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EC Health Assessment > Chapter 3: The Interview > Flashcards

Chapter 3: The Interview Flashcards

1
Q

Ad hoc interpreter

A

Using a patient’s family member, friend, or child as interpreter for a patient with limited English proficiency (LEP)

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2
Q

Animism

A

Imagining that inanimate objects (e.g. a blood pressure cuff) come alive and have human characteristics

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3
Q

Avoidance

A

The use of euphemisms to avoid reality or to hide feelings

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4
Q

Clarification

A

Examiner’s response used when the patient’s word choice is ambiguous or confusing

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5
Q

Closed questions

A

Questions that ask for specific information and elicit a short, one- or two- word answer, a “yes” or “no,” or a forced choice

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6
Q

Confrontation

A

Response in which examiner gives honest feedback about what he or she has seen or felt after observing a certain patient action, feeling, or statement

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7
Q

Distancing

A

The use of impersonal speech to put space between one’s self and a threat

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8
Q

Elderspeak

A

Infantilizing and demeaning language used by a health professional when speaking to an older adult

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9
Q

Electronic health recording

A

Direct computer entry of a patient’s health record while in the patient’s presence

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10
Q

Empathy

A

Viewing the world from the other person’s inner frame of reference while remaining yourself; recognizing and accepting the other person’s feelings without criticism

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11
Q

Ethnocentrism

A

The tendency to view your own way of life as the most desirable, acceptable, or best and to act in a superior manner to another culture’s may of life

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12
Q

Explanation

A

Examiner’s statements that inform the patient; examiner shares factual and objective information

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13
Q

Facilitation

A

Examiner’s response that encourages the patient to say more, to continue with the story

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14
Q

Geographic privacy

A

Private room or space with only the examiner and patient present

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15
Q

Interpretation

A

Examiner’s statement that is not based on direct observations, but is based on examiner’s inference or conclusion; links events, makes associations, or implies cause

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16
Q

Interview

A

Meeting between the examiner and patient with the goal of gathering a complete health history

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17
Q

Jargon

A

Medical vocabulary used with a patient in an exclusionary and paternalistic way

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18
Q

Leading question

A

A question that implies that one answer would be better than another

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19
Q

Nonverbal communication

A

Message conveyed through body language - posture, gestures, facial expression, eye contact, touch, and even where one places the chairs

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20
Q

Open-ended question

A

Asks for longer narrative information; unbiased; leaves the person free to answer in any way

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21
Q

Reflection

A

Examiner response that echoes that patient’s words; repeats part of what the patient has just said

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22
Q

Summary

A

Final review of what examiner understands patient has said; condenses facts and presents a survey of how the examiner perceives the health problem or need

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23
Q

Telegraphic speech

A

Speech used by age 3 or 4 years in which three- or four-word sentences contain only the essential words

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24
Q

Verbal communication

A

Messages send through spoken words, vocalizations, or tone of voice

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25
Q

List 8 items of the information that should be communicated to the client concerning the terms or expectations of the interview.

A
  • Time and place of the interview
  • Introduce yourself and your role
  • Purpose of the interview
  • How long it will take
  • Expectations of participants
  • Confidentiality - to what extent
  • Any costs to the client
  • Presence of any additional individuals
  • Clear up any confusion
26
Q

Describe the points to consider in preparing the physical setting for the interview.

A
  • Temperature is comfortable
  • Sufficient lighting (not harsh/direct)
  • Quiet
  • Remove distractions
  • Appropriate distance (4-5 ft)
  • Equal status seating
  • Arrange face-to-face position
27
Q

List the pros and cons of note-taking during the interview.

A
  • Cons
    • Breaks eye contact
    • Shifts attention away from individual
    • May cause individual to slow down (not fulling express themself)
    • Impedes observation of nonverbal behavior
    • Threatening to client during discussion of sensitive issues
  • Pros
    • Accurate notes
    • Detailed notes
28
Q

Contrast open-ended versus closed questions, and explain the purpose of each during the interview.

A
  • Open-ended: used to start an interview
    • Allows patient to ellaborate and give an account fo their concerns and allows you to establish rapport and give you a chance to observe their nonverbals
  • Closed question: used to get specific information/facts
    • Helps clarify information
29
Q

List the 9 types of examiner responses that could be used during the interview, and give a short example of each.

A
  • Facilitation: mm-hmm
  • Silence: count to 10 silently
  • Reflection: patient says, “I have kids at home I am worried about.” Nurse says, “You have anxiety about your children?”
  • Empathy: “It must be hard”
  • Clarification: repeat back what they said using your own words and understanding
  • Confrontation: “You look sad”
  • Interpretation: links events, makes association, implies cause; “it seems that every time your stomach is upset there are a lot of stressors in your life.”
30
Q

List the 10 traps of interviewing, and give a short example of each.

A
  1. Provides false assurance or reassurance: “everything will be fine”
  2. Giving unwanted advice: “If I were you…”
  3. Using authority: “If your doctor knows best”
  4. Using avoidance language: “He has gone to a better place”
  5. Distancing: “There is a lump in the left breast” vs “Your left breast”
  6. Using professional jargon: “Your hypertension….”
  7. Using leading or biased questions: “You don’t smoke, right?”
  8. Talking too much: talking more than you listen
  9. Interrupting: cutting patient off
  10. Using “Why” questions implies blame: “Why did you wait so long”
31
Q

State at least 7 types of nonverbal behaviors that an interviewer could make

A
  • Physical appearance
  • Posture
  • Gestures
  • Facial expressions
  • Eye contact
  • Voice (tone/inflections)
  • Touch
32
Q

State a useful phrase to use as a closing when ending the interview.

A

“Is there anything else you would like to mention?”

“Do you have any questions?”

33
Q

Discuss special considerations when interviewing an older adult.

A
  • Address them by their proper surname
  • Avoid “elderspeak” (sweetie)
  • Interview will tend to be longer - they have more of a story to tell
  • Adjust pace as necessary - may need breaks/pauses
  • Touch helps ground them to reality
34
Q

How would you modify your interviewing technique when working with a hearing-impaired person?

A
  • Nonverbal cues
  • Face them so your mouth and face are fully visible
    • Good lighting
  • Do not shout - it distorts speech
  • May need a sign language interpreter
35
Q

Formulate a response you would make to a client who has spoken in a sexually aggressive way.

A

Make sure they understand you are a health professional and this relationship needs to be professional. Communicate you will not tolerate sexual advances. Use “I” statements.

36
Q

List at least 5 points to consider when using an interpreter during an interview.

A
  • Identify the language the patient is comfortable with
  • Used medically trained interpreter - and culturally trained
  • Be aware of rivalries and gender/culture differences
  • Plan what to say ahead of time - meet with interpreter
  • Ask interpreter to provide verbatim account of conversation
  • Longer than necessary explanatory exchanges often required
  • Use short, simple phrases, pause for interpretation to occur
  • Speak to the client not the interpreter
37
Q

The practitioner, entering the examining room to meet a patient for the first time, states: “Hello, I’m M.M., and I’m here to gather some information from you and to perform your examination. This will take about 30 minutes. D.D. is a student working with me. If it’s alright with you, she will remain during the examination.” Which of the following must be added to cover all aspects of the interview contract?

a. A statement regarding confidentiality, patient costs, and the expectations of each person.
b. The purpose of the interview and the role of the interviewer.
c. Time and place of the interview and a confidentiality statement.
d. An explicit purpose of the interview and a description of the physical examination, including diagnostic studies.

A

a. A statement regarding confidentiality, patient costs, and the expectations of each person.

38
Q

_____ is exhibiting an accurate understanding of the other person’s feelings within a communication context.

a. Empathy
b. Liking others
c. Facilitation
d. A nonverbal listening technique

A

a. Empathy

39
Q

You conduct an admission interview. Because you are expecting a phone call, you stand near the door. Which would be a more appropriate approach?

a. Arrange to have someone page you so you can sit on the side of the bed
b. Have someone else answer the phone so you can give the patient your full attention
c. Use this approach given the circumstances
d. Arrange for a time free of interruptions after the initial physical examination is complete

A

b. Have someone else answer the phone so you can give the patient your full attention

40
Q

A patient asks the nurse, “May I ask you a question?” This is an example of:

a. An open-ended question
b. A reflective question
c. A closed question
d. A double-barreled question

A

c. A closed question

41
Q

Which statement best describes interpretation as a communication technique?

a. Interpretation is the same as clarification
b. Interpretation is a summary of a statement made by a patient
c. Interpretation is used to focus on a particular aspect of what the patient has just said
d. Interpretation is based on the interviewer’s inference from the data that have been presented

A

d. Interpretation is based on the interviewer’s inference from the data that have been presented

42
Q

Which demonstrates a good understanding of the interview process?

a. The nurse stops the patient each time something is said that is not understood
b. The nurse spends more time listening to the patient than talking
c. The nurse is consistently thinking of his or her next response so the patient will know he or she is understood
d. The nurse uses “why” questions to seek clarification of unusual symptoms or behavior

A

b. The nurse spends more time listening to the patient than talking

43
Q

During an interview, a patient denies having any anxiety. The patient frequently changes position in the chair, holds his arms folded tight against his chest, and has little eye contact with the interviewer. The interviewer should:

a. Use confrontation to bring the discrepancy between verbal and nonverbal behavior to the patient’s attention
b. Proceed with the interview. Patients usually are truthful with a health care practitioner
c. Make a mental note to discuss the behavior after the physical examination is completed
d. Proceed with the interview and examination as outlined on the agency assessment form. The patient’s behavior is appropriate for the circumstances

A

a. Use confrontation to bring the discrepancy between verbal and nonverbal behavior to the patient’s attention

44
Q

For what or with whom should touch be used during the interview?

a. Only with individuals from a Western culture
b. As a routine way of establishing contact with the person and communicating empathy
c. Only with patients of the same gender
d. Only if the interviewer knows the person well

A

d. Only if the interviewer knows the person well

45
Q

Children usually come for health care with a caregiver. At about what age should the interviewer begin to question the child himself or herself regarding presenting symptoms?

a. 5 years
b. 7 years
c. 9 years
d. 11 years

A

b. 7 years

46
Q

Because of adolescents’ developmental level, not all interviewing techniques can be used with them. Which techniques should be avoided?

a. Facilitation and clarification
b. Confrontation and explanation
c. Empathy and interpretations
d. Silence and reflection

A

d. Silence and reflection

47
Q

Knowledge of the use of personal space is helpful for the health care provider. Personal distance is generally considered to be:

a. 0 to 1-1/2 feet
b. 1-1/2 to 4 feet
c. 4 to 12 feet
d. 12 or more feet

A

b. 1-1/2 to 4 feet

48
Q

Mr. B tells you, “Everyone here ignores me.” You respond, “Ignores you?” This technique is best described as:

a. Clarification
b. Selective listening
c. Reflecting
d. Validation

A

c. Reflecting

49
Q

What does active listening not include?

a. Taking detailed notes during the interview
b. Watching for clues in body language
c. Repeating statements back to the person to make sure you have understood
d. Asking open-ended questions to explore the person’s perspective

A

a. Taking detailed notes during the interview

50
Q

When interviewing a patient who does not speak English, the examiner should:

a. Take advantage of family members who are readily available and willing to assist
b. Use a qualified medical interpreter who is culturally literate
c. Seek as much information as possible and then continue with the physical examination
d. Wait until a qualified medical interpreter is available before starting the interview

A

b. Use a qualified medical interpreter who is culturally literate

51
Q

With older adults, how should the examiner proceed with the interview?

a. Proceed in a more organized and concise manner
b. Consider the fatigue of the older person and breaks the interview into shorter segments
c. Ask a family member to complete some of the records while moving ahead with the interview
d. Raise your voice if the patient does not appear to hear you

A

b. Consider the fatigue of the older person and breaks the interview into shorter segments

52
Q

How would you describe hypertension to people with low health literacy?

A

Abnormally high blood pressure. The force of blood on the arteries is too high.

53
Q

How would you describe diabetes to people with low health literacy?

A

Blood sugars are too high or too low. Your body is not producing the correct amount of insulin (a hormone) that regulates these levels.

54
Q

How would you describe cardiac catherization to people with low health literacy?

A

Insertion of a catheter (a tube) into your heart/vessels to diagnose for diseases.

55
Q

How would you describe urinary tract infection to people with low health literacy?

A

A bacterial infection of your urinary tract. Can cause a lot of discomfort uriating.

56
Q

How would you describe incontinence to people with low health literacy?

A

Inability to control urine. May leak frequnetly.

57
Q

How would you describe diarrhea to people with low health literacy?

A

Loose stools that persist and feel urgent. Can be painful and lead to dehydration.

58
Q

How would you describe lymphedema to people with low health literacy?

A

When your lymph nodes are swollen. Caused by an infection that your body is trying to fight off.

59
Q

How would you describe glaucoma to people with low health literacy?

A

An eye condition that can cause blindness if not treated.

60
Q

How would you describe disease to people with low health literacy?

A

Disease is a process that can be caused by different agents. It can produce signs and symptoms that are abnormal and uncomfortable.

61
Q

How would you describe anticoagulation to people with low health literacy?

A

A treatment to thin the blood to prevent clots from forming.

EC Health Assessment (14 decks)

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