NR 509 midterm Exam Latest 2023 with 100% Verified
Questions and Answers
is the clinical encounter clinician-centered to patient-centered - ANSWER both;
needs to be a balance of the clinician meeting their needs of the interaction and the
patient feeling heard and create personal dimension
patient-centered approach - ANSWER Interviewing technique empowering the
patient to provide a candid and complete medical history
recognizes importance of patient concerns, feelings and emotions and understands
the patients personal contact of the symptoms/disease
FIFE model - ANSWER mnemonic for patients perspective on the illness
Feelings (fears and concerns about the problem)
Ideas (about nature and cause of problem)
Functioning (effect of illness on function)
Expectations
general structure of patient encounter (5 steps) - ANSWER initiate the encounter
gather information
perform the physical examination
explaining and planning
closing the encounter
2 frameworks that continue throughout whole clinical encounter - ANSWER
relationship building
structuring the interview
what happens while initiating the encounter - ANSWER greet the patient and set
the stage/preparation
what does it mean to set the stage - ANSWER prepare for the interview
check your appearance
make sure patient is comfortable and environment is conducive to private info being
shared
what happens during the gathering information stage - ANSWER initiate
information gathering
history of present illness
past medical history
social history
,explore patients perspective of disease and relevant background information
what happens during explaining and planning - ANSWER provide correct amount
and type of information
negotiate plan of action
shared decision making
when asking patient about there pronouns it may be helpful to.... - ANSWER share
your own pronouns
"in an effort to promote an inclusive and respectful environment, we use pronouns
that are right for us. The pronouns I prefer are......how about you what pronouns do
you prefer?
the initial moments of your encounter lay the foundation for.... - ANSWER your
ongoing relationship
how to establish rapport - ANSWER introduce yourself, explain your role and how
you will be a part of their care
3 dimensions of cultural humility - ANSWER 1) Self-awareness
2) Respectful communication
3) Collaborative partnerships
active listening - ANSWER Closely listening to what the patient is communicating,
connecting on an emotional state to the patient.
use both verbal and nonverbal skills to encourage pt to expand on their
feelings/concerns
Empathetic responses - ANSWER capacity to identify with a patient and feel
patients pain as your own and respond in a supportive manner
"That must have been difficult for you."
"I understand, you're worried."
Non-verbal: offering a tissue to a crying patient; reaching out and gently touching a
patient's hand.
Therapeutic use of self: "I've had surgery before, so I can relate to what you're going
through."
guided questioning - ANSWER Helps to continue the patients story, shows
sustained interest and allows clinician to adapt questioning based on patient i.e.:
-moving from open ended to focused questions
-using questions that elicit a graded response
-asking a series of questions, ONE at a time
-clarifying what the patient means
-encouraging with continuers
-using echoing
, guided questioning aka - ANSWER adaptive questioning
nonverbal communication - ANSWER communication using body movements,
gestures, and facial expressions rather than speech
validation - ANSWER affirm validity of patients emotional experience
"Your accident must have been terrifying. Car accidents are always unsettling
because they remind us how vulnerable we are. Perhaps that explains why you still
feel upset,"
reassurance - ANSWER first step is to identify and acknowledge the patients
feelings
Helps pt feel that the problems have been fully understood and are being addressed
partnering - ANSWER express commitment to an ongoing relationship
summarization - ANSWER giving a summary of pts story to communicate that you
have been listening
transitions - ANSWER inform pt when you are changing directions to prepare them
for what comes next
"now id like to ask some more questions about your past health"
empowering the patient - ANSWER Empower pt to ask questions, express
concerns, and probe your recommendations
people first language - ANSWER seeing individuals as people first and not as
being defined by their disorder/illness
i.e.: person with diabetes not diabetic, person with substance abuse not drug user
informed consent required elements - ANSWER discuss nature of procedure or
treatment
risks and benefits of the procedure or treatment
reasonable alternatives
risks and benefits of alternatives
assessment of the patients understanding go the first four elements
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
Questions and Answers
is the clinical encounter clinician-centered to patient-centered - ANSWER both;
needs to be a balance of the clinician meeting their needs of the interaction and the
patient feeling heard and create personal dimension
patient-centered approach - ANSWER Interviewing technique empowering the
patient to provide a candid and complete medical history
recognizes importance of patient concerns, feelings and emotions and understands
the patients personal contact of the symptoms/disease
FIFE model - ANSWER mnemonic for patients perspective on the illness
Feelings (fears and concerns about the problem)
Ideas (about nature and cause of problem)
Functioning (effect of illness on function)
Expectations
general structure of patient encounter (5 steps) - ANSWER initiate the encounter
gather information
perform the physical examination
explaining and planning
closing the encounter
2 frameworks that continue throughout whole clinical encounter - ANSWER
relationship building
structuring the interview
what happens while initiating the encounter - ANSWER greet the patient and set
the stage/preparation
what does it mean to set the stage - ANSWER prepare for the interview
check your appearance
make sure patient is comfortable and environment is conducive to private info being
shared
what happens during the gathering information stage - ANSWER initiate
information gathering
history of present illness
past medical history
social history
,explore patients perspective of disease and relevant background information
what happens during explaining and planning - ANSWER provide correct amount
and type of information
negotiate plan of action
shared decision making
when asking patient about there pronouns it may be helpful to.... - ANSWER share
your own pronouns
"in an effort to promote an inclusive and respectful environment, we use pronouns
that are right for us. The pronouns I prefer are......how about you what pronouns do
you prefer?
the initial moments of your encounter lay the foundation for.... - ANSWER your
ongoing relationship
how to establish rapport - ANSWER introduce yourself, explain your role and how
you will be a part of their care
3 dimensions of cultural humility - ANSWER 1) Self-awareness
2) Respectful communication
3) Collaborative partnerships
active listening - ANSWER Closely listening to what the patient is communicating,
connecting on an emotional state to the patient.
use both verbal and nonverbal skills to encourage pt to expand on their
feelings/concerns
Empathetic responses - ANSWER capacity to identify with a patient and feel
patients pain as your own and respond in a supportive manner
"That must have been difficult for you."
"I understand, you're worried."
Non-verbal: offering a tissue to a crying patient; reaching out and gently touching a
patient's hand.
Therapeutic use of self: "I've had surgery before, so I can relate to what you're going
through."
guided questioning - ANSWER Helps to continue the patients story, shows
sustained interest and allows clinician to adapt questioning based on patient i.e.:
-moving from open ended to focused questions
-using questions that elicit a graded response
-asking a series of questions, ONE at a time
-clarifying what the patient means
-encouraging with continuers
-using echoing
, guided questioning aka - ANSWER adaptive questioning
nonverbal communication - ANSWER communication using body movements,
gestures, and facial expressions rather than speech
validation - ANSWER affirm validity of patients emotional experience
"Your accident must have been terrifying. Car accidents are always unsettling
because they remind us how vulnerable we are. Perhaps that explains why you still
feel upset,"
reassurance - ANSWER first step is to identify and acknowledge the patients
feelings
Helps pt feel that the problems have been fully understood and are being addressed
partnering - ANSWER express commitment to an ongoing relationship
summarization - ANSWER giving a summary of pts story to communicate that you
have been listening
transitions - ANSWER inform pt when you are changing directions to prepare them
for what comes next
"now id like to ask some more questions about your past health"
empowering the patient - ANSWER Empower pt to ask questions, express
concerns, and probe your recommendations
people first language - ANSWER seeing individuals as people first and not as
being defined by their disorder/illness
i.e.: person with diabetes not diabetic, person with substance abuse not drug user
informed consent required elements - ANSWER discuss nature of procedure or
treatment
risks and benefits of the procedure or treatment
reasonable alternatives
risks and benefits of alternatives
assessment of the patients understanding go the first four elements
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
