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NURS 5220 FINAL EXAM QUESTIONS & DETAILED
ANSWERS (WELL VERIFIED) ALREADY GRADED A+
During an initial interview with your patient, you ask the patient, "Can you describe that for me?" Which statement best describes the question? A. It is the most risky type of question because the patient can say anything. B.The question is asking for specific information. C. The patient has discretion about the extent of the answer.
D. The answer can lead the interviewer away from the purpose of the interview. - CORRECT
ANSWER >>> C: The open-ended question gives the patient discretion about the extent of
an answer. This is an example of a question carefully formulated to illicit an enhanced patient response. The answer can lead the interviewer away from the purpose of the interview. Because an adolescent is often reluctant to talk during an interview, it is best to: A. tell the patient that you must have straight answers to your questions. B. ensure confidentiality regarding the information discussed. C. inform the patient that adolescents have trouble expressing their feelings.
D. obtain the history from a parent or other family member. - CORRECT ANSWER >>> C:
CorrectAdolescents may be reluctant to talk and have a clear need for confidentiality. All adolescent patients should be given the opportunity to discuss their concerns with you privately. It is wise to let parents or other caregivers know you will be asking them to step out of the room to provide this important opportunity for the adolescent. For which age group is a functional assessment most critical? A. Children B. Adolescents C. Adults
D. Older adults - CORRECT ANSWER >>> D: CorrectQuite simply, functional assessment is
an attempt to understand a patient's ability to achieve the basic activities of daily living. This assessment should be made for all older adults and for any person limited by disease or disability, acute or chronic. Which of the following will best facilitate an interview with a deaf person? A. Speaking loudly B. Using gestures C. Sitting or standing at eye level
D. Sitting to the side of the patient - CORRECT ANSWER >>> c: CorrectPersons with impaired
hearing often read, write, sign, and/or read lips, but you must speak slowly and enunciate each word clearly and in full view. Sitting or standing at eye level allows for full view. Which of the following questions may lead to an inaccurate response? A. "Where do you feel the pain?" B. "How does this situation make you feel?" C. "What happened after you noticed your injury?"
A. testing the patient's knowledge. B. teaching the patient new medical terms. C. discouraging an emotional outburst.
D. encouraging more detail. - CORRECT ANSWER >>> D: CorrectWhen you repeat a patient's
answer, you are engaging in reflecting. Reflecting encourages patients to provide more detail. While interviewing an angry patient, you start to become annoyed and are beginning to dislike the patient. The best way to resolve this is to: A. spend the least amount of time possible with the patient. B. displace your annoyance toward the patient on an inanimate object. C. ignore the feelings and remain neutral in your interactions. D. express concern and explore
the problem with the patient. - CORRECT ANSWER >>> D:
CorrectWhen dealing with the angry patient, it is appropriate to confront or acknowledge the anger and explore the potential issue. Answer d is the best example in the scenario given. Which of the following behaviors is most important in establishing a connection with the patient? A. Documenting data from the history using direct patient quotes B. Phrasing questions so that they are clear and explicit C. Avoiding the trap of giving advice during an interview D. Listening intently while observing
nonverbal cues - CORRECT ANSWER >>> D:
CorrectEstablishing a connection with the patient is essential to good communication. Being a skilled listener and being alert to patients' nonverbal communication help establish meaningful connection.
During an interview, the patient describes problems associated with an illness and begins to cry. The best action in this situation is to: A. stop the interview and reschedule for another time. B. allow the patient to cry, then resume when the patient is ready. C. change the topic to something less upsetting.
D. continue the interview while the patient cries in order to get through it quickly. -
CORRECT ANSWER >>> B:CorrectPeople will cry. Let the emotion proceed at the patient's
pace. Resume your questioning only when the patient is ready. If you suspect a patient is holding back, give permission. Offer a tissue or simply say, "It seems like you're feeling bad. It's okay to cry." Name the emotion. Be direct about such a tender circumstance, but gently, not too aggressively or insistently. Which statement best describes the chief complaint? A.General health and illness B. The reason the individual is seeking care C. Information to make the diagnosis
D. Concerns about confidentiality and trust - CORRECT ANSWER >>> B: CorrectThe chief
complaint is the main reason the person is seeking care or the chief concern. The other answers are parts of the history and physical or review of symptoms. A woman presents to a women's health clinic stating that she has had a positive home pregnancy test and desires prenatal care. You would conduct a(n): A. complete history. B. focused history.
Which of the following information is particular to a pediatric history? A. Family history B. Developmental history C. Social history
D. Past medical history - CORRECT ANSWER >>> B:CorrectThe developmental history tells
the examiner when the child achieved developmental milestones and is a key indicator in discerning developmental delays. A 45-year-old patient presents with a complaint of anxiety related to his wife's criticism of his drinking. During the history you ask several of the CAGE model questions and the patient tells you that he wants to cut down on his drinking. Which conclusion would you draw about this patient? A. He is an alcoholic. B. His drinking is caused by anxiety. C. He may be an alcohol abuser.
D. He should be examined for symptoms of withdrawal. -^ CORRECT ANSWER
>>> C:CorrectThe CAGE questionnaire is one model for discussing the use of alcohol. CAGE is an
acronym for Cutting down, Annoyed by criticism, Guilty feeling, Eye-openers. Its use does not ensure absolute sensitivity in the detection of a problem. There is a difference between a screening and an assessment interview. The goal of screening is to find out if a problem exists. This is particularly true of CAGE, CRAFFT, and TACE screening tools. They are effective, but they are only the start, and assessment goes on from there. A conversation with a parent concerning a 5-year-old child: A. violates the child's need for privacy. B. is inappropriate because the child is able to talk with you.
C. provides significant information about family dynamics. D. causes distrust in the child toward
the examiner. - CORRECT ANSWER >>> C:
CorrectFamily dynamics become evident during history taking and may even lead to clues that a parent is in need. Your responsibility goes beyond that for the child. Answers a, b, and d may apply to the adolescent child. Mr. Sandstrom has come for his routine appointment for his hypertension. He is not experiencing medication side effects or other health problems. Which of the following questions is most appropriate to ask when you begin the interview? A. "How have you been doing since your last visit?" B. "Have you been taking your medications?" C. "What brings you to the office today?"
D. "How are you doing with your hypertension?" - CORRECT ANSWER >>> A:CorrectAt the
start, greet the patient and those with the patient. Begin by asking open-ended questions ("How have you been feeling since we last met?" "What questions would you like to discuss?" "What do you want to make sure we cover in today's visit?"). During an interview, a patient admits to feeling worthless and having a sleep disturbance for the last 3 weeks. These clues warrant exploring the possibility of: A. altered cognition. B. suicidal ideation or plan. C. substance abuse.
D. panic attacks. - CORRECT ANSWER >>> B:CorrectA sense of sluggishness in the daily
experience; disturbances in sleeping, eating, and social contact; and feelings of loss of selfworth can be clues for depression.
Mr. Jerry Spenser, a 26-year-old homosexual man, is having a health history taken. Which question regarding sexual activity would most likely hamper trust between Jerry and the interviewer? A. "Are you married or do you have a girlfriend?" B. "Tell me about your living situation." C. "Are you sexually active?"
D. "Are your partners men, women, or both?" - CORRECT ANSWER >>> A:CorrectThe
sexual orientation of a patient must be known if appropriate continuity of care is to be offered. The apprehension these patients may feel in revealing their preferences should be respected. Reassuring, nonjudgmental words help. Trust is best achieved if questions are gender neutral and open ended. If you use a nonjudgmental approach, a variety of questions applicable to any patient and any sexual circumstance becomes possible. Long periods of silence during an interview may indicate: A. a need for the health care provider to increase the pace of the interview. B. an inability of the patient to communicate. C. a reluctance of the patient to verbalize information.
D. a need to terminate the interview because of the decreased attention of the patient. -
CORRECT ANSWER >>> C: CorrectSometimes intimidated by silence, many clinicians feel
the urge to break it. Be patient. Do not force the conversation. You may have to move the moment along with an open-ended question or a mild nudge. Remember, though, that silence allows the patient a moment of reflection or time to summon courage. Some issues can be so painful and sensitive that silence becomes necessary and should be allowed. Most people will talk when they are ready. Interviewers should identify and assess their own feelings, such as hostility and prejudice, in order to:
A. avoid inappropriate behavior. B. explain their biases to patients. C. express personal idiosyncrasies.
D. promote self-awareness. - CORRECT ANSWER >>> A: CorrectYour own beliefs, attitudes,
and values cannot be discarded, but you do have to discipline them. You have to be aware of your cultural beliefs, faith, and conscience so that they do not inappropriately intrude as you discuss with patients a variety of issues. That means knowing yourself. You will better control possible barriers to a successful outcome. J.F. shares with you that he has an uncle and a brother with sickle cell disease. Where would this information best be documented? A. Chief complaint B. Medical history C. Social history
D. Family history - CORRECT ANSWER >>> D:CorrectThe pathway to detecting risk is the
family history. Blood relatives in the immediate or extended family with illnesses with features similar to the patient's are an immediate concern. If a disease "runs in the family," such as sickle cell disease, ask about everyone from grandparents to cousins. A thorough and well-done family history is the essence of genomic medicine. A mother runs into the emergency department with her 6-year-old son. She says that her son fell 15 feet from a tree. The child is screaming and has an open fracture of the left forearm. You would conduct a(n): A. complete history. B. focused history.. C. problem-oriented history.
A. Respond warmly and intimately. B. Remain calm, firm, and direct. C. Recognize that flattery can be manipulative.
D. Ignore the patient's behavior. - CORRECT ANSWER >>> A:CorrectResponding warmly and
intimately is inappropriate. Avert it courteously and firmly, delivering the immediate message that the relationship is and will remain professional. It takes skill to do this while maintaining the patient's dignity, but there is no room for sexual misconduct in the relationship, and there can be no tolerance for exploitation of the patient in this regard. Some older adults may have sensory losses that make communication more difficult. Some degree of hearing loss is common in older adults. One action that tends to worsen hearing or communication problems is: A. positioning yourself so the patient is looking at your face. B. speaking clearly and slowly. C. using a high-pitched voice.
D. avoiding noisy interviewing rooms. - CORRECT ANSWER >>> C:CorrectUsing a highpitched
voice is a form of shouting. Shouting magnifies the problem by distorting consonants and vowels. Position yourself so that the patient can see your face. Speak clearly and slowly, taking care to always face the patient while you are talking. Older adults with impaired visual perception and light-dark adaptation generally do better: A. with written interviews. B. in dimly lit interview rooms. C. in a well-illuminated environment.
D. with a light source that reflects in their eyes. -^ CORRECT ANSWER
>>> C:CorrectImpaired vision and light-dark adaptation are a problem with written interview
forms. Ensure large print and ample lighting with a source that does not glare or reflect in the eyes. A 26-year-old woman presenting for a preemployment physical is found to have bruising on her back and buttocks. What would be your best immediate response? A. Ask, "Would you care to tell me about these bruises on your back and buttocks?" B. Say, "I see bruises. How did you get them?". C. Ask, "Do you feel safe in your current relationships?" D. Say, "I am required by the law to document these bruises, so I am asking your permission to
take a picture of them." - CORRECT ANSWER >>> B:CorrectShould the examiner see
something suggestive like bruises, follow-up questions are required. "How did you get them" is an appropriate nonjudgmental follow-up question. Answers a, c, and d are representative of judgmental questions Developing cultural awareness and sensitivity is vital for the examiner to succeed at: A. applying statistical trends of various ethnic and cultural groups. B. performing a physical examination. C. identifying patients at high risk for various diseases.
D. recognizing and accepting beliefs about health that differ from personal beliefs.. -
C. White collar professionals
D. Upper class men - CORRECT ANSWER >>> B: CorrectPoverty and inadequate education
disproportionately affect various cultural groups (e.g., ethnic minorities and women); socioeconomic disparities negatively affect the health and medical care of individuals belonging to these groups. Which of the following statements regarding the effect of gender on health care is true? A. Individuals treated by male clinicians have lower mortality rates than those treated by female clinicians. B. Male family practice clinicians order more laboratory tests than do their female counterparts. C. Male clinicians are more likely to provide diet and exercise counseling to obese men than are female clinicians. D. Female clinicians write more prescriptions for pain medications than do their male
counterparts. - CORRECT ANSWER >>> C: CorrectIn a qualitative study examining
videotapes of primary care visits, compared with male physicians, women physicians were more "patient centered" in their communication skills. The greatest amount of patient- centeredness was observed when female physicians interacted with female patients. Conversely, compared with a female physician, obese men seen by a male physician were more likely to receive diet and exercise counseling. Over a period of 3 years, the mother of three young children has repeatedly been instructed by the health care provider to get the children immunized; however, the children are still not immunized. The answer to which of the following questions would help the health care provider understand this situation? A. "When are you going to get your children immunized?"
B. "What are your beliefs about immunizations?" C. "We have asked you to get your children immunized. Why has this not been done?"
D. "Don't you understand that your children may get ill without immunizations?" - CORRECT
ANSWER >>> B: CorrectAnswer b is an example of a question that delves into the health
beliefs and practices of the mother. Answers a, c, and d do not allow the mother to define her health and illness practices. The use of physical characteristics to predict health care beliefs about an individual: A. is encouraged when conducting a health interview. B. provides insight into appropriate treatment. C. helps develop rapport.
D. is erroneous thinking on the part of the health care provider. -^ CORRECT ANSWER
>>> D: CorrectThe use of physical characteristics (e.g., gender or skin color) to distinguish a
cultural group or subgroup is inappropriate. There is a sharp difference between distinguishing cultural characteristics and distinguishing physical characteristics. Do not confuse the physical with the cultural or allow the physical to symbolize the cultural. To assume homogeneity in the beliefs, attitudes, and behaviors of all individuals in a particular group leads to misunderstandings about the individual. Answers a, b, and c are inaccurate and may serve as prejudicial factors in the care provided. Which is the best description of cultural humility? A. Viewing each individual as a unique person and the center of care B. Identifying one's own ethnocentricity and tendencies to bias C. Using a social context perspective when interacting with ethnic minorities D. Being aware of one's own limitations in knowledge and cultural perspective along with
openness to new perspectives - CORRECT ANSWER >>> D: CorrectCultural humility
B. Transgender individuals C. Women who have undergone hysterectomy
D. Infertility patients - CORRECT ANSWER >>> B: CorrectIt is imperative that health care
providers invest time in becoming culturally competent and develop cultural humility to work effectively with lesbian, gay, bisexual, and transgender (LGBT) patients. Specific responsibilities include providing a welcoming and safe environment, gathering a history with sensitivity and compassion, and performing a physical examination using a "gender- affirming" approach (i.e., using the correct name and pronouns). A young Native American/American Indian child with severe abdominal pain and fever is brought to the clinic by his mother and grandmother. On examination, you find a foul-smelling cloth wrapped around the child's abdomen. If not removed, the cloth will interfere with the completion of the examination. Of the following, which action best demonstrates cultural sensitivity? A. Ask about its purpose and then remove the cloth. B. Ignore the cloth. C. Ask permission to remove the cloth. D. Inform the family that the cloth will be replaced immediately after the abdominal
examination. - CORRECT ANSWER >>> A: CorrectAsking about the purpose of the cloth
before removing the cloth best depicts cultural sensitivity. Beliefs and behaviors that have an effect on patient assessment will exist. When differences exist, be certain that you grasp exactly what the patient means and know exactly what the patient thinks you mean in words and actions. Asking the patient if you are not sure is far better than making a damaging mistake. Avoid assumptions about cultural beliefs and behaviors made without validation from the patient. A habitual activity passed along by family members is a: A. ritual. B. custom.
C. belief.
D. norm. - CORRECT ANSWER >>> B: CorrectA custom is a traditional practice within a
specific group. Which is a health care disparity identified in the 2013 Centers for Disease Control and Prevention (CDC) Health Disparities and Inequalities Report? A. A higher percentage of black women died from coronary heart disease before age 75 than white women. B. Non-Hispanic white women experienced a higher infant mortality rate than non- Hispanic black women. C. A higher percentage of white men older than age 50 died from coronary artery disease than black men.
D. Asian/Pacific Islanders were uninsured at a higher rate than Hispanics. - CORRECT
ANSWER >>> A: CorrectData from the 2013 CDC Health Disparities and Inequalities Report
revealed a variety of health care disparities such as that, compared with white women, a much higher percentage of black women died from coronary heart disease before age 75 (37.9% vs. 19.4%). Direct, objective, and logical are typical characteristics of verbal communication among the Japanese and other Asian people. True
False - CORRECT ANSWER >>> false- CorrectIn the United States, people are direct in
conversation and are eager to be thought logical, preferring to avoid the subjective and to come
