Advanced Physical Assessment NR-509 Bates Interactive Question Bank Chapters 1-17

Chapter 2: Interviewing, Communication, and Interpersonal Skills 1. 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? a. Perform a pelvic examination. b. Obtain a urine sample for testing. c. Obtain a more complete description of problems. d. Obtain blood for testing. e. Ask about recent travel destinations. 2. 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? a. Structured and clinician-centered with open-ended questions b. Validating and empathetic with open-ended questions c. Dismissive and concrete with open-ended questions d. Affirming and reassuring with close-ended questions e. Factual and structured with active listening 3. 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? a. Assuming that the event caused her to become depressed and expressing the same feeling on behalf of the patient b. Recognizing the patient9s emotions by asking or confirming how she feels about the event c. By allowing the crying patient to look around the room for tissues to permit her an excuse to hide her face and defer her emotions d. Presuming that the patient9s emotions meet social expectations, such as being depressed and even traumatized by her spouse9s death e. Narrowing the understanding of the patient9s emotional response to only thoughts and feelings that have been verbalized 4. 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, Don9t worry, you9re going to be fine.= b. Asking a series of negative questions such as, You don9t 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 diagnosis of chest pain f. Moving from open-ended to focused