Challenge Questions Flashcards
A patient who needs emergent surgery says, “I can’t afford the cost of staying in the hospital. I have no insurance. Just give me something to relieve the pain and I will leave.”
“I know that you are concerned about medical costs, but your life will be in danger if you don’t have surgery. Let our social workers help you with the cost issues.”
“Should I tell my sexual partner about my venereal disease?”
“Yes. There is a chance that you have already transmitted the disease to your partner, or he or she may be the source of your infection. The most important step is to have both of you evaluated and appropriately treated.”
An anxious patient who you suspect has been abused asks, “Why are you asking me all these questions?”
“I am primarily concerned about your safety, and my goal is to make sure that you are in a safe environment and that you are not a victim of abuse.”
A patient recently diagnosed with HIV asks, “Do I have to tell my wife?”
“I know that it’s difficult, but doing so will allow you and your wife to take the appropriate precautions to treat and prevent the transmission of the disease.”
A doorway information sheet indicates that the patient is Mr. Smith and that he presents with dizziness, but when you enter the room you, you find a female patient.
Begin by saying, “Excuse me, Mrs. Smith?” When the patient responds, “No, I am Mrs. Black,” you can say “Oh, I think the nurse must have given me the wrong chart, Hello Mrs. Black. What is your problem?” You can then go on to discuss the patient’s presenting complaint, but remember that the vital signs listed on the doorway information sheet are those of a different patient, so you will need to take the patient’s vitals during the physical exam.
A female patient attempts to seduce her male physician by saying, “Doctor, do you have time to have dinner with me at my place?”
“I am sorry, but that would be inappropriate, since you are my patient, and it would not be permissible in the context of a doctor-patient relationship.”
An elderly male patient says, “ I think that it is normal at my age to have this problem” (impotence) or “I am just getting old.”
“Not necessarily. Age may play a role in the change you are experiencing in your sexual function, but your problem may have other causes that we should rule out, such as certain diseases (hypertension, diabetes) or medications. We also have medications that may improve your sexual function.”
“I read in a journal that the treatment for this disease is herbal compounds.”
“Herbal medicines have been suggested for many diseases. However, their safety and efficacy may not always be clear-cut. Let me know the name of the herbal medicine and I will check into its potential treatment role for this disease.”
“I am afraid of surgery.”
“I understand your feelings. It is normal and very common to have these feelings before surgery. Is there anything specific that you are concerned about?”
A patient who has a serious problem (unstable angina, colon cancer) asks, “If I want to go on a trip with my wife. Can we do the tests after I come back?”
“I know that you don’t want to put off your trip, but you may have a serious problem that may benefit from early diagnosis and management. Also, it is possible that you could suffer complications from this problem while you are on vacation if we do not effectively deal with it before you leave.”
“I did not understand your question, doctor. Could you repeat it, please?”
Repeat the question slowly. If the patient stil doesn’t comprehend the question, ask if there is any specific word he failed to understand, and try to explain it or use a simpler one.
“What is a bronchoscopy?” (MRI, CT, x-ray, colonoscopy)
Explain the meaning of the term using simple words. For example, “Bronchoscopy is using a thin tube connected to a camera to look into your respiratory airways and parts of your lungs,” or “An MRI is a machine that uses a large magnet to obtain detailed pictures of your brain or body.”
“What do you mean by ‘workup’?”
“It means all the tests that we are going to do to help us make the final diagnosis.”
A patient who is late in seeking medical advice asks, “Do you think it is too late for recovery?”
“It is never too late to seek help, and I am glad you made the decision to pursue treatment options with me. We will do our best to help you, but next time I want you to feel comfortable coming to me as soon as you feel you might have a problem.”
A patient with pleuritic chest pain asks, “Is this a heart attack? Am I going to die?”
“On the basis of your history an my clinical exam and findings, my suspicion for a heart attack is low. It is more likely that inflammation of the membranes surrounding your lungs is causing your pain, and this is usually not a life-threatening condition. However, we still need to do some tests to confirm the diagnosis and rule out heart problems.”
