NR509 Midterm Exam Questions & Answers Verified 100% Correct

NR509 Midterm Exam Questions & Answers Verified 100% Correct Protocol for delivering bad news? - ANSWER -S-set up meeting P-perception (patients) I-invitation (of conversation/questions) K-knowledge E-empathy S-summarise and strategise how to deal with a patient who is silent - ANSWER -remember silence can have many meanings and silence can be therapeutic possibly the patient is having difficulty controlling emotions, deciding to open up, od possibly you've offended them "you are quiet, what are you thinking?" how to deal with a patient who is talkative - ANSWER -give pt free reign of first 5-10 minutes while listening carefully focus on what seems most important to the patient and ask questions in those areas brief summary may help you change subject yet validate any concerns "let me make sure I understand, you have brought up many concerns, I heard 2 different types of pain. lets focus on the pain...." dealing with a patient giving a confusing narrative - ANSWER -assess why its confusing (pts style vs underlying communication issue) guide interview into psychosocial assessment how to deal with patient with altered state of cognition - ANSWER -obtain hx from other sources (family, caregiver) while obtains info do not give out info about patient unless they are the patients healthcare proxy dealing with a patient with emotional lability - ANSWER -pausing, gentle probing, respond with empathy, offer a tissue supportive remark "im glad you were able to express your feelings" dealing with an angry or aggressive patient - ANSWER -stay clam do not be confrontational, acknowledge situation, make amends, validate patients feelings without agreeing to their reasons for beings upset alert security staff dealing with flirtatious pt - ANSWER -calmly and firmly set boundaries about your relationship being professional not personal maybe get a chaperone if needed dealing with a discriminatory patient - ANSWER -assess illness acuity of patient cultivate a therapeutic alliance with help of supervisor supportive environment from healthcare team dealing with a patient with hearing loss or deaf - ANSWER -ask preferred method of communication use normal volume rate of talking allow lip reading utilize touchback method to determine if they heard/understood you dealing with nonadherant patient - ANSWER -assess factors that may cause nonadherance like socioeconomic factors, cognition, cultural beliefs give informative handouts, cues, emails simplify dosing schedules/disease monitoring Format of Health History - ANSWER -initial information chief complaint history of present illness past medical history family history personal and social history review of systems Comprehensive Health History- when to do - ANSWER -new patient establishment-first encounter Comprehensive Health History - ANSWER -includes all components of a health history and complete physical examination focused health history- when to use - ANSWER -returning patients for routine care patients with specific "urgent care" concerns key factors to adjusting scope of health history - ANSWER -magnitude and severity of pt problem need for thoroughness clinical setting time available which occurs most often comprehensive or focused assessment - ANSWER focused Is health history subjective or objective? - ANSWER -subjective subjective information during patient encounter - ANSWER -chief complaint health history review of systems Is physical exam subjective or objective? - ANSWER -objective objective information during patient encounter - ANSWER -physical exam lab information test data health history- initial information - ANSWER -age gender source of information health history- chief complaint - ANSWER -Tells you what is wrong with them Main reason they are there Should be in quotation marks because it is what the pt is telling you Ex: "chest pain" Health history-HPI - ANSWER -Hostory of present illness think OLDCARTS 7 attributes of a symptom - ANSWER -OLD CARTS OLDCARTS - ANSWER -Onset