Physical Assessment - Chamberlain/GET IT
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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?
a. Providing serial reassurances such as, "Don't worry, you're
going to be fine."
,b. Asking a series of negative questions such as, "You don't
have any swelling in your feet, do you?"
c. Nonverbally cuing the patient to focus on his narrative
regarding a motor vehicle accident
d. (MVA) that led to back pain
e. Asking leading questions that focus on the presumed diag -
✔✔ANSWER ✔✔-f. Moving from open-ended to focused
questions
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?
a. Focusing on the need for immediate diagnostic certainty over
personal connection
,b. Taking charge of the interaction to meet the clinician's desire
to acquire diagnostic information
c. Following the patient's lead to understand their thoughts,
ideas, concerns, and requests
d. Deferring respect, empathy, - ✔✔ANSWER ✔✔-c. 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?
a. Ignoring visual cues to focus on the patient's exact words
b. Setting aside the patient's emotional state to focus on his
medical needs
, c. Paring down the patient's conce - ✔✔ANSWER ✔✔-d. 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?
a. Focus, intensity, function, and evaluation
b. Facts, intensity, focus, and evidence
c. Feelings, ideas, function, and expectations
d. Feelings, impression, fantasy, and em - ✔✔ANSWER ✔✔-c.
Feelings, ideas, function, and expectations