1.
During the course of taking a history, an example of a confrontational response would be
Correct Answer
C. "You are looking very upset. What is happening?"
Explanation
The correct answer is "You are looking very upset. What is happening?" because this response is confrontational in nature. It directly addresses the person's emotional state and demands an explanation for their distress. This type of response can be seen as intrusive and insensitive, as it puts the individual on the spot and may make them feel uncomfortable or defensive.
2.
You are working in a local health clinic and you've been thinking about asking out a former patient on a date.
The most appropriate ethical response is:
Correct Answer
A. forget it, once a patient always a patient.
Explanation
The most appropriate ethical response is to forget it, once a patient always a patient. This answer aligns with professional boundaries and ethical guidelines that healthcare professionals should maintain. It emphasizes the importance of maintaining a professional relationship with patients and avoiding any potential conflicts of interest or exploitation. It recognizes that personal relationships with former patients can compromise the trust and integrity of the healthcare profession.
3.
You think that one of your doctor colleagues is drinking too much alcohol and it's affecting her work.
The most appropriate action to take is:
Correct Answer
D. Refer her to an impaired pHysician's program
Explanation
The most appropriate action to take in this situation is to refer the doctor colleague to an impaired physician's program. This option shows concern for the colleague's well-being and acknowledges the potential impact of alcohol on her work. It prioritizes her health and offers a supportive approach rather than punitive measures like reporting her to the police. Confronting her in front of others may not be helpful, and joining her for drinks after work would not address the issue at hand. The final option, "It depends on how 'hot' she is," is inappropriate and irrelevant to the situation.
4.
At the beginning of an initial interview, the patient wants to discuss his perceptions of why he felt ill but the interviewer wants to know the chronology of his symptoms to complete the history interview. The interviewer should:
Correct Answer
B. Allow him to complete his thoughts
Explanation
In this scenario, the interviewer should allow the patient to complete his thoughts. By doing so, the patient will feel heard and understood, which can help establish rapport and trust. Additionally, allowing the patient to express his perceptions can provide valuable insights into his illness and help the interviewer gather a more comprehensive understanding of his symptoms. Interrupting the patient or using closed-ended questions may hinder the flow of information and prevent the interviewer from gaining a thorough understanding of the chronology of symptoms.
5.
Mr. T, a 59-year old man, 12 months after the death of his wife of 35 years, reluctantly mentioned to his son that he wished he was dead, but would never do anything about these wishes. Concerned, the son took him to a psychiatrist for an evaluation. Which of the following is true?
Correct Answer
B. Detailed questions about his suicidality are essential for prevention
Explanation
The correct answer is "Detailed questions about his suicidality are essential for prevention." This is because the man expressed a wish to be dead, which indicates potential suicidal ideation. By asking him detailed questions about his suicidality, the psychiatrist can assess the severity of his thoughts and determine the appropriate intervention or prevention strategies. It is important to address and evaluate any potential suicide risk to ensure the safety and well-being of the individual.
6.
A 4th semester Ross student is assigned to stay with a 9-year old girl who is waiting to have surgery to repair a cleft palate. The girl, who has recently arrived alone from Cambodia, does not speak English and appears anxious. The charge nurse at the hospital has requested a translator but the translator has not yet arrived. At this time, the most appropriate action for the medical student to take is to
Correct Answer
A. Listen to the child's heart with a stethoscope and then let the child try to use the stethoscope to listen to his heart.
Explanation
The most appropriate action for the medical student to take is to listen to the child's heart with a stethoscope and then let the child try to use the stethoscope to listen to his heart. This action would help to establish a connection with the child and alleviate some of her anxiety. It would also provide an opportunity for the child to become familiar with the medical equipment and feel more comfortable in the hospital setting. Additionally, it would demonstrate empathy and care towards the child, which is important in building trust and rapport.
7.
Children who can understand the principle of conservation are likely to be in which Paget stage?
Correct Answer
B. Concrete operation
Explanation
Children who can understand the principle of conservation are likely to be in the Concrete operational stage according to Piaget's stages of cognitive development. In this stage, which typically occurs between the ages of 7 and 11, children are able to think logically and understand conservation, which is the understanding that the quantity or amount of a substance remains the same even if its appearance changes. This stage is characterized by the ability to reason and think logically about concrete objects and events.
8.
When a doctor is interviewing a patient, the perceptual filters of life experience, self- image, values and prejudices/biases:
Correct Answer
D. May occur both with the patient and doctor.
Explanation
When a doctor is interviewing a patient, the perceptual filters of life experience, self-image, values, and prejudices/biases may occur both with the patient and the doctor. This means that both the doctor and the patient bring their own unique perspectives and biases into the conversation, which can influence their perceptions and understanding of each other. It is important for the doctor to be aware of these filters and strive to maintain objectivity and empathy in order to provide the best possible care for the patient.
9.
The use of influencing skills by the physician
Correct Answer
B. May involve self-disclosure
Explanation
The use of influencing skills by the physician may involve self-disclosure. This means that the physician may share personal information or experiences with the patient in order to establish trust and encourage open communication. However, it is important to note that this approach is not appropriate in interviews where the physician's objective is to gather complete and unbiased information about the patient. Self-disclosure should be used judiciously and only when it is relevant to the patient's care or treatment.
10.
A health care provider is addressing a culturally, ethnically, and racially diverse group of expectant mothers in the context of a birthing class. While discussing the differences between Western and non-Western approaches to child-birth, she refers to one of the participants, a young woman from a rural, traditional village in Africa, as someone who could provide the group with rich perspectives regarding natural child-birth. Which is the most salient Feature of the health care provider's style of communication in relation to the young African woman?
Correct Answer
B. Stereotyping or prejudging the influence of an individual's culture.
Explanation
The health care provider's style of communication is characterized by stereotyping or prejudging the influence of the young African woman's culture. This is evident in the provider's assumption that the woman, coming from a rural, traditional village in Africa, would have rich perspectives on natural child-birth. This assumption is based on preconceived notions about African culture and may not accurately reflect the woman's individual beliefs or experiences.
11.
A 35 year-old male comes to the ER and presents with chest pain, nausea, dizziness, and sweating. He voices that he is afraid he is going to die. The HPI includes three previous episodes during the past two months, each episode lasting about 30 minutes. He has been afraid to visit the doctor but he has become more afraid during the past month of having yet another episode. So this time he figured he had better seek treatment before this kills him. The most likely diagnosis is:
Correct Answer
E. Panic disorder
Explanation
The patient's symptoms of chest pain, nausea, dizziness, and sweating, along with the fear of dying and previous episodes lasting about 30 minutes, are consistent with a panic attack. The fact that he has been avoiding seeking medical help due to fear suggests that he may have panic disorder, which is characterized by recurrent panic attacks and the fear of having future attacks. This diagnosis is more likely than factitious disorder or malingering, as there is no evidence to suggest that the patient is intentionally producing or exaggerating his symptoms. Agoraphobia is not the most likely diagnosis, as it is not mentioned in the patient's presentation.
12.
Your patient, a recent immigrant to the US, reports that she experiences frequent trance states during which she is possessed by a demon who demands gifts from the patient's family members. Such belief and associated behaviors are consistent with the norms of her culture of origin. The most appropriate diagnosis is:
Correct Answer
A. No diagnosis is warranted
Explanation
The patient's experiences of trance states and being possessed by a demon are consistent with the norms of her culture of origin. Therefore, it is important to consider cultural factors when making a diagnosis. In this case, the patient's beliefs and behaviors are not indicative of a dissociative disorder but rather a cultural belief or practice. As such, no diagnosis is warranted as the symptoms are not causing distress or impairment in the patient's life.
13.
Your 43 year old male patient presents with the chief complaint "that he has a brain tumor. He presented to you 3 weeks ago with the complaint of stomach cancer and a week before that he complained about having melanoma. All of his physical exams and lab tests indicated that your patient was in excellent health. The most accurate diagnosis that best fits his overall presentation is:
Correct Answer
D. Hypochondriasis
Explanation
The most accurate diagnosis that best fits the patient's overall presentation is hypochondriasis. Hypochondriasis is a mental disorder characterized by excessive worry and fear of having a serious medical condition, despite medical reassurance and lack of evidence. In this case, the patient has a pattern of presenting with multiple complaints of different types of cancer, despite being in excellent health according to physical exams and lab tests. This suggests that the patient's symptoms are not based on actual medical conditions, but rather on excessive health anxiety and preoccupation with illness.
14.
You are on holiday in Puerto Vallarta, Mexico, far away from your clinical practice in Toledo, Ohio. While having a drink at the hotel bar you coincidentally encounter one of your patients, a person you find to be very attractive. The patient tells you that he/she is really attracted to you and would like to get together later for some intimate time together. In fact they are even Willing to see a different physician back home so that they can pursue something with you. The most ethical course of action for you to take is:
Correct Answer
B. Politely decline
Explanation
The most ethical course of action in this situation is to politely decline the invitation. As a healthcare professional, it is important to maintain professional boundaries and avoid any potential conflicts of interest or breaches of trust. Engaging in a personal or intimate relationship with a patient can compromise the therapeutic relationship and may be considered unethical or unprofessional. It is essential to prioritize the well-being and best interests of the patient, and declining the invitation is the appropriate and ethical response in this scenario.
15.
An effective interviewing skill includes the following behaviors: Listening carefully; "entering" the world of the patient; communicating that you imagine the patient's world as the patient sees and experiences it, YET, not becoming the patient---you relate, and also remain separate from the patient. From the following list, select the communication skill most closeIy described above:
Correct Answer
A. Empathy
Explanation
The communication skill that is most closely described in the given scenario is empathy. Empathy involves listening carefully and trying to understand the patient's perspective and experiences without losing one's own identity. It requires relating to the patient while also maintaining a sense of separateness. Empathy allows the interviewer to create a supportive and understanding environment for the patient.
16.
You are interviewing a female patient who works as a legal assistant for several different attorneys. Her chief presenting issue is recurrent migraine headaches. As you explore this presenting illness, you learn that her headaches occur most often during certain days when she is assigned to work with a particularly mean and spiteful attorney who makes the patient feel extremely uncomfortable. When the headaches do occur, she is forced to leave work. You suspect that the patient's headaches represent a learned behavior that allows her to avoid an unpleasant experience. This would be an example of:
Correct Answer
C. Negative reinforcement
Explanation
The patient's headaches occur most often when she is assigned to work with a mean and spiteful attorney who makes her feel uncomfortable. When the headaches occur, she is forced to leave work, which allows her to avoid the unpleasant experience of working with that attorney. This pattern suggests that the headaches serve as a way for the patient to escape or avoid the unpleasant situation, which is an example of negative reinforcement.
17.
Your "foreign born" patient has migrated approximately 5 years ago . She is likely to have difficulty trusting you, understanding your treatment plans/rationale and being willing/able to follow your recommendations if her degree of acculturation is
Correct Answer
D. Marginal
Explanation
If the patient's degree of acculturation is marginal, it means that she has not fully assimilated into the new culture and may still hold on to her traditional beliefs and practices. This could lead to difficulties in trusting the healthcare provider, understanding treatment plans, and following recommendations, as her cultural background may influence her perceptions and attitudes towards healthcare.
18.
Your 24 year old single white male American patient presents with the following chief complaint: "Rogue doctors entered my apartment last night and removed my spleen." Physical examination does not reveal the presence of any scars, incisions, fresh wounds or any other sign that the patient was a victim of invasive surgical proced ures.
The type of psychiatric symptom exhibited by your patient is best described as a(n):
Correct Answer
C. Bizarre Delusion
Explanation
The patient's belief that rogue doctors entered his apartment and removed his spleen is an example of a bizarre delusion. This is because the belief is clearly false and not based on any evidence or reality. Additionally, the belief is highly implausible and goes against common sense. The lack of physical evidence, such as scars or wounds, further supports the idea that this is a delusion rather than a hallucination or illusion.
19.
Your 24 year old single white male American patient presents with the following chief complaint: "Rogue doctors entered my apartment last night and removed my spleen." Physical examination does not reveal the presence of any scars, incisions, fresh wounds or any other sign that the patient was a victim of invasive surgical proced ures.
During this first interview with this patient he says, "You can see my spleen has been removed, can't you, doctor?" The most useful response would be
Correct Answer
D. "I hear that this situation is concerning to you and I am here to help you"
Explanation
The most useful response would be "I hear that this situation is concerning to you and I am here to help you." This response acknowledges the patient's concern and shows empathy, while also reassuring the patient that the doctor is there to provide assistance and support. It is important to validate the patient's feelings and address their concerns in a compassionate manner.
20.
) You are in the process of taking the history of a 23 year old male patient who is new to your practice. During the course of the psychosocial history he becomes enraged when you ask him about his sexual relationship with his girlfriend of 4 years, informing you that "The bitch cheated on me with my best friend and I'm gonna kill her." The most appropriate response on your part would be to:
Correct Answer
A. Ask him questions that assess the lethality or seriousness of his remark.
Explanation
In this scenario, the patient's response indicates that he is expressing anger and making a threat towards his girlfriend. As a healthcare professional, it is essential to prioritize the safety of all individuals involved. By asking questions that assess the lethality or seriousness of his remark, the healthcare professional can gather more information about the situation and determine if there is a potential risk of harm to the patient or others. This response allows for further evaluation and appropriate intervention if necessary.
21.
Arguments exist about the "art" of communication versus the "science" of communication. Select the item below which supports the position that there is a science of communication.
Correct Answer
A. Research with medical students indicates benefits from communication training persist for years.
Explanation
The given answer supports the position that there is a science of communication because it suggests that communication skills can be trained and improved through research-based methods, and the benefits of this training can last for a long time. This implies that there are specific techniques and strategies that can be studied and applied in order to enhance communication effectiveness, indicating that communication is not simply an innate talent but a subject that can be studied and understood scientifically.
22.
Which is the most salient reason that health care providers must become culturally competent?
Correct Answer
A. There exist a growing gap between the ethnic distribution of the population and the characteristics of health care providers.
Explanation
The most salient reason that health care providers must become culturally competent is because there is a growing gap between the ethnic distribution of the population and the characteristics of health care providers. This means that healthcare providers may not fully understand or be able to meet the unique needs and beliefs of patients from different cultural backgrounds. By becoming culturally competent, healthcare providers can effectively communicate with and provide appropriate care to patients from diverse backgrounds, improving overall healthcare outcomes and reducing disparities.
23.
A 42-year-old woman comes to you, as her family doctor with a chief complaint of pain and discomfort around her vagina. The patient is concerned that she may have acquired an infection from a recent sexual encounter. Which of the following questions should you, as the doctor, ask to determine the patient's sexual orientation?
Correct Answer
C. Do you have sex with men, women or both men and women?
Explanation
The question "Do you have sex with men, women or both men and women?" is the most appropriate to ask in order to determine the patient's sexual orientation. This question allows the patient to provide information about their sexual partners and preferences, which can help the doctor understand their sexual orientation. The other options are either too direct (asking about being gay or straight) or inappropriate (asking about sex with a minor or using derogatory language like "Dyke"). The last option is irrelevant and disrespectful.