CH 3 THE Interview - test bank PDF

Preview

Summary

test bank ...

Description

PHYSICAL EXAMINATION AND HEALTH ASSESSMENT 8TH EDITION JARVIS TEST BANK

TestBank-PhysicalExaminationandHealthAssessment8e(byJarvis)

31

Chapter03:TheInterview 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nursesresponse. DIF:CognitiveLevel:Analyzing(Analysis) NURSINGTB.COM 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) MSC:ClientNeeds:PsychosocialIntegrity 3.Thenursemakeswhichadjustmentinthephysicalenvironmenttopromotethesuccessofaninterview?

NURSINGTB.COM

PHYSICAL EXAMINATION AND HEALTH ASSESSMENT 8TH EDITION JARVIS TEST BANK TestBank-PhysicalExaminationandHealthAssessment8e(byJarvis)

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

32

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) 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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. NURSINGTB.COM

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notetaking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patients narrativeflow,anditimpedestheobservationofthepatientsnonverbalbehavior. DIF:CognitiveLevel:Understanding(Comprehension) 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

NURSINGTB.COM

PHYSICAL EXAMINATION AND HEALTH ASSESSMENT 8TH EDITION JARVIS TEST BANK TestBank-PhysicalExaminationandHealthAssessment8e(byJarvis)

c.

Body

d.

Openingorintroduction

33

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) 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.Illneedtoaskyouafewquestionsaboutwhathappened. NURSINGTB.COM

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) 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th personintroducesanewtopic.

NURSINGTB.COM

PHYSICAL EXAMINATION AND HEALTH ASSESSMENT 8TH EDITION JARVIS TEST BANK TestBank-PhysicalExaminationandHealthAssessment8e(byJarvis)

34

DIF:CognitiveLevel:Understanding(Comprehension) 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persons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) MSC:ClientNeeds:PsychosocialIntegrity

NURSINGTB.COM

9.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: 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 patients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patients frameofreference. DIF:CognitiveLevel:Remembering(Knowledge) MSC:ClientNeeds:PsychosocialIntegrity 10.Whentakingahistoryfromanewlyadmittedpatient,thenursenoticesthatheoftenpausesandexpectantly

NURSINGTB.COM

PHYSICAL EXAMINATION AND HEALTH ASSESSMENT 8TH EDITION JARVIS TEST BANK TestBank-PhysicalExaminationandHealthAssessment8e(byJarvis)

35

looksatthenurse.Whatwouldbethenursesbestresponsetothisbehavior? a.

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 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) MSC:ClientNeeds:PsychosocialIntegrity 11.Awomanisdiscussingtheproblemssheishavingwithher2-year-old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: NURSINGTB.COM

a.

Goon,Imlistening.

b.

Fits?Tellmewhatyoumeanbythis.

c.

Yes,itcanbeupsettingwhenachildhasafit.

d.

Dontbeupsetwhenhehasafit;every2yearoldhasfits.

ANS:B Thenurseshoulduseclarificationwhenthepersonswordchoiceisambiguousorconfusing(e.g.,Tellmewha youmeanbyfits.).Clarificationisalsousedtosummarizethepersons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) 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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? a.

Youfeelalone.

NURSINGTB.COM

PHYSICAL EXAMINATION AND HEALTH ASSESSMENT 8TH EDITION JARVIS TEST BANK TestBank-PhysicalExaminationandHealthAssessment8e(byJarvis)

b.

Youcant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.

36

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personsarm.Simplyreflectingthepersonswordsoragreeing withthepersonisnotanempatheticresponse. DIF:CognitiveLevel:Applying(Application) 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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.

NURSINGTB.COM

ANS:D Inthecaseofconfrontation,acertainaction,feeling,orstatementhasbeenobserved,andthenursenow focusesthepatients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) MSC:ClientNeeds:PsychosocialIntegrity 14.Thenursehasusedinterpretationregardingapatients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.

NURSINGTB.COM

PHYSICAL EXAMINATION AND HEALTH ASSESSMENT 8TH EDITION JARVIS TEST BANK TestBank-PhysicalExaminationandHealthAssessment8e(byJarvis)

c.

Continuewiththeinterviewasthoughnothinghashappened.

d.

Immediatelyrestatethenursesconclusiononthebasisofthepatientsnonverbalresponse.

37

ANS:B Interpretationisnotbasedondirectobservationasisconfrontation,butitisbasedonones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) 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 fathersviolence,butIjustcantseemtoleavehim.Usinginterpretation,thenursesbestresponsewouldbe: a.

Youaregoingtoleavehim?

b.

Ifyouareafraidforyourchildren,thenwhycant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. NURSINGTB.COM

ANS:C Thisstatementisnotbasedonones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) MSC:ClientNeeds:PsychosocialIntegrity 16.Apregnantwomanstates,IjustknowlaborwillbesopainfulthatIwontbeabletostandit.Iknowit soundsawful,butIreallydreadgoingintolabor.Thenurserespondsbystating,Oh,dont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nurses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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.

NURSINGTB.COM

PHYSICAL EXAMINATION AND HEALTH ASSESSMENT 8TH EDITION JARVIS TEST BANK TestBank-PhysicalExaminationandHealthAssessment8e(byJarvis)

38

ANS:B Byprovidingfalseassuranceorreassurance,thiscouragebuilderrelievesthewomans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) 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 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: a.

Id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?Didntthedoctorgiveyoutheinformationaboutthesmokingcessation programweoffer?

ANS:B NURSINGTB.COM Clarificationshouldbeusedwhenthepersonswordchoiceisambiguousorconfusing.Clarificationisalso usedtosummarizethepersons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) MSC:ClientNeeds:PsychosocialIntegrity 18.Asthenurseentersapatientsroom,thenursefindshercrying.Thepatientstatesthatshehasjustfoundou 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: a.

Youreafraidyoumightloseyourbreast?

b.

No,Imnotsurewhatyouaretalkingabout.

c.

Ill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patientswords,repeatingpartofwhatthepersonhasjustsaid.Reflectioncanalsohelp expressthefeelingsbehindapersonswords. DIF:CognitiveLevel:Applying(Application)

NURSINGTB.COM

PHYSICAL EXAMINATION AND HEALTH ASSESSMENT 8TH EDITION JARVIS TEST BANK TestBank-PhysicalExaminationandHealthAssessment8e(byJarvis)

39

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donts...