Chapter 01: The Patient Interview
Des Jardins: Clinical Manifestations and Assessment of Respiratory Disease, 9th Edition

MULTIPLE CHOICE

	1.	The respiratory care practitioner is conducting a patient interview. The main purpose of this interview is to:
a.	review data with the patient.	
b.	gather subjective data from the patient.	
c.	gather objective data from the patient.	
d.	fill out the history form or checklist.	

ANS:	B
The interview is a meeting between the respiratory therapist and the patient. It allows the collection of subjective data about the patient's feelings regarding his/her condition.

	2.	For there to be a successful interview, the respiratory therapist must:
a.	provide leading questions to guide the patient.	
b.	reassure the patient.	
c.	be an active listener.	
d.	use medical terminology to show knowledge of the subject matter.	

ANS:	C
Listening is not a passive process. Listening is active and demanding. It requires the practitioner's complete attention. If the examiner is preoccupied with personal needs or concerns, he or she will invariably miss something important. Active listening is a cornerstone to understanding.

	3.	Which of the following would be found on a history form?
a.	Present health, patient history, and family history	
b.	Chief complaint and present health	
c.	Age, medications, present health, and family history	
d.	Age, chief complaint, present health, and family history	

ANS:	D
Age, chief complaint, present health, and family history are typically found on a health history form because each can impact the patient’s health. Health insurance provider information, while needed for billing purposes, would not be found on the history form.

	4.	External factors the respiratory care practitioner should make efforts to provide during an interview include which of the following?
1. Minimize or prevent interruptions.
2. Ensure privacy during discussions.
3. Interviewer is the same sex as the patient to prevent bias.
4. Be comfortable for the patient and interviewer.
a.	1, 4	
b.	2, 3	
c.	1, 2, 4	
d.	2, 3, 4	

ANS:	C
External factors, such as a good physical setting, enhance the interviewing process. Regardless of the interview setting (the patient’s bedside, a crowded emergency room, an office in the hospital or clinic, or the patient’s home), efforts should be made to (1) ensure privacy, (2) prevent interruptions, and (3) secure a comfortable physical environment (e.g., comfortable room temperature, sufficient lighting, absence of noise). An interviewer of either gender, who acts professionally, should be able to interview a patient of either gender.

	5.	The respiratory therapist is conducting a patient interview. The therapist chooses to use open-ended questions. Open-ended questions allow the therapist to do which of the following?
1. Gather information when a patient introduces a new topic.
2. Introduce a new subject area.
3. Begin the interview process.
4. Gather specific information.
a.	4	
b.	1, 3	
c.	1, 2, 3	
d.	2, 3, 4	

ANS:	C
An open-ended question should be used to start the interview, introduce a new section of questions, and gather more information from a patient’s topic. Closed or direct questions are used to gather specific information.

	6.	The respiratory therapist is conducting a patient interview and recording responses in the patient’s electronic health record. The respiratory therapist should take which of the following into account regarding the use of the computer to record responses?
a.	The therapist’s attention may be shifted from the patient to the computer.	
b.	The patient will feel more important than if the information is recorded on paper.	
c.	The therapist will be less likely to make spelling errors if using a spell-check program.	
d.	The environment will be more professional and the patient will be more likely to open up if the interview is conducted with paper.	

ANS:	A
In addition, the interviewer's focus is often shifted from the patient to the EHR and this can cause him/her to overlook important verbal and nonverbal messages. This situation also has the potential to cause patients to think they are not important.

	7.	During the interview the patient states, “Every time I climb the stairs I have to stop to catch my breath.” Hearing this, the respiratory therapist replies, “So, it sounds like you get short of breath climbing stairs.” This interviewing technique is called:
a.	clarification.	
b.	modeling.	
c.	empathy.	
d.	reflection.	

ANS:	D
Reflection is used to echo the patient's words. The examiner repeats a part of what the patient has just said to clarify or stimulate further communication. Reflection helps the patient focus on specific areas and continue in his or her own way.

	8.	The respiratory therapist may choose to use the patient interview technique of silence in which of the following situations?
a.	To prompt the patient to ask a question	
b.	After a direct question	
c.	After an open-ended question	
d.	To allow the patient to review his/her history	

ANS:	C
The open-ended question is unbiased; it allows the patient freedom to answer in any way. This type of question encourages the patient to respond at greater length and give a spontaneous account of the condition. As the patient answers, the examiner should stop and listen. Patients often answer in short phrases or sentences and then pause, waiting for some kind of direction from the examiner.

	9.	Which of the following are the most important components of a successful interview?
a.	Communication and understanding	
b.	Authority and the use of medical terminology	
c.	Providing assurance and giving advice	
d.	Asking leading questions and anticipating patient responses to questions	

ANS:	A
Communication and understanding are the basis for a good patient interview. Authority, the use of medical jargon, providing assurance, giving advice, asking leading questions, and anticipating are all types of nonproductive communication forms and create barriers to patient communication.

	10.	The respiratory therapist should be aware of a patient’s culture and religious beliefs for which of the following reasons?
a.	To be able to engage in a meaningful conversation	
b.	To change any misguided notions the patient has that may impact his/her health	
c.	To explain to the patient how these beliefs will lead to discrimination and stereotyping	
d.	To better understand how the patient’s beliefs may impact how the patient thinks and behaves	

ANS:	D
Culture and religious beliefs may have a profound effect on how patients think and behave, and this may impact their health or health care decisions. The role of the respiratory therapist is not to change the patient’s beliefs, engage in sensitive conversations, or discuss discrimination. Rather, the respiratory therapist needs to understand how these beliefs may impact the patient’s health care decisions.