Nr509 Midterm Exam UPDATED
ACTUAL Exam Questions and CORRECT
Answers
is the clinical encounter clinician-centered to patient-centered - CORRECT ANSWER✔✔-
both; needs to be a balance of the clinician meeting their needs of the interaction and the
patient feeling heard and create personal dimension
patient-centered approach - CORRECT ANSWER✔✔- Interviewing technique empowering
the patient to provide a candid and complete medical history
recognizes importance of patient concerns, feelings and emotions and understands the
patients personal contact of the symptoms/disease
FIFE model - CORRECT ANSWER✔✔- mnemonic for patients perspective on the illness
Feelings (fears and concerns about the problem)
Ideas (about nature and cause of problem)
Functioning (effect of illness on function)
Expectations
general structure of patient encounter (5 steps) - CORRECT ANSWER✔✔- initiate the
encounter
gather information
perform the physical examination
explaining and planning
closing the encounter
2 frameworks that continue throughout whole clinical encounter - CORRECT ANSWER✔✔-
relationship building
structuring the interview
,what happens while initiating the encounter - CORRECT ANSWER✔✔- greet the patient
and set the stage/preparation
what does it mean to set the stage - CORRECT ANSWER✔✔- prepare for the interview
check your appearance
make sure patient is comfortable and environment is conducive to private info being shared
what happens during the gathering information stage - CORRECT ANSWER✔✔- initiate
information gathering
history of present illness
past medical history
social history
explore patients perspective of disease and relevant background information
what happens during explaining and planning - CORRECT ANSWER✔✔- provide correct
amount and type of information
negotiate plan of action
shared decision making
when asking patient about there pronouns it may be helpful to.... - CORRECT ANSWER✔✔-
share your own pronouns
"in an effort to promote an inclusive and respectful environment, we use pronouns that are
right for us. The pronouns I prefer are......how about you what pronouns do you prefer?
the initial moments of your encounter lay the foundation for.... - CORRECT ANSWER✔✔-
your ongoing relationship
how to establish rapport - CORRECT ANSWER✔✔- introduce yourself, explain your role
and how you will be a part of their care
,3 dimensions of cultural humility - CORRECT ANSWER✔✔- 1) Self-awareness
2) Respectful communication
3) Collaborative partnerships
active listening - CORRECT ANSWER✔✔- Closely listening to what the patient is
communicating, connecting on an emotional state to the patient.
use both verbal and nonverbal skills to encourage pt to expand on their feelings/concerns
Empathetic responses - CORRECT ANSWER✔✔- capacity to identify with a patient and
feel patients pain as your own and respond in a supportive manner
"That must have been difficult for you."
"I understand, you're worried."
Non-verbal: offering a tissue to a crying patient; reaching out and gently touching a patient's
hand.
Therapeutic use of self: "I've had surgery before, so I can relate to what you're going
through."
guided questioning - CORRECT ANSWER✔✔- Helps to continue the patients story, shows
sustained interest and allows clinician to adapt questioning based on patient i.e.:
-moving from open ended to focused questions
-using questions that elicit a graded response
-asking a series of questions, ONE at a time
-clarifying what the patient means
-encouraging with continuers
-using echoing
guided questioning aka - CORRECT ANSWER✔✔- adaptive questioning
, nonverbal communication - CORRECT ANSWER✔✔- communication using body
movements, gestures, and facial expressions rather than speech
validation - CORRECT ANSWER✔✔- affirm validity of patients emotional experience
"Your accident must have been terrifying. Car accidents are always unsettling because they
remind us how vulnerable we are. Perhaps that explains why you still feel upset,"
reassurance - CORRECT ANSWER✔✔- first step is to identify and acknowledge the
patients feelings
Helps pt feel that the problems have been fully understood and are being addressed
partnering - CORRECT ANSWER✔✔- express commitment to an ongoing relationship
summarization - CORRECT ANSWER✔✔- giving a summary of pts story to communicate
that you have been listening
transitions - CORRECT ANSWER✔✔- inform pt when you are changing directions to
prepare them for what comes next
"now id like to ask some more questions about your past health"
empowering the patient - CORRECT ANSWER✔✔- Empower pt to ask questions, express
concerns, and probe your recommendations
people first language - CORRECT ANSWER✔✔- seeing individuals as people first and not
as being defined by their disorder/illness
i.e.: person with diabetes not diabetic, person with substance abuse not drug user
informed consent required elements - CORRECT ANSWER✔✔- discuss nature of procedure
or treatment
ACTUAL Exam Questions and CORRECT
Answers
is the clinical encounter clinician-centered to patient-centered - CORRECT ANSWER✔✔-
both; needs to be a balance of the clinician meeting their needs of the interaction and the
patient feeling heard and create personal dimension
patient-centered approach - CORRECT ANSWER✔✔- Interviewing technique empowering
the patient to provide a candid and complete medical history
recognizes importance of patient concerns, feelings and emotions and understands the
patients personal contact of the symptoms/disease
FIFE model - CORRECT ANSWER✔✔- mnemonic for patients perspective on the illness
Feelings (fears and concerns about the problem)
Ideas (about nature and cause of problem)
Functioning (effect of illness on function)
Expectations
general structure of patient encounter (5 steps) - CORRECT ANSWER✔✔- initiate the
encounter
gather information
perform the physical examination
explaining and planning
closing the encounter
2 frameworks that continue throughout whole clinical encounter - CORRECT ANSWER✔✔-
relationship building
structuring the interview
,what happens while initiating the encounter - CORRECT ANSWER✔✔- greet the patient
and set the stage/preparation
what does it mean to set the stage - CORRECT ANSWER✔✔- prepare for the interview
check your appearance
make sure patient is comfortable and environment is conducive to private info being shared
what happens during the gathering information stage - CORRECT ANSWER✔✔- initiate
information gathering
history of present illness
past medical history
social history
explore patients perspective of disease and relevant background information
what happens during explaining and planning - CORRECT ANSWER✔✔- provide correct
amount and type of information
negotiate plan of action
shared decision making
when asking patient about there pronouns it may be helpful to.... - CORRECT ANSWER✔✔-
share your own pronouns
"in an effort to promote an inclusive and respectful environment, we use pronouns that are
right for us. The pronouns I prefer are......how about you what pronouns do you prefer?
the initial moments of your encounter lay the foundation for.... - CORRECT ANSWER✔✔-
your ongoing relationship
how to establish rapport - CORRECT ANSWER✔✔- introduce yourself, explain your role
and how you will be a part of their care
,3 dimensions of cultural humility - CORRECT ANSWER✔✔- 1) Self-awareness
2) Respectful communication
3) Collaborative partnerships
active listening - CORRECT ANSWER✔✔- Closely listening to what the patient is
communicating, connecting on an emotional state to the patient.
use both verbal and nonverbal skills to encourage pt to expand on their feelings/concerns
Empathetic responses - CORRECT ANSWER✔✔- capacity to identify with a patient and
feel patients pain as your own and respond in a supportive manner
"That must have been difficult for you."
"I understand, you're worried."
Non-verbal: offering a tissue to a crying patient; reaching out and gently touching a patient's
hand.
Therapeutic use of self: "I've had surgery before, so I can relate to what you're going
through."
guided questioning - CORRECT ANSWER✔✔- Helps to continue the patients story, shows
sustained interest and allows clinician to adapt questioning based on patient i.e.:
-moving from open ended to focused questions
-using questions that elicit a graded response
-asking a series of questions, ONE at a time
-clarifying what the patient means
-encouraging with continuers
-using echoing
guided questioning aka - CORRECT ANSWER✔✔- adaptive questioning
, nonverbal communication - CORRECT ANSWER✔✔- communication using body
movements, gestures, and facial expressions rather than speech
validation - CORRECT ANSWER✔✔- affirm validity of patients emotional experience
"Your accident must have been terrifying. Car accidents are always unsettling because they
remind us how vulnerable we are. Perhaps that explains why you still feel upset,"
reassurance - CORRECT ANSWER✔✔- first step is to identify and acknowledge the
patients feelings
Helps pt feel that the problems have been fully understood and are being addressed
partnering - CORRECT ANSWER✔✔- express commitment to an ongoing relationship
summarization - CORRECT ANSWER✔✔- giving a summary of pts story to communicate
that you have been listening
transitions - CORRECT ANSWER✔✔- inform pt when you are changing directions to
prepare them for what comes next
"now id like to ask some more questions about your past health"
empowering the patient - CORRECT ANSWER✔✔- Empower pt to ask questions, express
concerns, and probe your recommendations
people first language - CORRECT ANSWER✔✔- seeing individuals as people first and not
as being defined by their disorder/illness
i.e.: person with diabetes not diabetic, person with substance abuse not drug user
informed consent required elements - CORRECT ANSWER✔✔- discuss nature of procedure
or treatment
