A patient reports that he is overwhelmed with anxiety. Which question would be most important to use in assessing the patient during your first meeting?

Question

a. "What kinds of things do you do to reduce or cope with your stress?"
b. "Tell me about your family history—do any relatives have problems with stress?"
c. "Tell me about exercise—how far do you typically run when you go jogging?"
d. "Stress can interfere with sleep. How much did you sleep last night?"

Answer 1

ANS: A
The most important data to collect during an initial assessment is that which reflects how stress is affecting the patient and how he is coping with stress at present. This data would indicate whether his distress is placing him in danger (e.g., by elevating his blood pressure dangerously or via maladaptive responses such as drinking) and would help you understand how he copes and how well his coping strategies and resources are serving him. Therefore, of the choices presented, the highest priority would be to determine what he is doing to cope at present, preferably via an open-ended or broad-opening inquiry. Family history, the extent of his use of exercise, and how much sleep he is getting are all helpful but seek data that is less of a priority. Also, the manner in which such data is sought here is likely to provide only brief responses (e.g., how much sleep he got on one particular night is probably less important than how much he is sleeping in general).