Chapter 4

Question 1

A sender sends a message to a receiver

Answer 1

Essence of communication

Question 2

Means “spoken or written”

Answer 2

verbal communication

Question 3

Expressed through body language, facial expression, or other means. Expressed without words.

Answer 3

nonverbal communication

Question 4

Usually more formal than spoken communication. With increasing use of email, this may be as informal as oral communication.

Answer 4

Written communication

Question 5

Type of nonverbal communication. Includes tone of voice, voice pitch, voice volume and voice quality.

Answer 5

Secondary communication

Question 6

Distracting environment, noise, lack of privacy.

Answer 6

External factors

Question 7

Emotions, such as fear or anxiety, pain

Answer 7

Internal factors

Question 8

Most important form of listening. Being in the moment. The listener focuses attention on the speaker. The listener does not allow thoughts or emotions to interfere with communication. Paying close attention to what is being said without thinking about anything else.

Answer 8

Active listening

Question 9

What other measures are considered effective listening:

Answer 9

• check to make sure his or her interpretation of message is correct
• Identify what the speaker is feeling
• Observe the speaker closely
• Be patient and listen completely
• Avoid interrupting the speaker

Question 10

Facilitates effective communication

Answer 10

Assertive behavior

Question 11

Ignores opinions of others and impedes effective communication

Answer 11

Aggressive behavior

Question 12

Causes communication to be ineffective

Answer 12

Passive behavior

Question 13

Sign of interest and involvement . Some cultures feel it is not respectful to look directly at older people.

Answer 13

Eye Contact

Question 14

What is usually more accurate reflection of feelings than actual words?

Tough may communicate caring, but patients may find touch intrusive and there are cultural differences related to meaning of touch.
Medical assistants need to be sensitive if patients seem uncomfortable to touch.
If procedure requires touch or close contact what can help a patient prepare?

Answer 14

Body language.
- verbal indication

Question 15

Questions that can be answered yes/no or in a short answer.
Example: What is your date of birth? Have you taken any medication for your pain?
- Effective to ask for specific information

Answer 15

Closed Questions

Question 16

Questions that encourage the person being asked the question to open up and talk.
Example: What has been going on since your last visit?
Example: What is your pain like?
Questions that ask patient to describe things being discussed.
Useful for getting patient to describe a current problem.

Answer 16

Open Questions

Question 17

Restating what the patient has said in one’s own words

Answer 17

Paraphrasing

Question 18

Turning a question or statement around to give the patient an opportunity to continue

Answer 18

Reflecting

Question 19

Using a shorter statement to highlight what patient said previously

Answer 19

Summarizing

Question 20

Gives the patient time to respond and add to the information. Most people are uncomfortable with silence and will speak to fill the hole. Can be counterproductive if patient finds it awkward.

Answer 20

Silence

Question 21

Avoid the following responses:

Answer 21

• Avoid responses that express disapproval or blame
• Avoid challenging responses or responses that are not genuine
• If patient does not feel validated, may become defensive
• Important to accept strong emotions rather than offering false reassurance
• Avoid arguing, because it sets up a competitive situation

Question 22

What to do when people have impaired level of understanding:

Answer 22

• Use short sentences and simple words
• Speaking slowly is helpful; using a loud voice is not
• Good eye contact makes it easy for the listener to focus
• Repeating or saying again in a different way facilitates understanding
• Gestures and demonstration reinforce understanding
• Complete instructions should be given at the patient’s level of understanding
• Ask patient to repeat explanation to evaluate if it was understood
• The person who is legally responsible must give consent for all procedures

Question 23

Inability to perceive light and form

Answer 23

total blindness

Question 24

Failure to correct vision beyond 20/200 in better eye is called

Answer 24

legal blindness

Question 25

A patient is what if vision is better than 20/200 with decreased field of vision or low vision?

Answer 25

sight-impaired

Question 26

What to do with people who are sight impaired:

Answer 26

- be verry descriptive - The patient may prefer to take the MA's arm to move from one place to another - Use "clock image" to describe where things are; example: "The examination table is to your left at nine o-clock"

Question 27

What is more common than total deafness?

Answer 27

Hearing impairment

Question 28

What do to with people who are hearing impaired:

Answer 28

- Use a clear voice, a little louder than normal speech, and short sentences - Good eye contact is helpful to increase nonverbal communication or if the patient can lip read - May need to touch person gently to get his or her attention at beginning of conversation

Question 29

Things to do with deaf individuals:

Answer 29

- Sign language often used with hearing-impaired individuals - If patient uses sign language, he or she usually brings interpreter - If patient doesn’t have interpreter, the law requires medical office to provide a translator

Question 30

Who should be avoided as translators because they may skip words they don't know how to translate? Who may be embarrassed to discuss medical problems?

Answer 30

Children, Adults

Question 31

Guidelines for using a translator:

Answer 31

- speak directly to patient, not translator - speak slowly and carefully; patient may understand partially - use simple terms and short sentences to facilitate understanding

Question 32

Patient Expectations of Health Care:

Answer 32

- To be seen by doctor in reasonable amount of time - To have the doctor “fix” whatever is wrong - To avoid nagging about changing his or her lifestyle - Often focused more on relief of symptoms than diagnostic testing to determine cause - Want medication or treatment to promote a speedy recovery

Question 33

Arranged in order of importance

Answer 33

Hierarchy

Question 34

Shows most important needs at which level?

Answer 34

lowest level

Question 35

Bottom level: oxygen, food, water, excretion, shelter, sexual expression

Answer 35

physiological needs

Question 36

Level 2: physical safety, emotional security

Answer 36

safety and security

Question 37

Level 3: Example-- intervening for a victim of abuse fosters a sense of...

Answer 37

love and belonging

Question 38

Level 4: Example-- teaching a patient to manage a chronic disease fosters...

Answer 38

esteem and recognition

Question 39

Top level. Fulfillment of an individuals potential

Answer 39

self-actualization

Question 40

Trust versus mistrust

Answer 40

Infancy

Question 41

Autonomy versus shame/doubt

Answer 41

toddlerhood

Question 42

initiative versus inferiority

Answer 42

preschool age

Question 43

industry versus guilt

Answer 43

school age

Question 44

identity versus role confusion

Answer 44

Adolescence

Question 45

intimacy versus isolation

Answer 45

Young adult

Question 46

Generativity versus stagnation

Answer 46

Adulthood

Question 47

integrity versus despair

Answer 47

old age

Question 48

Ability to put oneself in another's position and imagine what one would feel. Objective.

Answer 48

Empathy

Question 49

Experiencing the same emotion as another

Answer 49

Sympathy

Question 50

Amount of guilt may or may not relate to a person's responsibility for the disease or condition Sometimes people with unhealthy lifestyles or habits don't seem to experience any guilt Sometimes people feel guilt when there is no known way to prevent their illness

Answer 50

Guilt

Question 51

Common in illness. Patient may become irritable, anxious, and defensive

Answer 51

Loss of control

Question 52

Response to a perceived threat. Can impair patient's ability to understand. Important to help the patient stay focused. Written instructions may be necessary for this type of patient.

Answer 52

Anxiety

Question 53

Symptoms of anxiety attack:

Answer 53

- Hyperventilation - Rapid heart rate - numbness in fingers and toes - intense fear or sense of dread

Question 54

Medical assistant response to anxiety attack:

Answer 54

- Encourage person to describe feelings - Coach person to take slow, deep breaths - Remain calm and stay with the person until symptoms subside, usually within 1-2 mins

Question 55

The cause may be subconscious. MA should try to help identify the source of anger. It may be necessary to move the patient to a more private area to defuse the anger.

Answer 55

anger

Question 56

State of shock and disbelief. Defense against unmanageable anxiety. MA should listen, without confronting unrealistic statements.

Answer 56

Denial

Question 57

"Why me" mode. Patient may be belligerent, uncooperative, and critical. Do not take criticism personally.

Answer 57

Anger

Question 58

Patient tries to give up something to gain more time. Usually between the patient and God.

Answer 58

Bargaining

Question 59

Patient recognizes facts May become silent and prefer to be alone May be more difficult to deal with Medical assistant should strive to maintain communication For patients in this stage, counseling and support groups may be appropriate referrals for both patients and family members.

Answer 59

Depression

Question 60

Some people find a degree of peace Seldom seen in medical offices, more often in hospitals or hospice care Make patients aware of community resources for grief Communicate needs of the patient and his or her family to the doctor

Answer 60

Acceptance