Question 1
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?
a. Adjust lighting so it is tangential to the patient's body.
b. Explain how the examination will proceed.
c. Ask the patient where he comes from.
d. Explain that she is a PA student.
e. Provide ongoing interpretation of findings.
Answer: b. Explain how the examination will proceed.
Rationale:
Explaining the process reduces anxiety, promotes professionalism, and builds trust.
,Question 2
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, humility, and sensitivity in favor of the acquisition of concrete
details about the patient's condition
e. Taking a symptom-focused approach to reduce the involvement of the patient's emotional
difficulties
,Answer: c. Following the patient's lead to understand their thoughts, ideas, concerns, and
requests
Rationale:
Patient-centered care improves compliance and trust.
Question 3
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 concerns to concrete medical needs
d. Using nonverbal communication to encourage the patient to expand their narrative
e. Considering a differential diagnosis while the patient is speaking to maximize the patient's
time with the provider
Answer: d. Using nonverbal communication to encourage the patient to expand their
narrative
Rationale:
Nonverbal cues encourage communication and trust.
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?
a. Adjust lighting so it is tangential to the patient's body.
b. Explain how the examination will proceed.
c. Ask the patient where he comes from.
d. Explain that she is a PA student.
e. Provide ongoing interpretation of findings.
Answer: b. Explain how the examination will proceed.
Rationale:
Explaining the process reduces anxiety, promotes professionalism, and builds trust.
,Question 2
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, humility, and sensitivity in favor of the acquisition of concrete
details about the patient's condition
e. Taking a symptom-focused approach to reduce the involvement of the patient's emotional
difficulties
,Answer: c. Following the patient's lead to understand their thoughts, ideas, concerns, and
requests
Rationale:
Patient-centered care improves compliance and trust.
Question 3
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 concerns to concrete medical needs
d. Using nonverbal communication to encourage the patient to expand their narrative
e. Considering a differential diagnosis while the patient is speaking to maximize the patient's
time with the provider
Answer: d. Using nonverbal communication to encourage the patient to expand their
narrative
Rationale:
Nonverbal cues encourage communication and trust.
