senario questions Flashcards
A 70-year-old Mandarin-speaking man comes to your office for treatment of his prostate cancer. He does not speak English and his family informs you that he has not been told of his diagnosis. They ask that you provide him treatment but keep from telling him of his true diagnosis. What do you do?
First I would ask for an online translator, next I would describe to him any type of symptoms that he was having loss of appetite etc. Next, I would ask him has he taken anything for his symptoms and does he has any history of cancer in his family. And move forward with his treatment plan by asking him his thoughts on chemo therapy or radiation therapy and move forward from there. Explain to him what is going on with his body if his is experiencing any abnormal symptoms. Most people are open to a diagnosis if we talk about different options for treatment plans first along with positive results that are seen from these treatment plans.It is my ethically obligation as an provider to inform the patient of their symptoms. unless in the exceptional case of patient waiver violates the ethical principles of patient autonomy and beneficence.
How would you consult with a family who has a son that needs a leg amputated?
An amputation can be stressful for the entire family. Those stressors can include fears about your child’s future and insecurity about making the right decisions.I would approach the situation with pure understanding because I understand the stress that they have dealt with especially in regards to their son, but I could never understand the magnitude that they are going through. Informing the parents that we have the best surgeons,physicalandoccupational therapists,and other care providers understand the concerns of your sons in navigating this journey.
- Connecting the family to an local support groupto find other families living with limb loss. Finding participate in meaningful life activities for the family and their son to be involved in , the main goal is to reestablish a sense of normality and self-worth.
Say you needed treatment and you received treatment X. You go through school and you learn that treatment X isn’t the best treatment anymore. Now you are a doctor and a patient comes in and insists that they receive treatment X. What will you do
- Ive always believed in evidence- based medicine and i alway have to present the data first To convince a physician to consider alternative treatment options, you need topresent credible and relevant evidence that supports your case. This means doing your research and finding reliable sources of information, such as peer-reviewed studies, clinical guidelines, or expert opinions, and talk to the patient an doctor how the current treatment will not benefit them currently and they need a new treatment
“If a patient was brain dead and on life support, how would you make the decision on whether to discontinue life support?”
-Talk about shadowing a PA who was within they palliative care role, everything is left up to an living will, as well as the patients family who is the main decision make which is known as an this person is called a healthcare proxy, a healthcare surrogate, durable power of attorney for healthcare, or a healthcare agent.
-The healthcare team will conduct several tests to be completely certain there’s no chance of recovery before making this recommendation most situations medical teams will make sure that parents are in agreement before a decision is made to stop life support treatment.
My 90-year-old mother with dementia needs a hip replacement surgery. If you are her PA would you try to convince me to allow the surgery? Why or Why not?
-I would tell the granddaughter that All patients go through a consultation to assess age, medicine, and preexisting conditions. The ideal patient should bea healthy non-smoker with no other significant medical conditionsto be considered a good surgical candidate.for older adults who have been repeatedly told that they are “high risk” for surgery, the thought can be downright scary. While it is true that an elderly person has a higher risk of complications during and after surgery, that does not mean that a person should expect the worst during. And this hip replace could change her quality of life but on the other hand older patients are at risk for more post operative complications such as pneumonia, prolonged hospilization , and intensive care.
I’m a father of four, and you found out I have stage IV pancreatic cancer how are you going to tell me.
-You should discuss there symptoms and what they were doing before they decided to come into the hospital or an clinic and when did the symptoms begin.You have to explain where the cancer is located, maybe from results from CT and other examinations I believe you should always start there and then do forward with various treatments options and positive outcomes from their treatment options. Also make them feel supported within this process that they have a great medical team behind them. As well as support groups and programs we can find throughout the hospital to get in contact with that patient When a definite diagnosis is made, do not increase a patient’s anxiety unnecessarily by saying, ‘You should be admitted as soon as possible or your condition will become serious’. Patients need time to prepare for hospitalization, both socially and mentally.
What would you tell your patient who doesn’t believe in vaccinations for their newborn?
-I would inform that patient. I appreciate your concern about having your child vaccinated, however vaccines can protect against common infections like measles and whooping cough, which can cause serious illness or death.However, I firmly think that the risk of contracting an illness outweighs any risk associated with vaccinations.. Vaccines will get your baby off to a great start for a long, healthy life.
Your supervising MD tells you to do something that you know is dead wrong; what do you do?
At the end of the day As a physician assistant, my primary job is to deliver ethical and safe patient care. If my supervising MD directs me to do something I know is completely inappropriate, I would handle the situation by first bringing the issue to the notice of the relevant supervisor or discussing it with the supervising MD. I would also seek advice from colleagues or professional organizations if necessary. I would examine the best course of action while taking into account the needs of the patient, the supervising MD, and the healthcare team. I would likewise take responsibility for my acts and accept the repercussions of my decisions.
Who do you believe is responsible for a patient’s healthcare?”
-Responsibility for health should be a collaborative effort amongindividual nurses; health educators, administrators, and researchers, providers and patients.Ultimately,your health is your responsibility. There are people who can help, but it’s important to step up and engage in self-care. You are the best-qualified person to look after yourself on a daily basis. And if they patient can no care for them selves there are many resources that they patients can use to ensure that they are taken care of. Which can include nursing facilities and home health aids.
How would you handle a mistake made by your supervising physician in a private practice? What would you say to the patient and to your supervisor?
-Mistakes happen a lot especially if you are working in an fast pace environment such as the ED. When ever I catch an mistake that an provider does, you should alway approach the provider first in regards to the mistake.Always talk to a physician in private, away from your patients, and make sure you have their full attention. You want to show that you are on the same team to ensure confidence with your patients. Next we would have to Disclose the error to the patient, his or her family, or both.State the facts without blame. That is, give an account of what happened, the consequences, what treatments are being given to correct the error, and the results of treatment.
How do you help a patient who has the means to be healthy but has no interest in doing so?”
-force a patient to be coherent with their medication.Patient have a hard time taking action unless we feel heard and understood. Place a notion to explore other options explore options together
If a patient says “I don’t want to do this,” then you’re probably going to make things more difficult for yourself by demanding it. You might say, “Ok. What’s something youdowant to do?” For some who aren’t sure or aren’t ready to address their mental illness, don’t use those words right away. I would as them about their work,relationships,life,stress,sleep. Explain the long term affects of their unhealthy lifestyle. If you dont change your diet, this will increase your chances of being insulin resistant thus leading to the development of risk for type 2 diabetes.
-As a physician assistant, I intend to devote my career to addressing health inequities while also educating and giving back to marginalized communities through my role as a primary healthcare provider.
What do you think will happen to the Affordable Care Act now?”
One of the primary goals of the Affordable Care Act (ACA) was to expand health insurance coverage and ensure that more individuals have access to healthcare from what Ive seen in the past 14 years Medicaid Expansion: The expansion extended coverage to more individuals, including adults without dependent children, who previously did not qualify for Medicaid. This expansion has helped millions of low-income Americans gain access to affordable healthcare.
Doctor left the surgery room and asked you (a student) to close the incision, what do you do?
This happens you can alway so you dont feel comfortable with preforming this incision due to the lack of training and supervision and I would remind my attending that Students are not permitted to perform procedures without direct supervision.
If you are in a dissection group and one of your lab group members is going too quickly, cutting things, and you think they are impeding your learning, how would you handle this situation?
-The main thing is to say something and not getting too frustrated and let it ruin your experience.. I always say well why d you feel like with are bisect this biopsy instead of trisecting his biopsy. I make make to to slow down saying we let’s read the lab manual first before we begin or lets confirm with our professor that we are dissecting this properly. Its all about knowing what type of personality that you are dealing with an knowing how to effectively communicate with them without being too offensive
If you were an extern and a superior (more experienced vet) thinks one thing about patient, but based on symptoms you believe it is something else and you should therefore do something else (different treatment), what do you do?
- its alway good to present different idea’s during a huddle or a meeting whenever you have a patient that has a complex case.
- Gather your evidence:
Before approaching your superior, carefully review the patient’s history, physical exam findings, and any relevant diagnostic tests, noting specific details that support your alternative diagnosis.
-Ask clarifying questions:
Actively listen to your superior’s perspective and ask questions to better understand their reasoning behind the initial diagnosis.
At the end of the day As a physician assistant, my primary job is to deliver ethical and safe patient care. If my supervising MD directs me to do something I know is completely inappropriate, I would handle the situation by first bringing the issue to the notice of the relevant supervisor or discussing it with the supervising MD. I would also seek advice from colleagues or professional organizations if necessary. I would examine the best course of action while taking into account the needs of the patient, the supervising MD, and the healthcare team. I would likewise take responsibility for my acts and accept the repercussions of my decisions.
-scope of practice
-Seek advice from colleagues
-Examine a new course of action while teaming in account the patient
-Take responsibility for my actions and stress the notion to the MD that I do not feel comfortable doing it due the fact that this may be against hospital policies.
“Who do you believe is responsible for a patient’s healthcare?”
Responsibility for health should be a collaborative effort amongindividual nurses; health educators, administrators, and researchers, providers and patients.Ultimately,your health is your responsibility. There are people who can help, but it’s important to step up and engage in self-care. You are the best-qualified person to look after yourself on a daily basis. And if they patient can no care for them selves there are many resources that they patients can use to ensure that they are taken care of. Which can include nursing facilities and home health aids.
-Physician’s role:
The doctor is generally considered the primary decision-maker regarding diagnosis and treatment plans, due to their medical expertise.
-Patient’s role:
Patients are responsible for actively participating in their care by providing accurate medical history, following treatment plans, asking questions, and making informed decisions about their health.
-Collaborative approach:
Ideally, patient care should involve open communication and collaboration between the patient and their healthcare team to ensure the best possible outcome.
”How do you help a patient who has the means to be healthy but has no interest in doing so?”
In stances such as think this goes back to listening an validated a patients opinions, you can’t force a patient to be compliant medication. You should know what the t patient is up against. Some factors could be:
-Cost of food
-Non compliance with medication: due to the lack of understanding on why they have to taken their medication
-Transportation
-To counter this it is best to:
Set small, achievable goals:
Break down large lifestyle changes into manageable steps to promote a sense of accomplishment and build momentum.
1)Consider the patient’s individual needs and preferences when suggesting lifestyle modifications.
2)Positive reinforcement:
Acknowledge and praise any positive changes the patient makes, no matter how small.
3)Collaborate with other professionals:
Refer the patient to a dietitian, exercise specialist, or therapist for additional support and guidance.
Educate and empower:
Provide clear information about the health risks associated with their current lifestyle and empower them to make informed choices
