Medical Communication (Drexel)

Question 1

Module 1

It’s late on a Friday afternoon and you are tired….Which of the following questions represents mindfulness, and is most important to contemplate to make this encounter more successful, for you and for the patient?

(Mindfulness and Reflection)

Answer 1

How do I feel about the fact that he has rejected my efforts to help him with his real problem, the recent loss of his wife?

Question 2

Module 1

One of your colleagues made a serious mistake and administered the wrong antibiotic to a patient….Which of the following questions are most important to contemplate to make that encounter more successful, for yourself and for the patient’s family?

(Mindfulness and Reflection)

Answer 2

What are my beliefs about such mistakes?

Question 3

Module 1

You just saw a patient whom you have known for many years- one of the first in your practice….Which of the following considerations is most important to contemplate in order to optimize future encounters for yourself as well as for the patient?

(Mindfulness and Reflection)

Answer 3

I give bad news quite frequently, so what is it about this patient that makes me feel so discouraged?

Question 4

Module 1

Your first patient is new, and you are trying to establish a rapport with her…What could you contemplate during the clinical encounter to reduce your frustration and stay focused on the patient?

(Mindfulness and Reflection)

Answer 4

What successful strategies have I employed in the past to reduce stress?

Question 5

Module 1

Right now, you are way behind in your schedule…..What should you contemplate to reduce your frustration and get ready for seeing the patients and catching up with the other tasks?

(Mindfulness and Reflection)

Answer 5

I’m so mad. I should call my spouse, even if the patients have to wait a bit longer.

Question 6

Module 1

You are following up with Mrs. Gonzales, who has persistent headaches….What could you contemplate (in the spirit of mindfulness) to improve the situation for yourself and for Mrs. Gonzales?

(Mindfulness and Reflection)

Answer 6

Am I assuming something about this patient that might not be true?

Question 7

Module 1

For some years you’ve seen each in a couple for preventive care and minor health care problems…What could you contemplate that might help you balance your feelings towards the wife with upholding the ethical principles?

(Mindfulness and Reflection)

Answer 7

Do I experience a similar type of helplessness and frustration as she does?

Question 8

Module 1

You have good rapport with a 70-year-old woman with diabetes whom you’ve known for a long time….What can you contemplate to make sure that you are not overlooking the onset of dementia?

(Mindfulness and Reflection)

Answer 8

Does the patient remind me of my own parents and their struggle to lead an independent life?

Question 9

Module 1

Your new admission is a 90-year-old man in renal failure who has not much longer to live, and there is little you can offer medically at this point…What can you contemplate to maximize your future impact in this and similar situations, for your patients as well as for yourself?

(Mindfulness and Reflection)

Answer 9

What would I want and need from my physician if I were dying?

Question 10

Module 1

Your department chair asked you to take over the establishment of a new pain center, and this means that you will need to cut down on your patient load….What can you contemplate to prepare yourself for informing your patients about the upcoming transfers and changes?

(Mindfulness and Reflection)

Answer 10

What are my feelings about saying good-bye to these patients?

Question 11

Module 2

Your son’s 3-year-old friend falls and scrapes his knee while playing with his puppy at the park….In this scenario which of the following is the most important healing role you played?

(Therapeutic Aspects of Medical Encounters)

Answer 11

Physical presence in the midst of his distress

Question 12

Module 2

An unidentified homeless man is brought to the hospital by ambulance….Which of the following is the most important therapeutic role you played in the care of this patient?

(Therapeutic Aspects of Medical Encounters)

Answer 12

Supplying human contact in the midst of illness

Question 13

Module 2

A usually healthy 32-year-old physician comes to a walk-in clinic complaining of unilateral ear pain…As she is gathering up the children to leave you remark, “You really have a lot to manage!” Your comment best fits with which of the following therapeutic interventions?

(Therapeutic Aspects of Medical Encounters)

Answer 13

Acknowledgement of stress

Question 14

Module 2

Your patient, an intelligent and educated man, comes to clinic for ongoing treatment of his Graves disease…Which of the following statements would best encourage your patient to change his maladaptive behaviors?

(Therapeutic Aspects of Medical Encounters)

Answer 14

“Your lab tests are still abnormal, and you’ve told me that you have difficulty remembering to take your medication. What is it that makes it hard to take your medication?”

Question 15

Module 2

Mrs. B, a 45-year-old has managed her diabetes well for years…You say: “Kidney failure is one of the things that can happen after you’ve had diabetes for a long time…Your statement is one of the therapeutic interventions in the list below. Which one?

(Therapeutic Aspects of Medical Encounters)

Answer 15

Reassurance

Question 16

Module 2

Mrs. B, a 45-year-old has managed her diabetes well for years…You say: “Many patients worry that taking medications may not keep them from having kidney failure…Your statement is one of the therapeutic interventions in the list below. Which one?

(Therapeutic Aspects of Medical Encounters)

Answer 16

Legitimization

Question 17

Module 2

Mrs. B, a 45-year-old has managed her diabetes well for years…You say: “So, you have been feeling that you will end up on dialysis like your aunt.” Your statement is one of the therapeutic interventions in the list below. Which one?

(Therapeutic Aspects of Medical Encounters)

Answer 17

Reflective comment

Question 18

Module 2

Mrs. B, a 45-year-old has managed her diabetes well for years…You say: “I think that we can work together to get your sugars back where they should be and keep your kidneys healthy.” Your statement is one of the therapeutic interventions in the list below. Which one?

(Therapeutic Aspects of Medical Encounters)

Answer 18

Partnership

Question 19

Module 2

As a clinician you want to behave in a manner that will encourage your patients to trust you. Which of the following behaviors is most likely to encourage patient trust?

(Therapeutic Aspects of Medical Encounters)

Answer 19

Carefully listen to patient preferences

Question 20

Module 2

What percentage of adult primary care patients indicate that they felt some important psychological distress during the week prior to their medical visit?

(Therapeutic Aspects of Medical Encounters)

Answer 20

60%

Question 21

Module 3

Dr. Ibrahim, an internal medicine intern at a respected medicine program, is in the running for the “top intern” award…Which of the following would most clearly support that Dr. Ibrahim has imposter syndrome?

(Balance and Self Care)

Answer 21

He harbors an insecurity that his competence is false and will eventually be unmasked.

Question 22

Module 3

Dr. Mathews is a bright young surgeon….This mode of putting off important things is best characterized by which of the following statements?

(Balance and Self Care)

Answer 22

Putting important portions of one’s life aside is necessary at certain stages of a physician’s career.

Question 23

Module 3

Dr. Trang is a third-year resident in OB-GYN…Which of the following characteristics are most associated with the burnout syndrome?

(Balance and Self Care)

Answer 23

Compassion fatigue, feeling as if others are objects, and perceived clinical ineffectiveness.

Question 24

Module 3

Considering Dr. Trang’s situation in the previous question, which of the following work conditions are most likely to have contributed to Dr. Trang’s burnout?

(Balance and Self Care)

Answer 24

Always placing service to others first.

Question 25

Module 3

You are one of a group of students at your institution that has formed a task force to devise methods to improve and enhance the well-being of the second-year nursing students. Of the practices below, which is most likely to enhance student well-being?

(Balance and Self Care)

Answer 25

Initiate the production of a musical spoof of the curriculum.

Question 26

Module 3

You miss your son’s performance in his third-grade school play because you are working on a grant application…Which of the following concepts about self-awareness/self-care is best illustrated by the above statement?

(Balance and Self Care)

Answer 26

Postponement

Question 27

Module 3

As she enters the room where she will greet her next patient, Dr. Smith pauses for a moment….Which of the following concepts about self-awareness/ self-care is best illustrated by the above statement?

(Balance and Self Care)

Answer 27

Mindfulness

Question 28

Module 3

Everyone wants to work for Dr. W. He is remarkable in bringing out the best in people. Which of the following concepts about self-awareness/self-care is best illustrated by the above statement?

(Balance and Self Care)

Answer 28

Emotional intelligence

Question 29

Module 3

“The hospital administrator probably bribed the site visitors”…Which of the following concepts about self-awareness/self-care is best illustrated by the above statement?

(Balance and Self Care)

Answer 29

Cynicism

Question 30

Module 3

Dr. T regularly meets with a group of pediatric interns. Dr T encourages the interns to keep balance in their lives….Which of the following concepts about self-awareness/self-care is best illustrated by the above statement?

(Balance and Self Care)

Answer 30

Sustainability

Question 31

Module 4

Integrated patient-centered and doctor-centered interviewing:

(Intergrated Interviewing)

Answer 31

Provides more accurate medical diagnoses than isolated doctor-centered interviewing.

Question 32

Module 4

Which one of the following is not one of the 7 cardinal features of a symptom?

(Intergrated Interviewing)

Answer 32

Attribution

Question 33

Module 4

An empathic response to a patient distraught about a new diagnosis of breast cancer might be:

(Intergrated Interviewing)

Answer 33

I can understand; this news is devastating for you.

Question 34

Module 4

Which of the following statements about disease and illness is most accurate?

(Intergrated Interviewing)

Answer 34

Illness is a patient’s experience of disease.

Question 35

Module 4

Mr. Jones, age 50, comes to the office and says he is worried about his cough. You ask “Please tell me more about this?” Which of his statements about his situation is likely to emerge earlier than the others?

(Intergrated Interviewing)

Answer 35

I was treated with antibiotics last month for this cough and it didn’t help.

Question 36

Module 4

Mr. J has come to your office for a new patient visit. The process of patient-centered interviewing suggests that early in the interview, after introducing yourself and ensuring that he is comfortable, you should say:

(Intergrated Interviewing)

Answer 36

“Tell me what is on your mind today. … What else?”

Question 37

Module 4

Which of the statements below is most accurate about the process of patient-centered interviewing?

(Intergrated Interviewing)

Answer 37

It prompts patients to offer psychosocial details

Question 38

Module 4

A new patient in your office, Mr. Smith told you his concerns, and said that his biggest concern is a recent episode of chest pain; he appears quite anxious. Your next best step toward completing the history of present illness is to say

(Intergrated Interviewing)

Answer 38

“You look worried.”

Question 39

Module 5

For your patient who is concerned about chest pain, which informational statement will be included in the History of Present Illness (HPI)?

(Intergrated Interviewing)

Answer 39

This burning chest pain started after I had a bowl of chili.

Question 40

Module 5

Ken Fortek is a 40-year-old bookkeeper who complains of persistent headaches….Which of the following responses would best illustrate Attentiveness and Warmth?

(Building the Relationship)

Answer 40

State “I can see that you are still worried about the possibility of a brain tumor. Help me understand why that is the case.”

Question 41

Module 5

Peter Erman is 18, a high school student admitted to the hospital for internal injuries after driving a car into a tree….Which of the following responses would best convey Support?

(Building the Relationship)

Answer 41

State: “There are many situations that can result in someone driving while they are drunk. I would like to help you figure out what led to your accident so that you can avoid it in the future.”

Question 42

Module 5

Francine Bacon is a single mother of 3 school-aged children….Which of the following responses would best illustrate Partnership?

(Building the Relationship)

Answer 42

State “You are coping with a lot of challenges. Let’s see if we can devise a new plan that won’t add to your stress levels.”

Question 43

Module 5

Francesca Chen is 35, a hairdresser with diabetes….Which of the following statements would show that you understand and empathize with her likely emotional state?

(Building the Relationship)

Answer 43

State “As you speak, I get the sense that the many changes in your life are very stressful.”

Question 44

Module 5

Carlos Rodriguez is 60, owns a neighborhood grocery store, and is in the hospital with a heart attack….Which of the following responses would best convey Partnership?

(Building the Relationship)

Answer 44

State “Many people in your situation would feel hesitant to stay longer in the hospital. Let’s work together to make sure that you are stable enough to return home.”

Question 45

Module 5

Israel Wasserman, a 50-year-old teacher, was brought to the hospital after experiencing a seizure while shopping….Which of the following statements best conveys Respect?

(Building the Relationship)

Answer 45

State: “I admire your devotion to your work, and I’m sure your students appreciate all you do for them.”

Question 46

Module 5

James King, 70, is a patient of your colleague on vacation and a retired postal worker….Which of the following responses would best convey Attentiveness and Warmth?

(Building the Relationship)

Answer 46

State: “I can see that you are anxious about going into hospital without having your regular physician at your side. Please tell me more about your concerns.”

Question 47

Module 5

Juanita Perez, 21, is a single college student….Which of the following responses would best convey Support?

(Building the Relationship)

Answer 47

State: “I can see that being pregnant is very upsetting to you. How can I help you?”

Question 48

Module 5

This is your first encounter with Margot Gwen, a 20-year-old single college student with Crohn’s disease whose previous physician just moved out of town….Which of the following responses would best illustrate Empathy?

(Building the Relationship)

Answer 48

State: “You seem uncomfortable with our conversation, so far.”

Question 49

Module 5

Renata Bowen, an 80-year-old widow and retired antiques dealer was brought to the hospital for a hip fracture….After greeting her, what statement would best demonstrate respect, as you begin today’s conversation?

(Building the Relationship)

Answer 49

State: “I am so impressed with your ability to lead a remarkably independent life until now.”

Question 50

Module 6

Typically, clinicians begin interviews by inquiring about what concerns brought the patient into the office…The most likely result of this pattern of limiting the list of concerns in opening the dscussion is to

Answer 50

Increase the frequency of late-arising concerns

Question 51

Module 6

Your patient, a 54-year-old woman, returns to your office for a blood pressure follow-up…You can best facilitate addressing all of the important concerns for the visit today by which of the following:

Answer 51

Allow the patient to complete her statement about the recent painful episode, then ask “In addition to your back pain, is there anything else?”

Question 52

Module 6

Ms. S., a 23-year-old, returns to your office for an oral contraceptive follow-up visit…What is your best statement to Ms. S. to help you reach agreement on the agenda for the remainder of the visit?

Answer 52

“Let’s start with more discussion about your headache symptoms and an exam so we can decide what tests and referrals might be needed.”

Question 53

Module 6

“I know that you are concerned about losing weight. I’d like to be sure I know the other things that are on your mind.” Which of the following communication skills used in opening the discussion best describes the physician’s statement?

Answer 53

Survey symptoms

Question 54

Module 6

“You mentioned that your wife is having health problems. Let’s get back to how that is affecting you.” Which of the following communication skills used in opening the discussion best describes the physician’s statement?

Answer 54

Redirect patient

Question 55

Module 6

“Headache, backache, difficulty sleeping, tiredness.” Which of the following communication skills used in opening the discussion best describes the physician’s statement?

Answer 55

List concerns

Question 56

Module 6

“Let’s see if I have this right: you’d like to talk about your blood pressure, your biggest worry is side effects of the medicine, and you’d like to talk about alternatives.” Which of the following communication skills used in opening the discussion best describes the physician’s statement?

Answer 56

Summarize

Question 57

Module 6

“Tell me what is on your mind today.” Which of the following communication skills used in opening the discussion best describes the physician’s statement?

Answer 57

Open-ended inquiry