Par 2 - Dealing with Difficult Patients

Question 1

What is level 1 in trauma-informed care?

Answer 1

patient centered communication skills

Question 2

What is level 2 in trauma-informed care?

Answer 2

understanding the health effects of trauma

Question 3

What is level 3 in trauma-informed care?

Answer 3

collaboration & understanding of professional’s role

Question 4

What is level 4 in trauma-informed care?

Answer 4

understanding one’s own history of trauma

Question 5

What is level 5 in trauma-informed care?

Answer 5

screening

Question 6

What is the ALERT technique?

Answer 6

A – Acknowledge the existence of a difficulty
L – Listen first, as you begin the discussion
E – Establish the facts
R – Recap the facts – Reflect facts and feelings
T – Take Action

Question 7

What are the 5 skill sets of EQ?

Answer 7

Self - self awareness, self mgmt, motivation

Others - empathy-social awareness, relationship management

Question 8

What is NURS?

Answer 8

N - name the emotions
U - understand
R - respect
S - support

Question 9

T/F? TN ranks high in prescription drug abuse & accidental poisoning from prescription drugs.

Answer 9

TRUE.

Question 10

Prescribers are required to report undisclosed Dr.Shopping to the local law enforcement agency within ___ business days.

Answer 10

5

Question 11

A civil penalty of $__ per day on any dispenser who may

potentially dispense a controlled substance and who does not provide access to the TN controlled Substance Database.

Answer 11

100

Question 12

What is CSMD?

Answer 12

Controlled Substance Monitoring Database

TN practitioners required to check before:

• prescribing opioids, BZDs, other Schedule II-V drugs
• new course of tx lasting more than 7 days
• at least annually during an episode of tx unless it falls under an exception

Question 13

What are some examples of schedule II drugs?

Answer 13

codeine, vicodin, methadone, hydromorphone, meperidine, morphine, opium, oxycodone, fentanyl

Question 14

What are some examples of schedule III drugs?

Answer 14

combo drugs w/ <90mg of codeine (tylenol w/ codeine), ketamine, anabolic steroids, testosterone

Question 15

What are some examples of schedule IV drugs?

Answer 15

Xanax, Soma, Darvon, Darvocet, Valium, Ativan, Talwin, Ambien

Question 16

What are the signs & symptoms of narcotic use?

Answer 16

1. euphoria or lethargy, drowsiness
2. confusion, slurred speech
3. glazed eyes, pinpoint pupils
4. constipation, nausea, vomiting
5. dry mouth
6. itching
7. orthostatic hypotension

Question 17

Codeine w/ ibuprofen can lead to…?

Answer 17

kidney dmg

Question 18

acetaminophen & codeine can lead to…?

Answer 18

liver dmg

Question 19

aspirin & codeine can lead to…?

Answer 19

internal hemorrhaging

Question 20

9 potential SE’s of opioids?

Answer 20

1. Respiratory depression
2. Cognitive changes like confusion
3. Constipation
4. Sleepiness
5. Pruritus (itchiness)
6. Nausea
7. Overdose - slowed breathing,
   low heart beat, dizziness, seizures
8. Sexual Side Effects - lowers testosterone, Erectile dysfunction,
   orgasm problems for men and women

Question 21

What is the Mum Effect?

Answer 21

Withholding bad news

- dentists will put off delivering the bad news esp. when the pt is already dealing w/ “enough” bad news

Question 22

What is the SPIKES protocol?

Answer 22

S = Setting up the interview
P = Patient's perceptions
I = Invitation to ascertain how much pt wants to know
K = knowledge & info giving
E = Explore & empathize
S = Strategy & summary of key points

Question 23

What is the ABCDE Mnemonic?

Answer 23

A ‐ Advance preparation
B ‐ Build a therapeutic relationship
C ‐ Communicate well
D ‐ Deal with patient and family reactions 
E ‐ Encourage and validate emotions