NR 509 Midterm Study Guide
i i i i
Week 4: Preparing for the Midterm
i i i i i
Midterm iStudy iGuide
General iStudy iTips iand iRecommendations:
• Topics iand icontent ion iguides iare iintended ito ifocus istudent iattention
iwhenireading/studying.
• Multiple itest iitems iare iderived ifrom ithe isame itopic iareas ito
iencourageideeper icomprehension.
• Students imust ihave ia ibroad iunderstanding iof icontent iand inot
isimplyimemorize ipassages iin itextbooks ior iarticles.
• Information iin ired iletters iin ithe ichapters ias iwell ias itables iand
iappendicesiat ithe iend iof ithe ichapters imay iinclude itest iitems.
• All iexam iquestions iare iwritten iat ia ihigh ilevel iof icomprehension. iYou iare
iexpected ito ianalyze, isynthesis, iand ievaluate ipatient iscenarios iin iorder
itoianswer ithe iquestions.
• Read iall iof ithe ianswers iBEFORE ireading ithe istem iof ithe iquestion. iThis
iwillihelp iyou ifocus ion ithe ikey icontent iand inot iget idistracted iby iextraneous
iinformation.
• Be ifamiliar iwith i“Techniques iof iExamination” iand i“Recording
iYouriFindings” ifor iall ibody isystem ichapters iin ithe itextbook.
Chapter i1 iApproach ito ithe iClinical iEncounter iWeek i1
• The iInterviewing iProcess iCH i2
• The iapproach ito ia iclinical iencounter iis iboth iclinician-centered iand ipatient-
icentered.
• Patient-centered iapproach- irecognizes ithe iimportance iof ipatients iexpressions
iofitheir ipersonal iconcerns, ifeelings iand iemotions.
• Clinician-centered iapproach- iclinician itakes icharge iof ithe iinteraction ito imeet ihisior
iher iown ineeds.
• Disease- iExplanation iclinician iuses ito iorganize isymptoms ithat ilead ito
iaidiagnosis.
• Illness- iWays ithe ipatient iexplain ihow ithey iexperience ithe idisease, iincluding ihowiit
iaffects itheir irelationship, ifunction iand isense iof iwell-being.
• *Include iboth, iclinician’s iand ipatient’s iview iof ireality, idisease iand iillness!*
• Approach iand iStructure iof ithe iClinical iEncounter
• i
, • Stage i1: iRelationship ibuilding iwith ipatient.
• Rapport iwith iNewborns iand iinfants: iNewborn i(birth ito i30 idays) i/ iChildren
i(1imonth ito i1 iyear).
o Congratulate ifamily. iEncourage icaregivers ito ihold ibaby ias imuch
iasipossible.
• Rapport iwith iYoung iand ischool iaged ichildren: iYoung i(1 ito i4 iyears iold),
iSchooliaged i(5 ito i10 iyears).
o School iaged: iautonomy, isocialization iand icuriosity. iAsk ithem
iquestionsiduring ithe iinterview.
o Young: idistraction iand imood imanagement: itantrums iare icommon ihere.
• Adolescence: iTreat ilike ian iadult iand igive irespect iand ichoices. iDirect iquestionsito
ithem, ibut ialso ilisten ito itheir ifamily.
• Older iadults: iAllow itime ifor iopen iended iquestions.
• Patients iwith isensory idisabilities: iAlways iassume ithat ithe ipatient iwith
idisabilityican ihandle itheir iown imedical icare, iDo inot iassume. i**
• Lesbian, iGay iand itranssexual ipatients: iCreate ia iwelcoming inon-
judgmentalienvironment.
• Stage i2: iGathering iinformation
• Consists iof igathering iand iproviding iinformation. iStart iwith iopen-ended
iquestions ito iallow ifreedom. iWhat iare iyour ipresenting iproblems? i– iWhat
iareiyour ispecial iconcerns itoday?
• Respond ito iemotions iusing ithe iNURSE: iPg i14.
• Stage i3: iPerform ia iphysical iexam
• Stage i4: iExplaining iand iPlanning: iThe igoal iis ito iassess iand irespond ito
itheipatient’s ineeds ifor iinformation.
• Shared idecision imaking iis ithe ipinnacle iof ipatient-centered icare:
o Introducing ichoices
o Describing ioptions
o Using ipatient idecision isupport itools
o Exploring ipatient ipreferences
o Moving ito ia idecision
o Checking iif ithe ipatient iis iready ito imake ia idecision iand ioffering
imoreitime iif ineeded.
• Stage i5: iClosing ithe iencounter:
o i Take itime ifor iself-reflection. iBrings ipersonal iawareness.
• Disparities iin iHealth iCare
• Social ideterminants iif ihealth, iracism iand ibias, iand icultural ihumility.
• The iWorld iHealth iOrganization(WHO) idef iof iSocial ideterminants iof ihealth ias:
iConditions iin iwhich ipeople iare iborn, igrow, iwork, ilive, iand iage, iand ithe iwider
iset iof iforces iand isystems ishaping ithe iconditions iof idaily ilife. i(The i“forces
iandisystems” iare, ieconomic ipolicies, isystems, iagendas, isocial inorms, isocial
i i i i
Week 4: Preparing for the Midterm
i i i i i
Midterm iStudy iGuide
General iStudy iTips iand iRecommendations:
• Topics iand icontent ion iguides iare iintended ito ifocus istudent iattention
iwhenireading/studying.
• Multiple itest iitems iare iderived ifrom ithe isame itopic iareas ito
iencourageideeper icomprehension.
• Students imust ihave ia ibroad iunderstanding iof icontent iand inot
isimplyimemorize ipassages iin itextbooks ior iarticles.
• Information iin ired iletters iin ithe ichapters ias iwell ias itables iand
iappendicesiat ithe iend iof ithe ichapters imay iinclude itest iitems.
• All iexam iquestions iare iwritten iat ia ihigh ilevel iof icomprehension. iYou iare
iexpected ito ianalyze, isynthesis, iand ievaluate ipatient iscenarios iin iorder
itoianswer ithe iquestions.
• Read iall iof ithe ianswers iBEFORE ireading ithe istem iof ithe iquestion. iThis
iwillihelp iyou ifocus ion ithe ikey icontent iand inot iget idistracted iby iextraneous
iinformation.
• Be ifamiliar iwith i“Techniques iof iExamination” iand i“Recording
iYouriFindings” ifor iall ibody isystem ichapters iin ithe itextbook.
Chapter i1 iApproach ito ithe iClinical iEncounter iWeek i1
• The iInterviewing iProcess iCH i2
• The iapproach ito ia iclinical iencounter iis iboth iclinician-centered iand ipatient-
icentered.
• Patient-centered iapproach- irecognizes ithe iimportance iof ipatients iexpressions
iofitheir ipersonal iconcerns, ifeelings iand iemotions.
• Clinician-centered iapproach- iclinician itakes icharge iof ithe iinteraction ito imeet ihisior
iher iown ineeds.
• Disease- iExplanation iclinician iuses ito iorganize isymptoms ithat ilead ito
iaidiagnosis.
• Illness- iWays ithe ipatient iexplain ihow ithey iexperience ithe idisease, iincluding ihowiit
iaffects itheir irelationship, ifunction iand isense iof iwell-being.
• *Include iboth, iclinician’s iand ipatient’s iview iof ireality, idisease iand iillness!*
• Approach iand iStructure iof ithe iClinical iEncounter
• i
, • Stage i1: iRelationship ibuilding iwith ipatient.
• Rapport iwith iNewborns iand iinfants: iNewborn i(birth ito i30 idays) i/ iChildren
i(1imonth ito i1 iyear).
o Congratulate ifamily. iEncourage icaregivers ito ihold ibaby ias imuch
iasipossible.
• Rapport iwith iYoung iand ischool iaged ichildren: iYoung i(1 ito i4 iyears iold),
iSchooliaged i(5 ito i10 iyears).
o School iaged: iautonomy, isocialization iand icuriosity. iAsk ithem
iquestionsiduring ithe iinterview.
o Young: idistraction iand imood imanagement: itantrums iare icommon ihere.
• Adolescence: iTreat ilike ian iadult iand igive irespect iand ichoices. iDirect iquestionsito
ithem, ibut ialso ilisten ito itheir ifamily.
• Older iadults: iAllow itime ifor iopen iended iquestions.
• Patients iwith isensory idisabilities: iAlways iassume ithat ithe ipatient iwith
idisabilityican ihandle itheir iown imedical icare, iDo inot iassume. i**
• Lesbian, iGay iand itranssexual ipatients: iCreate ia iwelcoming inon-
judgmentalienvironment.
• Stage i2: iGathering iinformation
• Consists iof igathering iand iproviding iinformation. iStart iwith iopen-ended
iquestions ito iallow ifreedom. iWhat iare iyour ipresenting iproblems? i– iWhat
iareiyour ispecial iconcerns itoday?
• Respond ito iemotions iusing ithe iNURSE: iPg i14.
• Stage i3: iPerform ia iphysical iexam
• Stage i4: iExplaining iand iPlanning: iThe igoal iis ito iassess iand irespond ito
itheipatient’s ineeds ifor iinformation.
• Shared idecision imaking iis ithe ipinnacle iof ipatient-centered icare:
o Introducing ichoices
o Describing ioptions
o Using ipatient idecision isupport itools
o Exploring ipatient ipreferences
o Moving ito ia idecision
o Checking iif ithe ipatient iis iready ito imake ia idecision iand ioffering
imoreitime iif ineeded.
• Stage i5: iClosing ithe iencounter:
o i Take itime ifor iself-reflection. iBrings ipersonal iawareness.
• Disparities iin iHealth iCare
• Social ideterminants iif ihealth, iracism iand ibias, iand icultural ihumility.
• The iWorld iHealth iOrganization(WHO) idef iof iSocial ideterminants iof ihealth ias:
iConditions iin iwhich ipeople iare iborn, igrow, iwork, ilive, iand iage, iand ithe iwider
iset iof iforces iand isystems ishaping ithe iconditions iof idaily ilife. i(The i“forces
iandisystems” iare, ieconomic ipolicies, isystems, iagendas, isocial inorms, isocial
