Question 1

Research about what patients want from health care is extensive. Of particular interest is the patient's perceptions about quality care and provider communication. Which factor best describes the patient's expectation?

Accepted Answer

Patients identify both clinical and provider interpersonal qualities as being an important indicating factor for high-quality health care. Physicians making time to address patient concerns is a part of interpersonal qualities expected by patients. While many people spend time researching the care they need, few research the quality of doctors or hospitals who deliver healthcare. Healthcare costs do not directly reflect the quality of medical service.

Question 2

Patients have multiple expectations of what they want from healthcare. Which is one of these expectations, according to research by the Picker Institute?

Accepted Answer

Patients expect to obtain information, communication, and education on illness status, prognosis, and the processes of care. Patients also have expectations about the ability to access and\or access healthcare in a timely manner, which is a major issue for adequate healthcare. Patient-centered care includes emotional support and alleviation of anxiety on all levels of healthcare; care providers and clinical personnel need to provide support without making referrals to additional sources only if needed. Patient expectations supports the involvement of family and friends in decision making as the patient desires.

Question 3

The nurse on a medical-surgical unit overhears a conversation between a patient and the patient's spouse. Which comment by the patient causes the nurse to identify a serious problem related to patient-centered care?

Accepted Answer

While the idea of partnerships with patients is gaining ground, large power differentials between patients and professionals widely persist among health providers. Waiting to ask for assistance because staff is busy indicates a possible effort on the part of the patient to not be viewed negatively. This comment indicates a serious problem with patient-centered care. The other options are indicative of appropriate patient-centered care.

Question 4

Shared decision making between patients and care providers is an essential part of patient-centered care. Which action is identified as a step in shared decision making?

Accepted Answer

With shared decision making, the patient is always informed about the benefits and risks associated with each possible decision. The patient is encouraged to make decisions based on all options, regardless of the staff's preformed decisions or preferences. The patient's goals and concerns are always considered in the process of shared decision making. To assist with shared decision making, staff assists the patient to make a decision by asking what additional information is needed and who else needs to be included in the process. Timeframes place the patient under pressure to make a decision.

Question 5

A patient is admitted to acute care with a diagnosis of serious gastric bleeding. The patient's history reveals multiple unsuccessful attempts to overcome an addiction to alcohol and drugs. For which reason does the nurse suspect the patient's strong resistance to receiving clinical care?

Accepted Answer

The patient's condition is indicative of a "danger zone." Poor experiences with the healthcare system, cultural beliefs, mental illness, substance abuse, dementia, or a variety of other reasons, can cause a patient to strongly resist partnerships with professionals. However, the patient is involuntarily tied to the health system because of very serious health problem. The patient's resistance may be fueled by a strong fear that healthcare will result in a one-way trip to the long-term unit and\or a loss of independence. There is no support in this scenario for the other options.

Question 6

A patient has a chronic illness and the nurse wants to assist the patient in learning how to gain the ability to self-manage the condition. Which task does the nurse identify as being necessary for this patient?

Accepted Answer

An important task for the patient who is self-managing a chronic health condition is to understand how to respond when symptoms change. The nurse will also help the patient to identify a healthy lifestyle, such as diet and rest, that is not necessarily directed by medical symptoms. Adjustment in medications are made by the healthcare provider and not the patient unless self-adjustment of medications is part of the patient's care plan. Appointments need to be coordinated so the patient is not stressed by spaced out appointments and visitations.

Question 7

The nurse is assigned to provide motivational interviewing with a patient who is newly diagnosed with type 2 diabetes mellitus. Which style of motivational interviewing does the nurse apply with this patient?

Accepted Answer

The nurse will apply a guiding style of interviewing with this patient. Guiding is a coaching, evoking, exploring style that works best when the patient is in the midst of defining goals, dealing with ambivalence, and creating small action plans. There is no specific style identified as affirming with motivational interviewing. The directive style is a teaching, telling style that would be most appropriate in risky health situations or those in which the patient has little capacity to act, such as a terminal illness. The following style is a more passive affirming and encouraging style that is best used when the patient is in the mastery phase of self-care.

Question 8

Healthcare providers understand that patient self-care is engineered by clinicians, and patients will follow the plan in an effort to assure better health.

Accepted Answer

Clinicians often perceive patient self-care as something that they must engineer for patients or do for them. In reality, patients are truly "driving the bus" on what they will and won't do to an extent that most clinicians don't totally understand.

Question 9

The clinician must closely monitor a patient's self-care plan in order to prevent deviating too far from the clinician's patient-focused plan.

Accepted Answer

The clinician uses support techniques with the patient's permission and in partner-ship with the patient. The clinician must also monitor and affirm the patient's own care strategies, many of which are part of the patient's "hidden" personal healthcare system, which is encouraged and not considered adverse to the clinician's plan.

Question 10

When preparing patient education materials, the clinician will attempt to help the patient to understand the medical terminology associated with the patient's diagnosis.

Accepted Answer

Health professionals need to act as if every patient has a low health literacy so anything that is taught or explained is understandable by all patients, but patients may not need or wish to understand all medical terminology associated with the patient's diagnosis. Patient education materials should substitute plain language for medical jargon as the real goal of patient education is to impart useful knowledge to the patient.

Quiz 7: Experiencing Connected Carethe Patient Role