Part II Ch 4-8

Question 1

Communicating with someone in a way that doesn’t disparage or put down the other person or their actions, whether or not you disagree

Answer 1

tactfulness and diplomacy

Question 2

Showing consideration for other people’s feelings and needs

Answer 2

courtesy

Question 3

To be completely yourself when dealing with others in all of your words and actions

Answer 3

genuineness

Question 4

When you are genuine in human interactions, you do not just go through the motions, but you ____ fully

Answer 4

engage

Question 5

To open up, or show something about one’s self

Answer 5

appropriate self-disclosure

Question 6

Self-disclosure is best used when it does these 2 things

Answer 6

1. shows another person that you have had experiences similar to theirs
2. it has significance because it allows you to show empathy for what that other person is feeling as a result of their experience

Question 7

What 4 things you should avoid re: self disclosure?

Answer 7

1. telling a story about yourself simply for the sake of telling a story about yourself
2. telling a story that is not about you but about the problems of someone else the patient doesn’t know
3. one-upping the patient by trying to outdo their story
4. removing the focus in any way from the patient

Question 8

To be able to stand up for what you believe is right without any undue anxiety about what others may think of you

Answer 8

assertiveness

Question 9

_____ communication uses clear and direct language while remaining relaxed and respectful

Answer 9

assertive

Question 10

_____ communication uses confrontational and even sarcastic language, while maintaining a tense and often superior attitude

Answer 10

aggressive

Question 11

Communication that advances the patient’s well-being and care

Answer 11

therapeutic communication

Question 12

HCPs should avoid giving easy reassurance because the patient has the right to feel any way they may feel and such reassurance ____ the patient’s feelings

Answer 12

diminishes

Question 13

HCPS should avoid giving easy reassurance because it may give ____ in the face of a negative outcome

Answer 13

false hope

Question 14

Approving or disapproving of the patient can falsely give the patient the impression that a _____ exists between them and their HCP

Answer 14

power relationship

Question 15

Agreeing/disagreeing with a patient is an ineffective communication behavior because it turns the discussion of the patient’s health into a matter of the patient’s being ____

Answer 15

right or wrong

Question 16

Prying is distinct from encouraging discussion; HCP with effective communication skills will understand how to strike the balance between ____ and ____

Answer 16

pushing too hard and helping a patient open up

Question 17

Defensive HCPs inappropriately changes the terms of the relationship from patient/provider to _____

Answer 17

attacker/defender

Question 18

T or F. Patients may not understand why they have acted a certain way; to ask them for their reasons can inhibit, confuse, or even anger them

Answer 18

T

Question 19

Cliches can cause the patient to feel that the HCP is giving a _____ response

Answer 19

mechanical, thoughtless

Question 20

Ineffective coping behavior: overemphasize a certain trait or behavior in one area because they believe they must make up for what they perceive as a deficiency, or failure, in another

Answer 20

compensation

Question 21

Ineffective coping behavior: patient attempts (unconsciously) to reject or deny the existence of feelings, needs, thoughts, desires, or even facts

Answer 21

denial

Question 22

Ineffective coping behavior: when it is impossible for the patient to accept ownership of certain thoughts, feelings, needs, desires; attributes them to a more acceptable substitute–someone or something outside of themselves

Answer 22

displacement

Question 23

Ineffective coping behavior: patient attempts to disconnect the emotional significance of certain ideas or events from those ideas or events

Answer 23

dissociation

Question 24

Ineffective coping behavior: patient mimics the behavior of someone else in order to conceal their own natural behavior

Answer 24

identification

Question 25

Ineffective coping behavior: patient projects onto another person or object their own feelings, as if the feelings originated in the other person or object

Answer 25

projection

Question 26

Ineffective coping behavior: using false reasoning to justify inappropriate or unacceptable behavior, hoping to make the behavior tolerable

Answer 26

rationalization

Question 27

Ineffective coping behavior: unconsciously returning to immature, or even infantile, behaviors or thoughts

Answer 27

regression

Question 28

Ineffective coping behavior: patient simply puts out of their mind painful or difficult thoughts, feelings, ideas or events

Answer 28

repression

Question 29

Syndrome where a patient may feel anxiety just because they are present in a medical practice

Answer 29

white coat syndrome

Question 30

T or F. If conflict with a coworker is serious (sexual harassment, quality of patient care concerns), you should speak with the other party first before involving a supervisor

Answer 30

F; involve a supervisor immediately

Question 31

Initially enacted to protect workers in the US from being denied health insurance coverage when changing jobs

Answer 31

HIPAA: Health Insurance Portability and Accountability Act

Question 32

Workers could change jobs with the confidence that their health insurance would not have to be interrupted between jobs or at the start of a new job

Answer 32

portability

Question 33

Rule that protects patients’ rights by ensuring the privacy of patients’ health information

Answer 33

HIPAA privacy rule

Question 34

Your healthcare organization must have policies and procedures that comply with either the state or federal law, whichever is ____

Answer 34

stricter

Question 35

States policies and procedures by which patient health information may be disclosed

Answer 35

Notice of Privacy Practices (NPP)

Question 36

Health orgs must have patients sign this document

Answer 36

Acknowledgement of Receipt of Privacy Practices

Question 37

The use and disclosure of health information are permitted only for TPO; expand

Answer 37

treatment, payment, healthcare operations

Question 38

TPO: includes activities like accreditation, employee training, and quality control

Answer 38

operations

Question 39

4 exceptions to TPO

Answer 39

1. court orders
2. workers’ compensation cases
3. statutory reports
4. research

Question 40

Used to properly diagnose the patient’s condition and develop the appropriate treatment plan; done by obtaining a thorough and accurate medical history

Answer 40

patient interview

Question 41

3 functions of the medical interview

Answer 41

1. information gathering
2. relationship building
3. patient education

Question 42

2 common approaches to the patient interview

Answer 42

1. primary care provider-only approach

2. team approach

Question 43

Approach where the patient relates their medical history only once

Answer 43

primary care provider-only approach

Question 44

Approach where the patient is interviewed more than once

Answer 44

team approach

Question 45

____ approach is time consuming but may result in a more thorough and complete medical record

Answer 45

team

Question 46

Primary interviewees are usually the patients themselves but may also be ____

Answer 46

family members, spouses, etc

Question 47

___ questions quickly provide a great deal of objective information about the patient

Answer 47

closed questions

Question 48

____ questions establish therapeutic communication and relationship between patient and HCP

Answer 48

open

Question 49

Avoid using questions that begin with ____

Answer 49

why

Question 50

Avoid ____ questions which are likely to prompt or encourage the patient to provide what they perceive is the desired answer

Answer 50

leading

Question 51

Statements that involves obtaining information from the patient without the patient feeling questioned; often starts with “tell me about…”

Answer 51

indirect statements

Question 52

Interview where the HCP controls the dialog; may interrupt the patient and may prevent the patient from continuing to express all of their concerns

Answer 52

HCP-centered interview

Question 53

Interview where HCP uses “continuers” expressions that encourage the patient to reveal all of their concerns at the beginning of the interview

Answer 53

patient-centered interview

Question 54

3 elements of the patient-centered interview

Answer 54

1. open-ended questions
2. indirect statements
3. specific closed questions

Question 55

The American Academy on Physician and Patient suggests “PEARLS” during a patient-centered interview; expand

Answer 55

Partnership
Empathy
Apology
Respect
Legitimization
Support

Question 56

PEARLS: conveys that the HCP and the patient are in this together

Answer 56

partnership

Question 57

PEARLS: expresses understanding and concern for the patient

Answer 57

empathy

Question 58

PEARLS: acknowledges that the HCP is sorry that the patient had to wait, that the procedure was painful, that the lab tests will take several days to process, and so on

Answer 58

apology

Question 59

PEARLS: acknowledges the patient’s suffering, anxiety, fear, etc

Answer 59

respect

Question 60

PEARLS: acknowledges that the patient may be angry, frustrated, depressed, etc

Answer 60

legitimization

Question 61

PEARLS: conveys that the HCP will be there for the patient and not abandon them

Answer 61

support

Question 62

The interviewer should sit approximately ____ from the patient and maintain a relaxed but attentive posture

Answer 62

an arm’s length

Question 63

____ questions help to eliminate ambiguous responses or confusion on the part of the patient

Answer 63

direct

Question 64

Another important aspect of listening is being aware of what the patient has ____ of their verbal response

Answer 64

left out

Question 65

HCPs should ____ the implied; derive a conclusion about what the patient really means

Answer 65

verbalize

Question 66

Primary goal of an interview is to identify the patient’s ____

Answer 66

chief complaint

Question 67

Interviews should focus on, or ____, specific symptoms or important medical information that will facilitate reaching an accurate diagnosis

Answer 67

pinpoint

Question 68

Many children are able to contribute substantially to the patient interview by the age of __ or __ years but must be verified by a guardian

Answer 68

5 or 6 years

Question 69

When interviewing adolescents, avoid ___ that would tend to elicit brief responses or silence

Answer 69

closed

Question 70

Discussing a patient with an unauthorized individual is a violation of the patient’s privacy and can turn into an ___ and ___ issue

Answer 70

ethical; legal

Question 71

The degree to which individuals have the capacity to obtain, process, and understand basic health info and services needed to make appropriate health decisions

Answer 71

health literacy

Question 72

Health literacy requires basic ____ skills and knowledge of ___ issues

Answer 72

literacy; health and medical issues

Question 73

Only __% of adults have proficient health literacy

Answer 73

12%

Question 74

Populations that frequently experience low health literacy

Answer 74

1. older people
2. racial and ethnic minorities
3. people without a high school diploma
4. people with low incomes
5. non-native speakers of English
6. people with chronic disease

Question 75

4 elements of plain language

Answer 75

1. organized info so that the most important points are delivered first
2. info broken down into understandable chunks
3. language that is simple with clearly defined medical terminology
4. use of the active voice

Question 76

Language barriers can cause an increased use of ____ tests and increased rates of _____

Answer 76

diagnostic; hospitalizations

Question 77

3 disadvantages in using family members as medical interpreters

Answer 77

1. unfamiliar with complex medical information
2. more likely to incorrectly translate words and phrases
3. loss of patient confidentiality

Question 78

Employ _____, that is, ask the patient to repeat important instructions or information in their own words

Answer 78

teach back

Question 79

Tell a visually impaired patient that you will be ____ them before you do so; never surprise them with needles, cold stethoscopes or other medical objects and devices

Answer 79

touching

Question 80

When providing instructions, be descriptive when conveying info that would be _____ to patients with normal vision

Answer 80

visually obvious

Question 81

T or F. Do not attempt to guide a visually impaired patient without asking

Answer 81

T

Question 82

When dealing with visually impaired patients, walk with the patient ____ you and the service dog

Answer 82

between

Question 83

Lower case “deaf” is used when referring to the ____ while uppercase “Deaf” is used when referring to a ____

Answer 83

audiologic condition; particular group of individuals who share a language

Question 84

Patients who were born ____ deaf are likely to communicate using ASL; not based on English and uses a different sentence structure and grammar

Answer 84

bilaterally

Question 85

T or F. If a deaf patient doesn’t understand, never say “it’s not important” as this is dismissive and disrespectful to the patient

Answer 85

T

Question 86

T or F. Focus on deal patients as opposed to friends or family members; they have lost their ability to hear, not their individuality, dignity or intellectual competence

Answer 86

T

Question 87

2 types of confusion

Answer 87

1. delirium or acute confusion

2. dementia or chronic confusion

Question 88

Many patients with dementia experience heightened confusion later in the day, also called ____

Answer 88

sundowning

Question 89

3 objectives of patient education

Answer 89

1. changing health outcomes
2. improving health status
3. improving patient compliance

Question 90

T or F. Patient education involves more than the transfer of information

Answer 90

T

Question 91

Estimates of patient noncompliance range from ___% to ___%

Answer 91

50 to 90%

Question 92

3 steps in the approach to patient education

Answer 92

1. assessment of the patient
2. design of the instruction
3. selection of teaching strategies and resources

Question 93

To determine the type of instruction needed for a particular patient, 4 categories of variables must be assesses

Answer 93

1. contexts for the education
2. patient demographics
3. patient learning styles
4. information and content to be included in the teaching session

Question 94

Refers to the medical condition that creates the need for the instruction

Answer 94

situational context

Question 95

Refers to the environment in which the instruction will take place

Answer 95

instructional context

Question 96

Certain characteristics of the patient that may influence their response to the instruction

Answer 96

patient demographics

Question 97

3 types of learners

Answer 97

1. visual
2. auditory
3. kinesthetic

Question 98

Learners respond well to pictures, diagrams, anatomic models, and literature

Answer 98

visual learners

Question 99

Learners prefer to be engaged verbally with the use of questions and answers or discussion

Answer 99

auditory learners

Question 100

Learners learn by physical demonstration of a task or technique by the HCP followed by the practice of the technique by the patient

Answer 100

kinesthetic learners

Question 101

Final component of the assessment phase; determines what info should be included in the teaching session for the particular patient

Answer 101

content analysis

Question 102

Content analysis focuses on what info is ___ rather than redundant, irrelevant, or simply interesting

Answer 102

essential

Question 103

HCP must distinguish between ____ and ____ information

Answer 103

need-to-know; nice-to-know

Question 104

In designing instruction, HCP should begin by establishing _____

Answer 104

behavioral objectives

Question 105

Behavioral objectives are ____ and ____ behaviors that result from the instruction

Answer 105

specific; measurable

Question 106

Final step in the development of instruction

Answer 106

selection of which strategies and resources to use with a particular patient

Question 107

American Academy on Physician and Patient suggests an ____ framework to determine what a patient already knows and what they think about the issue

Answer 107

ask-tell-ask

Question 108

In instructing patients, add ___ behaviors instead of eliminating ___ behaviors

Answer 108

new; old

Question 109

Kinesthetic instruction is beneficial in these 3 instances

Answer 109

1. use of inhalers
2. use of walkers
3. use of glucomenters

Question 110

HCP comes from an understanding of ____ the illness from which the patient suffers, and the patient comes from an experience of the ____ of the illness

Answer 110

what causes; symptoms of the illness

Question 111

HCP needs to develop an understanding of the complex diversity that will characterize society as well as a strong cultural sensitivity, also called

Answer 111

cultural competence

Question 112

The knowledge and interpersonal skills that allow providers to understand, appreciate, and work with individuals from cultures other than their own; involves an awareness and acceptance of cultural differences; self awareness; knowledge of the patient’s culture; and adaptation of skills

Answer 112

cultural competence

Question 113

Model that defines cultural competence as the process in which HCP strives to achieve the ability and availability to effectively work within the cultural context of the client; process of becoming culturally competent, not being culturally competent

Answer 113

the volcano model

Question 114

5 steps in the volcano model process

Answer 114

1. cultural awareness
2. cultural knowledge
3. cultural skill
4. cultural encounter
5. cultural desire

Question 115

Volcano model step: looking closely and honestly at your own biases toward other cultures; includes an awareness that racism and other forms of discrimination exist in healthcare delivery

Answer 115

cultural awareness

Question 116

Volcano model step: seeking thorough understanding of attitudes and beliefs of other cultural ethnic groups; as well as health conditions and diseases that exist among them

Answer 116

cultural knowledge

Question 117

Volcano model step: accurate understanding the cultural details surrounding the patient’s presenting problem; physically assessing the patient within the context of their culture

Answer 117

cultural skill

Question 118

Volcano model step: actively seeking face-to-face encounters with members of other cultures in order to better understand the HCP’s own beliefs about their cultures; prevents stereotyping

Answer 118

cultural encounter

Question 119

Volcano model step: desire of the HCP to become more culturally knowledgeable and skillful; genuine want instead of merely a need to fulfill a job requirement

Answer 119

cultural desire

Question 120

Model describing a range of six points on a scale of cultural competence

Answer 120

The Cultural Competence Continuum

Question 121

6 points in the cultural competence continuum

Answer 121

1. cultural destructiveness
2. cultural incapacity
3. cultural blindness
4. cultural precompetence
5. cultural competence
6. cultural proficiency

Question 122

The Cultural Competence Continuum point: attitudes, policies, structures, and practices by a system or organization that are destructive to members of a cultural group; openly hostile/racist behavior

Answer 122

cultural destructiveness

Question 123

The Cultural Competence Continuum point: inability of an individual or institution to respond effectively to the needs and interests of culturally and linguistically diverse groups; afraid to hire POC because of white customers

Answer 123

cultural incapacity

Question 124

The Cultural Competence Continuum point: viewing and treating all people from different cultures as if they were the same

Answer 124

cultural blindness

Question 125

The Cultural Competence Continuum point: level of awareness by people or institutions of their capacity for growth in responding effectively to culturally and linguistically diverse groups; recognizing the need to cultural train employees

Answer 125

cultural precompetence

Question 126

The Cultural Competence Continuum point: demonstrates an acceptance and respect for cultural differences

Answer 126

cultural competence

Question 127

The Cultural Competence Continuum point: high regard for diverse culture and use this ethical stance as a foundation to guide their endeavors

Answer 127

cultural proficiency

Question 128

6 universal facial expressions

Answer 128

1. happiness
2. sadness
3. fear
4. anger
5. disgust
6. surprise

Question 129

14 standards are organized by these 3 themes

Answer 129

1. culturally competent care
2. language access services
3. organizational supports for cultural competence

Question 130

3 categories with varying levels of stringency within the CLAS framework

Answer 130

1. mandates
2. guidelines
3. recommendations

Question 131

CLAS: current federal requirements for all recipients of federal funds

Answer 131

mandates

Question 132

CLAS: activities recommended for adoption

Answer 132

guidelines

Question 133

CLAS: suggested for voluntary adoption

Answer 133

recommendations

Question 134

T or F. Do unto others doesn’t necessarily hold in cross cultural communication

Answer 134

T

Question 135

When communicating with limited-english speakers, speak ___ not ____

Answer 135

slowly; loudly

Question 136

T or F. When an interpreter is present, look at the patient, not the interpreter

Answer 136

T