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Answers and Explanations

Chapter 2 Interviewing and the Health History

Multiple Choice

1. The correct answer is (B) Quality

Quality is the only one of the seven attributes of a symptom listed that is not addressed. The patient has not described the kind of pain he is experiencing other than that it is in his chest. Pain may be an ache, a sharp sensation, a pressure-like sensation, or a burning sensation, which are all important descriptors in helping to determine your differential diagnosis.

Remitting or exacerbating factors would be an incorrect choice in that the patient states during the history that nothing has made the pain better or worse. Likewise, severity is addressed in that the patient rates the pain as a 9 out of a 10-point scale. Timing is also covered when he states that the pain started 30 minutes prior to his arrival at the emergency room and has not gone away.

2. The correct answer is (C) Facilitation

Facilitation is the type of interviewing technique that you have demonstrated. By maintaining eye contact and asking the patient to go on, you have attempted to make her more comfortable in relating details about the concern that brought her into your office.

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Echoing would be an incorrect choice in that it is a simple repetition of the patients words; this was not done. Nor is direct questioning the correct choice since that is a technique in which you, the interviewer, use a series of questions to elicit more details about the patients concern. Reassurance is incorrect as well: As the interviewer, you have not made an attempt to tell her that everything will be alright, or words to that effect.

3. The correct answer is (C) Nonverbal communication

You have used nonverbal communication through the techniques of eye contact, sitting down, moving your body in slightly toward the patient, and nodding.

Echoing is not the correct response since it involves simple repetition of the patients words, and, as the interviewer in this scenario, you havent repeated the patients words. Adaptive questioning is also incorrect. It involves using various questions to clarify the patients story, and in this scenario, as the interviewer, you havent asked any questions yet. Empathic response is not correct. You have not identified the patients feelings; and she has not expressed any during the interview.

4. The correct answer is (B) Talkative patient

This patient wants to tell you her lifes story. Remember to let this type of patient talk for approximately 510 minutes while you listen closely to how she expresses her ideas, note the use of nonverbal cues, and so forth. A helpful technique is to have the patient focus on the most important thing that concerns her at todays visit and to schedule a follow-up appointment, setting a specific time limit on the follow-up as well.