NR509 Bates Interactive Chapters 1-17 Exam Solution Manual Solved 100%
A 23-year-old physician assistant (PA) student found that she felt nervous when called upon to examine
men in her age group. On one occasion, she encountered a young male patient who appeared
embarrassed to see her walk into the room. What should the PA do to minimize their mutual
discomfort? - Answers Explain how the examination will proceed.
A 34-year-old male with a history of complex social and medical needs (including current substance
abuse) presents to a primary care teaching clinic. The patient has experienced a number of adversarial
relationships with prior clinicians, including voluntarily leaving two practices within the previous year
and being asked to leave care at a third clinic due to misbehavior. The attending physician desires to
utilize the approaches to this patient that are most likely lead to comprehensive care and patient
compliance. Which of the following is the most appropriate interview style for the attending physician to
use? - Answers Following the patient's lead to understand their thoughts, ideas, concerns, and requests
A 17-year-old male presents to a sexually transmitted disease clinic at the behest of his brother, who
convinced the patient to attend the clinic after he disclosed that he prefers homosexual partners but is
afraid that his last partner may have given him an infection. The patient expresses to the intake nurse
that he is unashamed of his sexual orientation and will not stay through the visit if he feels that he is
dismissed or discriminated against because of it. The nurse practitioner receives this communication
prior to entering the examination room and decides to employ active listening to best connect with the
patient at this critical juncture in his care with the clinic. Which of the following is an example of an
active listening technique? - Answers Using nonverbal communication to encourage the patient to
expand their narrative
A 42-year-old female mathematician presents for follow-up care regarding a new diagnosis of systemic
lupus erythematosus 6 months ago after a lengthy diagnostic process during which she was debilitated
with fatigue and joint pain. Since her diagnosis, she has been minimally compliant with medications and
has switched her rheumatology provider twice. She continues to feel ill, and, in explanation for her lack
of adherence to the prescribed treatment, she simply says, "I don't like it." At this initial visit with her
third rheumatology provider, the clinician elects to explore the issues behind her noncompliance before
engaging in diagnostics and treatment using the FIFE model. Which of the following best defines the
elements of the FIFE model? - Answers Feelings, ideas, function, and expectations
A 39-year-old nurse who is a well-established patient complains of irregular menstrual periods and
pelvic pain. She says that she is having trouble sleeping and asks whether she could be given a "sleeping
pill." The patient also says she is thinking of leaving her job. What is the best "next step" in caring for this
patient? - Answers Obtain a more complete description of problems
A 29-year-old female professional athlete presents to a new primary care provider with chronic
menstrual complaints. She remarks to the nursing staff that, in the past, she has experienced a dismissal
of her complaints because of her high level of physical fitness and conditioning. She is seeking a care
provider who will explore the issue in more detail and work with her particular concerns. Which of the
, following is the description of the patient-centered care this individual seeks? - Answers Validating and
empathetic with open-ended questions
A 36-year-old female air traffic controller presents to her primary care provider for a routine visit 3
months after losing her spouse to a lengthy battle with a neurodegenerative disease. The patient denies
any psychiatric symptoms on review of systems and, in fact, states that she has slept better in the last
month than she had in the previous years. She endorses a healthy support system, including the
extended family of her deceased spouse, with whom she is still close. She becomes wistful and briefly
tearful when speaking of the plans that they had when they first married that were never fulfilled; she
then changes the subject rapidly to whether her Pap smear is due. Which of the following is an example
of an empathetic response to this patient? - Answers Recognizing the patient's emotions by asking or
confirming how she feels about the event
A 63-year-old male presents to establish care at a new primary care clinic to discuss issues with pain and
fatigue. The clinician conducting the visit begins with general historical questions but quickly becomes
suspicious that the patient is suffering from decompensated heart failure. When the patient mentions
that he has had vague chest pain since last night, the clinician feels that the focus must be redirected to
this potentially emergent condition. Which of the following interview techniques is the most appropriate
to effectively manage this visit? - Answers Moving from open-ended to focused questions
A 59-year-old patient presents to his primary care provider with a history of several episodes of sharp
epigastric pain. His father died of pancreatic cancer at age 52 years, and the patient recalls to the
clinician that, "His pain was just like mine is now ..." The patient then pauses several seconds. The
clinician replies, "Just like?" after which the patient restarts his narrative. Which of the following is an
example of the interviewing techniques employed by the clinician? - Answers Echoing
A 14-year-old male presents to a new primary care provider after his family relocates to a state. The
patient underwent treatment for sarcoma when he was age 11 years, including an above-the-knee
amputation. He has learned to successfully navigate with a prosthetic leg and even engage in
competitive athletics at school. He does not like to speak of his experience with cancer and often makes
up humorous stories to tell new acquaintances about his amputation (such as, "I got bit by a squirrel and
they had to amputate."). Although he is very well engaged in most of the visit with the new clinician,
when the topic of cancer arises, he demurs to his father, who accompanies him to this appointment.
Which of the following statements is most likely to be helpful in cementing the patient's trust in the new
provider - Answers "That sounds like a frightening experience that you are recovering well from."
A 54-year-old diplomat working at the United Nations reports occasional chest pain and a sense of
tightness in his chest when particularly stressed over work deadlines. The patient is 6 feet 4 inches tall.
He has a temperature of 98.6ºF and blood pressure of 140/78. He has a cut over one eye that he says is
"from shaving." Which of the following represents subjective information about this patient? - Answers
Cut over eye from shaving
A 32-year-old office worker reports excessive stress at work and pain in the right lower quadrant. She
states that last night she vomited twice. Her blood pressure is 120/75, heart rate 93 bpm. The patient
A 23-year-old physician assistant (PA) student found that she felt nervous when called upon to examine
men in her age group. On one occasion, she encountered a young male patient who appeared
embarrassed to see her walk into the room. What should the PA do to minimize their mutual
discomfort? - Answers Explain how the examination will proceed.
A 34-year-old male with a history of complex social and medical needs (including current substance
abuse) presents to a primary care teaching clinic. The patient has experienced a number of adversarial
relationships with prior clinicians, including voluntarily leaving two practices within the previous year
and being asked to leave care at a third clinic due to misbehavior. The attending physician desires to
utilize the approaches to this patient that are most likely lead to comprehensive care and patient
compliance. Which of the following is the most appropriate interview style for the attending physician to
use? - Answers Following the patient's lead to understand their thoughts, ideas, concerns, and requests
A 17-year-old male presents to a sexually transmitted disease clinic at the behest of his brother, who
convinced the patient to attend the clinic after he disclosed that he prefers homosexual partners but is
afraid that his last partner may have given him an infection. The patient expresses to the intake nurse
that he is unashamed of his sexual orientation and will not stay through the visit if he feels that he is
dismissed or discriminated against because of it. The nurse practitioner receives this communication
prior to entering the examination room and decides to employ active listening to best connect with the
patient at this critical juncture in his care with the clinic. Which of the following is an example of an
active listening technique? - Answers Using nonverbal communication to encourage the patient to
expand their narrative
A 42-year-old female mathematician presents for follow-up care regarding a new diagnosis of systemic
lupus erythematosus 6 months ago after a lengthy diagnostic process during which she was debilitated
with fatigue and joint pain. Since her diagnosis, she has been minimally compliant with medications and
has switched her rheumatology provider twice. She continues to feel ill, and, in explanation for her lack
of adherence to the prescribed treatment, she simply says, "I don't like it." At this initial visit with her
third rheumatology provider, the clinician elects to explore the issues behind her noncompliance before
engaging in diagnostics and treatment using the FIFE model. Which of the following best defines the
elements of the FIFE model? - Answers Feelings, ideas, function, and expectations
A 39-year-old nurse who is a well-established patient complains of irregular menstrual periods and
pelvic pain. She says that she is having trouble sleeping and asks whether she could be given a "sleeping
pill." The patient also says she is thinking of leaving her job. What is the best "next step" in caring for this
patient? - Answers Obtain a more complete description of problems
A 29-year-old female professional athlete presents to a new primary care provider with chronic
menstrual complaints. She remarks to the nursing staff that, in the past, she has experienced a dismissal
of her complaints because of her high level of physical fitness and conditioning. She is seeking a care
provider who will explore the issue in more detail and work with her particular concerns. Which of the
, following is the description of the patient-centered care this individual seeks? - Answers Validating and
empathetic with open-ended questions
A 36-year-old female air traffic controller presents to her primary care provider for a routine visit 3
months after losing her spouse to a lengthy battle with a neurodegenerative disease. The patient denies
any psychiatric symptoms on review of systems and, in fact, states that she has slept better in the last
month than she had in the previous years. She endorses a healthy support system, including the
extended family of her deceased spouse, with whom she is still close. She becomes wistful and briefly
tearful when speaking of the plans that they had when they first married that were never fulfilled; she
then changes the subject rapidly to whether her Pap smear is due. Which of the following is an example
of an empathetic response to this patient? - Answers Recognizing the patient's emotions by asking or
confirming how she feels about the event
A 63-year-old male presents to establish care at a new primary care clinic to discuss issues with pain and
fatigue. The clinician conducting the visit begins with general historical questions but quickly becomes
suspicious that the patient is suffering from decompensated heart failure. When the patient mentions
that he has had vague chest pain since last night, the clinician feels that the focus must be redirected to
this potentially emergent condition. Which of the following interview techniques is the most appropriate
to effectively manage this visit? - Answers Moving from open-ended to focused questions
A 59-year-old patient presents to his primary care provider with a history of several episodes of sharp
epigastric pain. His father died of pancreatic cancer at age 52 years, and the patient recalls to the
clinician that, "His pain was just like mine is now ..." The patient then pauses several seconds. The
clinician replies, "Just like?" after which the patient restarts his narrative. Which of the following is an
example of the interviewing techniques employed by the clinician? - Answers Echoing
A 14-year-old male presents to a new primary care provider after his family relocates to a state. The
patient underwent treatment for sarcoma when he was age 11 years, including an above-the-knee
amputation. He has learned to successfully navigate with a prosthetic leg and even engage in
competitive athletics at school. He does not like to speak of his experience with cancer and often makes
up humorous stories to tell new acquaintances about his amputation (such as, "I got bit by a squirrel and
they had to amputate."). Although he is very well engaged in most of the visit with the new clinician,
when the topic of cancer arises, he demurs to his father, who accompanies him to this appointment.
Which of the following statements is most likely to be helpful in cementing the patient's trust in the new
provider - Answers "That sounds like a frightening experience that you are recovering well from."
A 54-year-old diplomat working at the United Nations reports occasional chest pain and a sense of
tightness in his chest when particularly stressed over work deadlines. The patient is 6 feet 4 inches tall.
He has a temperature of 98.6ºF and blood pressure of 140/78. He has a cut over one eye that he says is
"from shaving." Which of the following represents subjective information about this patient? - Answers
Cut over eye from shaving
A 32-year-old office worker reports excessive stress at work and pain in the right lower quadrant. She
states that last night she vomited twice. Her blood pressure is 120/75, heart rate 93 bpm. The patient
