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CPM Final Exam- JSMBS (1)
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CPM Final Exam- JSMBS1- In which part of the patient encounter would it be most appropriate to include the
following statement; " My head feels like it is going to explode"?
-chief complaint/concern
-history of present illness
-past medical history
-assessment
-plan - ANS-chief complaint/concern
1- In which part of the patient encounter would it be most appropriate to include the
following phrase: Mr. Smith, a 55 year old male smoker with hypertension, was feeling
well until last Sunday when he experienced chest pain while mowing the lawn. It
radiated to his left arm. It was relieved when he sat down for 5 minutes. It occurred
again this morning when he needed to climb the stairs since the elevator at work was
broken.
-chief complaint/concern
-history of present illness
-past medical history
-assessment
-plan - ANS-history of present illness
1- A patient presents to the doctor's office complaining of "back pain". You enter the
room and introduce yourself to the patient. What would be the best opening statement
on your part once the patient says "I'm here because my back hurts"?
-"Does your pain radiate into your leg?"
-"Do you have any chronic medical conditions?"
-"Are you having any urinary problems with this back pain?"
-"Please tell me more about your back pain?" - ANS-"Please tell me more about your
back pain?"
1- Which statement is true regarding effective patient-doctor communication?
-Although it is a nice thing to strive for, it does not have any measurable impact on
patient-care
,-Physicians who are good communicators are usually better able to deal with emotional
situations. and often find increased professional satisfaction.
-Doctor-patient communication is not a significant factor in most malpractice cases
-Patients usually don't care too much about their doctor's communications skills -
ANS-Physicians who are good communicators are usually better able to deal with
emotional situations. and often find increased professional satisfaction.
1- An important part of the medical interview involves screening for lifestyle choices
which may impact a patient's health. One of the screening tools we discussed is the
"CAGE questions". The "A" in the CAGE questions stands for:
-Do you feel you consume Alcohol in excess?
-Have you physically Abused someone when drinking alcohol?
-Are you Annoyed when people criticize your drinking?
-Are you Able to arrive at work despite your drinking? - ANS-Are you Annoyed when
people criticize your drinking?
1- In a problem focused visit, for which chief complaint/concern would it be most
important to elicit a pertinent family history as part of the HPI?
-"I sprained my ankle while playing soccer"
-"I have had sinus pressure and congestions for 6 days"
-"For the past 3 months I have experienced chest pain while walking up stairs"
-"I was working in my garden yesterday and have developed an itchy rash." - ANS-"For
the past 3 months I have experienced chest pain while walking up stairs"
1- Which question would be most likely to encourage a patient to provide complete
information about their sexual history?
-"Are you married?"
-"Do you have a boyfriend ?"
-"Would you please tell me about your sexual relationships?"
-"Do you have a girlfriend?" - ANS-"Would you please tell me about your sexual
relationships?"
1- The complete medical encounter includes the Subjective, Objective, Assessment,
and Plan (SOAP). Which of the following belongs in the objective section of a note?
-Heart rate: 68 beats per minute
-The patient is employed as a high school teacher
, -The patient has been experiencing heartburn after eating pizza.
-The patient's father died of colon cancer at age 57 - ANS-Heart rate: 68 beats per
minute
1- If a patient presents to you in the ER with crushing chest pain and is visibly short of
breath, which type of history are you likely to obtain most immediately?
-Complete history
-Inventory history
-Problem (or focused) history
-Interim history - ANS-Problem (or focused) history
1- All of the following are strategies for establishing effective communication with the
patient except
-Eye contact which is assuring and comfortable
-Nodding in agreement
-Echoing and summarizing to confirm understanding
-Standing during the entire patient interview out of respect for the patient -
ANS-Standing during the entire patient interview out of respect for the patient
2- As presented in the smoking cessation article, what is the "patch plus" method for
smoking cessation?
-Using a nicotine patch plus varenicline (Chantix)
-Using a nicotine patch plus increasing coffee consumption
-Using a nicotine patch plus a short-acting form of nicotine replacement like lozenges
and gum for urges not relieved by the patch.
-nicotine patches plus scheduling an appointment with a psychiatrist or social worker. -
ANS-Using a nicotine patch plus a short-acting form of nictine replacement like
lozenges and gum for urges not relieved by the patch.
2- Which best describes the goals of motivational interviewing?
-to convince the patient to agree to adapt behaviors that will improve their health
-to help the patient resolve their ambivalence, develop some momentum and believe
that behavior change is possible
-to provide the patient with a list of referrals to resources such as dieticians and
counselors in case they should decide to pursue helath behavior change
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