NU 650 EXAM 1 WITH COMPLETE SOLUTION

NU 650 EXAM 1 WITH COMPLETE SOLUTION How are clinical encounters approached? Both clinician-centered and patient-centered What is the sequence of the clinical encounter? Initiating the encounter Gathering information Performing a physical examination Explaining and planning Closing the encounter What steps should be taken when initiating the encounter? Set the stage Adjust the environment Review the clinical record Set your agenda Greet the patient and establish initial rapport Identify patient title, name, and preferred gender pronouns Establish rapport What steps should be taken during the gathering information stage? Establish the agenda for the patient encounter Invite the patient's story Gather information about the patient's perspective of illness Identify and respond to emotional cues Gather information regarding the biomedical perspective, background information and context What is a social determinant of health? The circumstances in which people are born, grow, live, work, and age, and the systems put in place to deal with illness What is implicit bias? set of unconscious beliefs or associations that lead to a negative evaluation of a person on the basis of their perceived group identity What is explicit bias? refers to the attitudes and beliefs we have about a person or group on a conscious level What are some skills clinicians can use to mitigate the impact of bias in their clinical encounters? Reflect on patterns of emotions and behavior Pause before beginning and encounter and prepare for potential triggers of bias Generate alternative hypothesis for biases anchored in behavior Practice universal communication and interpersonal skills Explore your patients' identities Explore your patients' experience of bias What is cultural humility? A process that requires humility as individuals continually engage in self-reflection and self-critique as lifelong learners and reflective practitioners What are the three dimensions of cultural humility? Self-awareness Respectful communication Collaborative partnerships What elements constitute decisional capacity? The capability to communicate a choice Understand the relevant information Appreciate the situation and consequences Reason about treatment options What is active listening? Carefully attending to what the patient is communicating, connecting to the patient's emotional state, and using verbal and nonverbal skills to encourage the patient to expand on his or her feelings and concerns. What are ways to guide questions? Move from open-ended questions to focused ones Use questions that elicit a graded response Ask a series of questions one at a time Offer multiple choices for answers Clarify what the patient means Encourage with continuers Use echoing/repetition What is an empathic response? A response that recognizes the patient's feelings, then actively moves towards an emotional content What is the purpose of summarization? It communicates that you have been listening carefully, identifies what you know and don't know, and allows the patient to add information or clarify others. What is transitioning? When a provider informs a patient that they are moving from one point in the encounter to another What is validation? Affirming the patient's legitimacy of their emotional experience How can you empower a patient? Evoke the patient's perspective Convey interest in the person, not just the problem Follow the patient's leads Elicit and validate emotional content Share information with the patient, especially at transition points during the visit Make your clinical reasoning transparent to the patient Reveal the limits of your knowledge What are appropriate verbal communication techniques? using understandable language using nonstigmatizing language How should you interact with a patient requiring an interpreter? Speak to the patient, not the interpreter Make your questions clear, short and straightforward Retain control What is the main framework for inter professional communication? SBAR What type of assessment will you conduct when meeting a patient for the first time? Comprehensive health assessment What type of assessment will you conduct when seeing a patient for a subsequent encounter? Focused or problem-oriented assessment What is subjective information? Symptoms, which are health concerns that the patient tells you Complaints, feelings, perceptions CC-ROS