs. H., my name is Mrs. C. How are you?
2. Mrs. H., my name is Mrs. C. Ill need to ask

you a few questions about what happened.

 

• 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?

1. Reflection
2. Facilitation
3. Direct question
4. Open-ended question

 

• 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?

1. Mr. Y., at your age, surely you have been

hospitalized before!

1. 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?

Mr. Y., I just need to get some additional

1. Mr. Y., at your age, surely you have been

hospitalized before!

1. 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?

 

• In using verbal responses to assist the patients narrative, some

responses focus on the patients frame of reference and some focus

on the health care providers perspective. An example of a verbal

response that focuses on the health care providers perspective

would be:

1. Empathy.
2. Reflection.
3. Facilitation.
4. Confrontation.

 

• 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 nurses best response to this behavior?

1. Be silent, and allow him to continue when he

is ready.

b.

Smile at him and say, Dont worry about all of

this. Im sure we can find out why

youre having these pains.

c.

Lean back in the chair and ask, You are

looking at me kind of funny; there isnt

anything wrong, is ther

d.

Stand up and say, I can see that this interview

is uncomfortable for you. We can

continue it another time.

 

c.

Lean back in the chair and ask, You are

looking at me kind of funny; there isnt

anything wrong, is ther

d.

Stand up and say, I can see that this interview

is uncomfortable for you. We can

continue it another time.

 

• A woman is discussing the problems she is having with her 2-yearold

son. She says, He wont go to sleep at night, and during the day

he has several fits. I get so upset when that happens. The nurses

best verbal response would be:

1. Go on, Im listening.
2. Fits? Tell me what you mean by this.
3. Yes, it can be upsetting when a child has a fit.
4. Dont be upset when he has a fit; every 2 year

old has fits.

 

• 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 cant 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?

1. You feel alone.
2. You cant 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.

 

• a.

Mr. K., I know that you are lying.

b.

Mr. K., come on, tell me how much you smoke.

c.

Mr. K., I didnt 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 dont smoke,

but I see that you have an open pack of

cigarettes in your pocket.

 

• The nurse has used interpretation regarding a patients statement

or actions. After using this technique, it would be best for the

nurse to:

1. Apologize, because using interpretation can

be demeaning for the patient.

1. Allow time for the patient to confirm or

correct the inference.

1. Continue with the interview as though

nothing has happened.

1. Immediately restate the nurses conclusion on

the basis of the patients nonverbal response.

 

• During an interview, a woman says, I have decided that I can no

longer allow my children to live with their fathers violence, but I

just cant seem to leave him. Using interpretation, the nurses best

response would be:

1. You are going to leave him?
2. If you are afraid for your children, then why

cant you leave?

1. It sounds as if you might be afraid of how

your husband will respond.

1. It sounds as though you have made your

decision. I think it is a good one.

 

• 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 o the womans 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.

 

• During a visit to the clinic, a patient states, The doctor just told me

he thought I ought to stop smoking. He doesnt understand how

hard Ive tried. I just dont know the best way to do it. What should

I do? The nurses most appropriate response in this case would be:

1. Id quit if I were you. The doctor really knows

what he is talking about.

1. Would you like some information about the

different ways a person can quit smoking?

1. Stopping your dependence on cigarettes can

be very difficult. I understand how you feel.

d.

Why are you confused? Didnt the doctor give

you the information about the smoking

cessation progra

we offer?

 

• As the nurse enters a patients 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, Im so afraid of, um, you know. The

nurses most therapeutic response would be to say in a gentle

manner:

1. Youre afraid you might lose your breast?
2. No, Im not sure what you are talking about.
3. Ill wait here until you get yourself under

control, and then we can talk.

1. I can see that you are very upset. Perhaps we

should discuss this later.

 

• 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 dont 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.

 

• When observing a patients verbal and nonverbal

communication, the nurse notices a discrepancy. Which

statement is true regarding this situation? The nurse

should:

1. Ask someone who knows the patient well to

help interpret this discrepancy.

1. Focus on the patients 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 patients nonverbal behaviors,

because these are often more reflective

of a patients true feelings.

1. Ask someone who knows the patient well to

help interpret this discrepancy.

1. Focus on the patients 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 patients nonverbal behaviors,

because these are often more reflective

of a patients true feelings.

 

• During an interview, a parent of a hospitalized child is sitting in

an open position. As the interviewer begins to discuss his sons

treatment, however, he suddenly crosses his arms against his

chest and crosses his legs. This changed posture would suggest

that the parent is:

1. Simply changing positions.
2. More comfortable in this position.
3. Tired and needs a break from the interview.
4. Uncomfortable talking about his sons

treatment.

 

• 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.

1. Continue to ignore her until it is time for the

physical examination.

d.

Ask the mother to leave during the

examination of the toddler, because toddlers

often fuss less if their parent is not in view.

 

• 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 childs full cooperation?

1. Tell the child that the blood pressure cuff is

going to give her arm a big hug.

1. Tell the child that the blood pressure cuff is

asleep and cannot wake up.

1. Give the blood pressure cuff a name and refer

to it by this name during the assessment.

1. Tell the child that by using the blood pressure

cuff, we can see how strong her muscles are.

 

• A 16-year-old boy has just been admitted to the unit for overnight

observation after being in an automobile accident. What is the

nurses best approach to communicating with him?

1. Use periods of silence to communicate

respect for him.

1. Be totally honest with him, even if the

information is unpleasant.

1. Tell him that everything that is discussed will

be kept totally confidential.

1. Use slang language when possible to help him

open up.

 

• 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 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.

 

• The nurse is interviewing a male patient who has a hearing

impairment. What techniques would be most beneficial in

communicating with this patient?

1. Determine the communication method he

prefers.