Physical Examination And Health Assessment 7th Edition by Carolyn Jarvis -Test Bank
To Purchase
this Complete Test Bank with Answers Click the link Below
If face any problem or
Further information contact us At tbzuiqe@gmail.com
Sample Test
Chapter 03: The Interview
Jarvis: Physical Examination & Health Assessment, 7th
Edition
MULTIPLE CHOICE
1. 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 the 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 to her. |
|
d. |
Not excited about her
pregnancy but believes the nurse will negatively respond to her if she states
this. |
ANS: B
Communication is all behaviors, conscious and unconscious,
verbal and nonverbal. All behaviors have meaning. Her behavior does not imply
that she is nervous about labor, upset by her husband, or worried about the
nurse’s response.
DIF: Cognitive Level: Analyzing
(Analysis)
REF: p. 28
MSC: Client Needs: Psychosocial Integrity
2. 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 |
ANS: C
The receiver attaches meaning determined by his or her
experiences, culture, self-concept, and current physical and emotional states.
The man whose wife has just been diagnosed with lung cancer may be experiencing
emotions that affect his receiving.
DIF: Cognitive Level: Analyzing
(Analysis)
REF: p. 28
MSC: Client Needs: Psychosocial Integrity
3. 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 |
ANS: A
The nurse should reduce noise by turning off the television,
radio, and other unnecessary equipment, because multiple stimuli are confusing.
The interviewer and patient should be approximately 4 to 5 feet apart; the room
should be well-lit, enabling the interviewer and patient to see each other
clearly. Having a table or desk in between the two people creates the idea of a
barrier; equal-status seating, at eye level, is better.
DIF: Cognitive Level: Applying
(Application)
REF: p. 29
MSC: Client Needs: Psychosocial Integrity
4. 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. |
ANS: A
The use of history forms and note-taking may be unavoidable.
However, the nurse must be aware that note-taking during the interview has
disadvantages. It breaks eye contact too often and shifts the attention away
from the patient, which diminishes his or her sense of importance. Note-taking
may also interrupt the patient’s narrative flow, and it impedes the observation
of the patient’s nonverbal behavior.
DIF: Cognitive Level: Understanding
(Comprehension)
REF: p. 30
MSC: Client Needs: Psychosocial Integrity
5. 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 |
ANS: D
When gathering a complete history, the nurse should give the
reason for the interview during the opening or introduction phase of the
interview, not during or at the end of the interview.
DIF: Cognitive Level: Understanding
(Comprehension)
REF: p. 31
MSC: Client Needs: Psychosocial Integrity
6. 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.” |
ANS: D
Address the person by using his or her surname. The nurse should
introduce him or herself and give the reason for the interview. Friendly small
talk is not needed to build rapport.
DIF: Cognitive Level: Applying
(Application)
REF: p. 31
MSC: Client Needs: Psychosocial Integrity
7. 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 |
ANS: D
The open-ended question asks for narrative information. It
states the topic to be discussed but only in general terms. The nurse should
use it to begin the interview, to introduce a new section of questions, and
whenever the person introduces a new topic.
DIF: Cognitive Level: Understanding
(Comprehension)
REF: p. 31
MSC: Client Needs: Psychosocial Integrity
8. 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?” |
ANS: D
The nurse should use direct questions after the person’s opening
narrative to fill in any details he or she left out. The nurse also should use
direct questions when specific facts are needed, such as when asking about past
health problems or during the review of systems.
DIF: Cognitive Level: Applying
(Application)
REF: p. 31
MSC: Client Needs: Psychosocial Integrity
9. 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. |
ANS: D
When the health care provider uses the response of
confrontation, the frame of reference shifts from the patient’s perspective to
the perspective of the health care provider, and the health care provider
starts to express his or her own thoughts and feelings. Empathy, reflection,
and facilitation responses focus on the patient’s frame of reference.
DIF: Cognitive Level: Remembering
(Knowledge)
REF: p. 32
MSC: Client Needs: Psychosocial Integrity
10. 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.” |
ANS: A
Silent attentiveness communicates that the person has time to
think and to organize what he or she wishes to say without an interruption from
the nurse. Health professionals most often interrupt this thinking silence. The
other responses are not conducive to ideal communication.
DIF: Cognitive Level: Applying
(Application)
REF: p. 33
MSC: Client Needs: Psychosocial Integrity
11. 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.” |
ANS: B
The nurse should use clarification when the person’s word choice
is ambiguous or confusing (e.g., “Tell me what you mean by fits.”). Clarification
is also used to summarize the person’s words or to simplify the words to make
them clearer; the nurse should then ask if he or she is on the right track.
DIF: Cognitive Level: Applying (Application)
REF: p. 33
MSC: Client Needs: Psychosocial Integrity
12. 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.” |
ANS: C
An empathetic response recognizes the feeling and puts it into
words. It names the feeling, allows its expression, and strengthens rapport.
Other empathetic responses are, “This must be very hard for you,” “I
understand,” or simply placing your hand on the person’s arm. Simply reflecting
the person’s words or agreeing with the person is not an empathetic response.
DIF: Cognitive Level: Applying
(Application)
REF: p. 28
MSC: Client Needs: Psychosocial Integrity
13. 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.” |
ANS: D
In the case of confrontation, a certain action, feeling, or
statement has been observed, and the nurse now focuses the patient’s attention
on it. The nurse should give honest feedback about what is seen or felt.
Confrontation may focus on a discrepancy, or the nurse may confront the patient
when parts of the story are inconsistent. The other statements are not
appropriate.
DIF: Cognitive Level: Applying
(Application)
REF: p. 33
MSC: Client Needs: Psychosocial Integrity
14. 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. |
ANS: B
Interpretation is not based on direct observation as is
confrontation, but it is based on one’s inference or conclusion. The nurse
risks making the wrong inference. If this is the case, then the patient will
correct it. However, even if the inference is correct, interpretation helps
prompt further discussion of the topic.
DIF: Cognitive Level: Analyzing
(Analysis)
REF: p. 33
MSC: Client Needs: Psychosocial Integrity
15. 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.” |
ANS: C
This statement is not based on one’s inference or conclusion. It
links events, makes associations, or implies cause. Interpretation also
ascribes feelings and helps the person understand his or her own feelings in
relation to the verbal message. The other statements do not reflect
interpretation.
DIF: Cognitive Level: Applying
(Application)
REF: p. 33
MSC: Client Needs: Psychosocial Integrity
16. 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. |
ANS: B
By providing false assurance or reassurance, this courage builder relieves
the woman’s anxiety and gives the nurse the false sense of having provided
comfort. However, for the woman, providing false assurance or reassurance
actually closes off communication, trivializes her anxiety, and effectively
denies any further talk of it.
DIF: Cognitive Level: Analyzing
(Analysis)
REF: p. 32
MSC: Client Needs: Psychosocial Integrity
17. 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?” |
ANS: B
Clarification should be used when the person’s word choice is
ambiguous or confusing. Clarification is also used to summarize the person’s
words or to simplify the words to make them clearer; the nurse should then ask
if he or she is on the right track. The other responses give unwanted advice or
do not offer a helpful response.
DIF: Cognitive Level: Applying
(Application)
REF: p. 33
MSC: Client Needs: Psychosocial Integrity
18. 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.” |
ANS: A
Reflection echoes the patient’s words, repeating part of what
the person has just said. Reflection can also help express the feelings behind
a person’s words.
DIF: Cognitive Level: Applying
(Application)
REF: p. 33
MSC: Client Needs: Psychosocial Integrity
19. 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. |
ANS: C
This question is an example of using leading or biased
questions. Asking, “You don’t smoke, do you?” implies that one answer is better than
another. If the person wants to please someone, then he or she is either forced
to answer in a way that corresponds to his or her implied values or is made to
feel guilty when admitting the other answer.
DIF: Cognitive Level: Understanding
(Comprehension)
REF: p. 34
MSC: Client Needs: Psychosocial Integrity
20. 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. |
ANS: D
When nonverbal and verbal messages are congruent, the verbal
message is reinforced. When they are incongruent, the nonverbal message tends
to be the true one because it is under less conscious control. Thus studying
the nonverbal messages of the patients and examiners and understanding their
meanings are important. The other statements are not true.
DIF: Cognitive Level: Applying
(Application)
REF: p. 28
MSC: Client Needs: Psychosocial Integrity
21. 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. |
ANS: D
The person’s position is noted. An open position with the
extension of large muscle groups shows relaxation, physical comfort, and a
willingness to share information. A closed position with the arms and legs
crossed tends to look defensive and anxious. Any change in posture should be
noted. If a person in a relaxed position suddenly tenses, then this change in
posture suggests possible discomfort with the new topic.
DIF: Cognitive Level: Analyzing
(Analysis)
REF: p. 35
MSC: Client Needs: Psychosocial Integrity
22. 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, because toddlers often fuss less if
their parent is not in view. |
ANS: B
Although most of the communication is with the parent, the nurse
should not completely ignore the child. Making contact will help ease the
toddler later during the physical examination. The nurse should begin by asking
about the toys the child is playing with or about a special doll or teddy bear
brought from home. “Does your doll have a name?” or “What can your truck do?”
Stoop down to meet the child at his or her eye level.
DIF: Cognitive Level: Applying
(Application)
REF: p. 37
MSC: Client Needs: Psychosocial Integrity
23. 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. |
ANS: D
Take the time to give a short, simple explanation with a
concrete explanation for any unfamiliar equipment that will be used on the
child. Preschoolers are animistic; they imagine inanimate objects can come
alive and have human characteristics. Thus a blood pressure cuff can wake up
and bite or pinch.
DIF: Cognitive Level: Applying
(Application)
REF: pp. 38-39
MSC: Client Needs: Psychosocial Integrity
24. 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. |
ANS: B
Successful communication with an adolescent is possible and can
be rewarding. The guidelines are simple. The first consideration is one’s
attitude, which must be one of respect. Second, communication must be totally
honest. An adolescent’s intuition is highly tuned and can detect phoniness or
the withholding of information. Always tell him or her the truth.
DIF: Cognitive Level: Applying
(Application)
REF: p. 39
MSC: Client Needs: Psychosocial Integrity
25. 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. |
ANS: A
The interview usually takes longer with older adults because
they have a longer story to tell. It is not necessarily true that all older
adults are lonely, have lost mental abilities, or are hard of hearing.
DIF: Cognitive Level: Understanding
(Comprehension)
REF: p. 40
MSC: Client Needs: Psychosocial Integrity
26. 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. |
ANS: A
The nurse should ask the deaf person the preferred way to
communicate—by signing, lip reading, or writing. If the person prefers lip
reading, then the nurse should be sure to face him squarely and have good
lighting on the nurse’s face. The nurse should not exaggerate lip movements
because this distorts words. Similarly, shouting distorts the reception of a
hearing aid the person may wear. The nurse should speak slowly and supplement
his or her voice with appropriate hand gestures or pantomime.
DIF: Cognitive Level: Understanding (Comprehension)
REF: p. 41
MSC: Client Needs: Psychosocial Integrity
27. 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?” |
ANS: B
A beginning examiner usually feels horrified when the patient
starts crying. When the nurse says something that “makes the person cry,” the
nurse should not think he or she has hurt the person. The nurse has simply hit
on an important topic; therefore, moving on to a new topic is essential. The
nurse should allow the person to cry and to express his or her feelings fully.
The nurse can offer a tissue and wait until the crying subsides to talk.
DIF: Cognitive Level: Applying
(Application)
REF: p. 42
MSC: Client Needs: Psychosocial Integrity
28. 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. |
ANS: A
Both the patient’s and the nurse’s sense of spatial distance are
significant throughout the interview and physical examination, with culturally
appropriate distance zones varying widely. Some cultural groups value close
physical proximity and may perceive a health care provider who is distancing
him or herself as being aloof and unfriendly.
DIF: Cognitive Level: Analyzing
(Analysis)
REF: p. 29
MSC: Client Needs: Psychosocial Integrity
29. 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. |
ANS: D
Eye contact is perhaps among the most culturally variable
nonverbal behaviors. Asian, American Indian, Indochinese, Arabian, and
Appalachian people may consider direct eye contact impolite or aggressive, and
they may avert their eyes during the interview. American Indians often stare at
the floor during the interview, which is a culturally appropriate behavior,
indicating that the listener is paying close attention to the speaker.
DIF: Cognitive Level: Analyzing
(Analysis)
REF: p. 36
MSC: Client Needs: Psychosocial Integrity
30. 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?” |
ANS: A
In a situation during which a language barrier exists and no
interpreter is available, simple words should be used, avoiding medical jargon.
The use of contractions and pronouns should also be avoided. Nouns should be
repeatedly used, and one topic at a time should be discussed.
DIF: Cognitive Level: Analyzing
(Analysis)
REF: p. 46
MSC: Client Needs: Psychosocial Integrity
31. 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?” |
ANS: D
Open-ended questions are used for gathering narrative
information. This type of questioning should be used to begin the interview, to
introduce a new section of questions, and whenever the person introduces a new
topic.
DIF: Cognitive Level: Applying
(Application)
REF: p. 31
MSC: Client Needs: Psychosocial Integrity
32. 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. |
ANS: C
Using authority responses promotes dependency and inferiority.
Avoiding the use of authority is best. Although the health care provider and
patient do not have equal professional knowledge, both have equally worthy
roles in the health process. The other statements are not correct.
DIF: Cognitive Level: Applying
(Application)
REF: p. 34
MSC: Client Needs: Psychosocial Integrity
33. 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 |
ANS: A
Whenever possible, the nurse should use a trained interpreter,
preferably one who knows medical terminology. In general, an older, more mature
interpreter is preferred to a younger, less experienced one, and the same
gender is preferred when possible.
DIF: Cognitive Level: Understanding
(Comprehension)
REF: p. 44
MSC: Client Needs: Psychosocial Integrity
34. 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. |
ANS: A
The adult’s use of “why” questions usually implies blame and
condemnation and places the person on the defensive. The other statements are
not correct.
DIF: Cognitive Level: Analyzing
(Analysis)
REF: p. 34
MSC: Client Needs: Psychosocial Integrity
35. 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.” |
ANS: B
This question offers the person a final opportunity for
self-expression. No new topic should be introduced. The other questions are not
appropriate.
DIF: Cognitive Level: Understanding
(Comprehension)
REF: p. 36
MSC: Client Needs: Psychosocial Integrity
36. During
the interview portion of data collection, the nurse collects __________ data.
|
a. |
Physical |
|
b. |
Historical |
|
c. |
Objective |
|
d. |
Subjective |
ANS: D
The interview is the first, and really the most important, part
of data collection. During the interview, the nurse collects subjective data;
that is, what the person says about him or herself.
DIF: Cognitive Level: Remembering
(Knowledge)
REF: p. 27
MSC: Client Needs: Psychosocial Integrity
37. 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 |
ANS: C
Social distance, 4 to 12 feet, is usually the distance category
for most of the interview. Public distance, over 12 feet, is too much distance;
the intimate zone is inappropriate, and the personal distance will be used for
the physical assessment.
DIF: Cognitive Level: Understanding
(Comprehension)
REF: p. 29
MSC: Client Needs: Psychosocial Integrity
Comments
Post a Comment