COMM

Four Principles of MI

1. Express empathy 2. Develop discrepancy 3. Avoid argument/Roll with Resistance 4. Support self-efficacy

13. All of the following are common reasons for not telling the family about a medical mistake EXCEPT: A. "I don't subscribe to medical malpractice insurance." B. "No permanent harm was done." C. "The family will just feel worse if they know." D. "It didn't make a difference. The patient would have died anyway."

A. "I don't subscribe to medical malpractice insurance."

9. If you visit a medical center in which the walls are painted soothing colors, large windows provide views of soothing gardens, and patients are able to control the temperature and lighting in their rooms, the staff has probably been directly or indirectly influenced by this model: A. Planetree B. Hippocratic C. Telemedical D. Practical structuration

A. Planetree

15. "Please review the scenario below and describe what you can deduce about the patient's condition." A test item such as this one is most consistent with: A. Problem-based learning B. Rote learning C. A medical initiative curriculum D. The traditional medical school curriculum

A. Problem-based learning

1. According to the book, which of the following is an important reason to study health communication? A. Communication is an important source of personal confidence and coping ability. B. Effective communication saves time and money. C. Communication helps people in health care organizations operate efficiently. D. All of the above

All of the above.

Common Techniques to Develop Discrepancy

Asking the patient to look into the future and imagine a changed life under certain conditions (i.e., condition is well managed) or to look into the past and recall periods of better functioning. Ask the patient to consider the worst possible scenario resulting from not changing behavior or the best possible consequences resulting from trying to change.

7. According to theorists such as Gary Kreps and Teresa Thompson, if health communication is unsatisfactory: A. Physicians are probably to blame. B. We should consider patients' communication as well as doctors'. C. Patients should shop around for different doctors. D. Patients should immediately report the problem to management.

B. We should consider patients' communication as well as doctors'.

6. Which of the following is most accurate? A. The United States system is based on France's model. B. The United States passed federal individual mandate laws in 1995. C. The United States is primarily a multi-payer system. D. The United States is a Six Sigma system.

C. The United States is primarily a multi-payer system.

15. The nurse says that your lab results look okay, but she seems worried and she looks you in the eye a little longer than usual with an expression that seems to convey concern. The idea that we pay attention both to what people say and how they behave is called: A. Content-level meaning B. The perceptual impact hypothesis C. The relational approach D. Relational-level meaning Correct

C. The relational approach

14. According to research described in your book, patients who are more likely than others to be satisfied, trust diagnoses, and carry out treatment advice. A. listen carefully to caregivers' directions B. study medical terminology in a college course C. take an active role in medical encounters D. have an external locus of control

C. take an active role in medical encounters

17. "I am more sympathetic toward my colleagues when things don't go well because I know that even good doctors make mistakes." This sentiment might occur when a doctor is in which stage of managing a serious medical mistake? A. Stepping in B. Integration C. Forgiving D. Wisdo

D. Wisdo

Principle 2: Develop Discrepancy

Developing discrepancy enables the participant to see that her the present situation does not necessarily fit into her values and what she would like in the future

Principle 3: Roll with Resistance

Rolling with resistance prevents a breakdown in communication between participant and health care professional and allows the participant to explore her views. Avoid arguing for change.

Principle 4: Support Self-efficacy

Self-efficacy is a crucial component to facilitating change. If a participant believes that she has the ability to change, the likelihood of change occurring is greatly increased. Provide skills to perform a behavior and highlight strengths that the client already has.

- Ambivalence

is accepted as a normal part of human experience and change

Principle 1: Express Empathy

• Expressing empathy towards a patient/client shows acceptance and increases the chance of the health care provider and participant developing a rapport.

8. When a patient introduces a medical concern in the last few moments of a medical encounter, we call it: A. A doorknob disclosure B. A transgression C. Blocking D. Patronization

A. A doorknob disclosure

8. When patients pay a set fee per year or month to cover all the medical services they will need, this is called: A. Capitation B. Fee for service C. Reimbursement D. The Cooperative Member Model

A. Capitation

4 Interview Techniques

• Open-ended questions • Reflective listening • Affirmation • Summarization

3. The employer mandate provision of the ACA is also known as pay or play. This means that they must: A. Provide company-sponsored health plans or pay fines B. Offer health education programs for their employees or pay for the employees to attend programs offered elsewhere C. Take part in national health research studies or pay others to submit data on their behalf D. Screen applicants for health concerns or pay stiff penalties Correct

A. Provide company-sponsored health plans or pay fines

17. A person who upholds the model of collaborative interpretation is most likely to make which of the following statements? A. "Patients should follow their doctors' orders without question." B. "Caregivers must treat patients like partners involved in a cooperative process." C. "Patients are like children and doctors are like parents." D. "Patients are consumers, and health professionals should cater to their wishes."

B. "Caregivers must treat patients like partners involved in a cooperative process."

18. You engage a client in a motivational interviewing session to talk about his desire to be more physically active. So far, he hasn't been successful at incorporating regular workouts into his schedule. Following the tenets of motivational interviewing, you might say all of the following EXCEPT: A. "What are the advantages of not working out more often?" B. "Why don't you team up with a workout partner? That always works for me." C. "On a scale of 1 to 10, how important is working out to you?" D. "What do you think it would take to move a little closer to your goal?"

B. "Why don't you team up with a workout partner? That always works for me."

14. A never event is most accurately defined as: A. A medical mistake that no one ever learns about. B. A clear, preventable error with serious consequences. C. A procedure that has never been done before. D. All of the above.

B. A clear, preventable error with serious consequences.

1. Mr. Johnson is angry that he was not discharged from the hospital sooner, and he takes it out on the health educator who comes to prepare him for home care. When a patient or caregiver steps over the line, as in delivering insults and making inappropriate expressions of anger, this is best described as: A. Antidecorous B. A transgression C. Boundary spanning D. Disenfranchisement

B. A transgression

16. Julia visits the doctor when her back pain begins to interfere with work and home life. For her, the symptoms are bearable, but it is unacceptable to disappoint people who are counting on her. Her perspective is compatible with which medical model? A. Biomedical B. Biopsychosocial C. Mechano D. Perceptual

B. Biopsychosocial

New perspectives are offered:Roll with Resistance

The participant is a primary resource in finding answers and solutions. Resistance is a signal for the counselor to respond differently.

2. All of the following are important to our definition of communication EXCEPT: A. Personal goals B. Shared meaning C. Autonomy D. Sensitivity

C. Autonomy

8. A nurse's aide who asks, "How does this condition affect your relationships and home life?" is behaving in line with the assumptions of which medical model? A. Mechano model B. Biomedical model C. Biopsychosocial model D. Social relevance theory

C. Biopsychosocial model

16. A patient says, "I believe this all began when I lost my job. I was so depressed and bored, I started eating too much. Then my liver started acting up. At that point, I got really scared and decided I had better do something fast." When patients tell their stories about how their illnesses occurred and affect them, they are engaging in: A. Narrative B. Supernormal identity management C. Social exchange theory D. All of the above Correct

A. Narrative

4. Which of the following best describes the use of electronic medical records in the United States? A. Only about 46% of U.S. physicians utilize them. B. The United States has been a leader in creating and using EMR technology. C. Federal legislation passed in 2009 requires that all physicians use EMRs. D. EMRs are banned in the United States because of privacy concerns.

A. Only about 46% of U.S. physicians utilize them.

6. As the overall population becomes more diverse and older, how is health care likely to be affected? A. More people will be able to afford medical treatment. B. People will be better informed, reducing the need for prevention efforts. C. Caregivers and patients may be very different from each other. D. The overall health of the population is likely to improve.

C. Caregivers and patients may be very different from each other.

13. As the term is described in your book, which of the following best describes collaborative medical communication? A. Participants act as peers who openly discuss health options and make decisions together. B. Patients are encouraged to choose health professionals who are highly similar to themselves. C. Managed care executives, caregivers, patients, and family members work together to assure the best care possible. D. Patients with similar concerns assist each other by answering questions, serving as social support networks, and sharing their own experiences.

A. Participants act as peers who openly discuss health options and make decisions together.

16. All of the following are good tips for managing medical mistakes EXCEPT: A. Rehearse how you will disclose the information. B. Deliver the news as simply and truthfully as possible. C. Don't allow the other person to interrupt until you have explained everything fully. D. Respond empathically.

C. Don't allow the other person to interrupt until you have explained everything fully.

13. Ron is trained in cardiovascular technology, but he considers that a major part of his job is making patients feel comfortable, so he strives to remember patients' names and ask about their children and hobbies. Attention to patients' social well-being as well as their physical health is part of which medical model? A. Biopsychosocial B. Biomedical C. Paternalistic D. Organic

A. Biopsychosocial

19. You decided to start a new, healthier diet this week. But you ate cake at your sister's birthday party Tuesday evening and were so hungry Wednesday afternoon that you grabbed a hamburger on the way to an evening meeting. In the language of sense making, you have experienced: A. Gaps B. Contrasensical confounders C. Goal ambivalence D. Health belief conflicts

A. Gaps

20. Since she became a medical assistant, Sonia is surprised at how differently patients react to the same illnesses and treatment plans. Some seem to be upset, whereas others are relatively calm. Which of the following perspectives emphasizes that health outcomes are neither static nor definitive; instead, one factor may influence others in unforeseen ways? A. Integrative health model B. Dynamic model of health care interactions C. Transitory health quotient D. Medical standpoint theory

A. Integrative health model

3. Which of the following is true of today's health care industry? A. It employs approximately 15.6 million people. B. It accounts for $8 billion a year in domestic spending. C. The number of health-related occupations is slowly increasing. D. Demand for health services is expected to decrease between now and 2020.

A. It employs approximately 15.6 million people.

18. All of the following are implications of the definition of communication provided in your book EXCEPT: A. It is important to identify communication strategies that work in every situation. B. People must try to understand each other's expectations. C. How effective communication is depends on circumstances and goals. D. Our expectations reflect our personal experiences, emotions, and cultural beliefs.

A. It is important to identify communication strategies that work in every situation.

5. How is the Information Age affecting health care? A. Patients are more empowered to ask questions and participate in decision-making than they used to be. B. People only visit doctors when they are sick, as compared with their parents, who made appointments just to get information. C. There is less competition in the health care industry than there used to be. D. With so much information available, health care organizations are less likely to advertise their services than their predecessors were 20 years ago. Correct

A. Patients are more empowered to ask questions and participate in decision-making than they used to be.

9. The empathic communication model reflects which common phenomenon? A. People who are attracted to health careers are often at high risk for burnout because they care so much. B. When patients are empathic communicators, their caregivers are likely to be more empathic as well. C. People must limit their empathic communication to avoid burnout. D. Empathic communication is the best means of reducing burnout and building quality relationships.

A. People who are attracted to health careers are often at high risk for burnout because they care so much.

1. "This all started when I went on vacation. I noticed that my eyes were especially sensitive to the sun. I figured it was because the sun was brighter in Florida. But then my eyes kept hurting, even after we got home." The tendency of patients to define health concerns within the context of their activities is called: A. The Voice of Lifeworld B. The Therapeutic Voice C. The Voice of Pharmacology D. A Healing Vocabulary

A. The Voice of Lifeworld

14. Daniel sought a medical team who would listen to his ideas and treat him as an active participant in his own care. His ideas are consistent with: A. The model of collaborative interpretation B. The health belief model C. The cognitive two-step flow process D. The elaboration likelihood model

A. The model of collaborative interpretation

2. Your brother and sister couldn't be more different. She is proactive as a patient, doing research on her own and confidently asking questions of medical professionals. Your brother is more passive and less likely to seek out information. In other words, your sister is more of a(n) _____ than your brother is. A. self-advocate B. interactional mediator C. convergent communicator D. rhetorical reflector

A. self-advocate

11. Renaldo has no specific illness, yet he hasn't felt well for several weeks, perhaps because he misses his parents since moving away to college. According to the definition of health supported by the World Health Organization: A. Since laboratory tests do not reveal an illness, we may consider Renaldo healthy. B. Renaldo is not in good health. C. If Renaldo is not careful, he may become ill. D. Renaldo's illness is probably all in his head.

B. Renaldo is not in good health.

6. When Norma tries to tell the nurse how frightened she is that she may die, the nurse says, "Oh, you shouldn't worry" and changes the subject. The process of avoiding emotional topics and complaints is called: A. Patronizing B. Blocking C. Transference D. Mocking

B. Blocking

19. If Juan is a patient of an accountable care organization, which of the following is he most likely to experience? A. Care providers' attention when he is sick, but not when he is well B. Care by an interdisciplinary team of professionals C. A biomedical approach to health and illness

B. Care by an interdisciplinary team of professionals

7. Managed care was created mostly to: A. Allow doctors to make more money B. Control health care costs C. Drive specialists out of business D. Improve the quality of care Americans receive

B. Control health care costs

4. Lucinda was relieved when the nurse practitioner came in with a smile, introduced herself, and seemed eager to hear more about Lucinda's life and concerns. She thought to herself, "This is a person I can trust to care about me, to avoid judging me, and to offer the expertise I need to get better." As a result, Lucinda told the nurse practitioner about a frightening health concern she hadn't shared with anyone else. This episode is a good example of the: A. Adaptive Structuration Theory B. Disclosure Decision-Making Model C. Elaboration Likelihood Model D. Coordinated Disclosure Approach

B. Disclosure Decision-Making Model

3. According to Kathy Charmaz's stages of identity management during long-term illnesses: A. People in the supernormal identity stage have accepted the effects of the illness and developed new (even improved) identities for themselves. B. During the contingent personal identity stage, people admit they cannot do everything they could do before the illness. C. In the salvaged-self stage, people refuse to admit that the illness affects their identity at all. D. All of these are true

B. During the contingent personal identity stage, people admit they cannot do everything they could do before the illness.

5. How did René Descartes change the history of medicine? A. He discovered germs. B. He asserted that the mind and body are separate entities. C. He said people must stop doubting so much and rely on spiritual faith to heal them. D. He proposed that surgeries and autopsies should be outlawed because they interfere with the human body as God's creation.

B. He asserted that the mind and body are separate entities.

20. You are happy to hear that the local hospital has just opened a full-service fitness center with a membership fee substantially lower than most health clubs'. The most likely reason for the new center is: A. A law passed in 2008 requires medical centers to devote a percentage of their profits to prevention efforts. B. Hospital leaders recognize that keeping patients healthy is usually less expensive than getting them well again. C. Hospital officials realize that people have more free time than ever before. D. Changes to the single-payer health system require health organizations to devote a percentage of their profits to prevention efforts. Correct

B. Hospital leaders recognize that keeping patients healthy is usually less expensive than getting them well again.

1. According to experts cited in your book, the United States could save $100 billion a year by: A. Requiring that everyone join an HMO B. Lowering insurance administrative costs C. Making vaccinations mandatory for preschoolers D. Abolishing electronic medical records

B. Lowering insurance administrative costs

18. Part of the controversy over HIPAA regulations involves the argument that: A. The forms are oversimplified. B. Patients do not have a choice about how their medical information will be used. C. Patients are still not given the right to see their own medical records. D. It gives patients the right to sue managed care organizations rather than suing doctors.

B. Patients do not have a choice about how their medical information will be used.

6. Which of the following best represents information in your textbook concerning patients' cooperation with treatment advice? A. Patients who do not follow treatment advice deserve whatever happens to them. B. Skillful caregivers ask patients' feedback about diagnosis and treatment advice. C. Medical compliance is the biggest issue inflating health care expenditures in the United States today. D. Most patients are in denial about the causes of their illnesses.

B. Skillful caregivers ask patients' feedback about diagnosis and treatment advice.

4. Pablo is inspired more by a video game that features people and scenarios that are familiar to him than by a televised PSA featuring "rich kids" that don't know what his life is like. Which of the following reflects the idea that health is embedded in shared values, traditions, and rituals? A. Mechano model B. Sociocultural perspective C. Biomedical model D. Social relevance axiom

B. Sociocultural perspective

8. The Sanders decide to change doctors because the nurse in their doctor's office seemed curt and uninterested when they mentioned how anxious they were about the chance of a big blizzard. They did not get a chance to say they were worried that a medical emergency would occur during the blizzard. Instead, the nurse switched the topic to questions about physical symptoms and health history. A vocabulary that is highly focused on physical health is called: A. The Therapeutic Voice B. The Voice of Medicine C. The Voice of Pharmacology D. A Healing Vocabulary

B. The Voice of Medicine

19. In the "Blowing the Whistle on an Impaired Physician" case study, the clinic manager reports the physician to authorities after: A. The doctor shows up drunk to perform surgery. B. The local pharmacy reports suspicious prescriptions for narcotics. C. The doctor physically threatens a patient. D. The physician refuses to admit that the effects of a recent stroke have made him incapable of performing surgery.

B. The local pharmacy reports suspicious prescriptions for narcotics.

2._____is based on a commitment to offer health services to everyone who needs them, regardless of age, ability to pay, or any other factor. A. Free enterprise B. Universal coverage C. Communal taxation D. The U.S.

B. Universal coverage

3. A landmark study suggests that doctors typically interrupt patients' initial explanation of their concerns after about: A. 2 minutes B. 1 minute C. 18 seconds D. Never. Doctors don't interrupt.

C. 18 seconds

10. All of the following are considered to be potential disadvantages of managed care EXCEPT: A. Medical records are less private than in former medical systems. B. Caregivers may be tempted to undertreat patients to save money. C. Gag rules prevent patients from talking to attorneys about their care. D. Managed care requires a great deal of paperwork.

C. Gag rules prevent patients from talking to attorneys about their care.

10. The number of jobs in the health care industry is expected to: A. Decrease slightly, although opportunities will still be available B. Decrease until the year 2022 and then increase sharply as the first baby boomers reach age 70 C. Increase dramatically between 2012 and 2022 D. Stay about the same

C. Increase dramatically between 2012 and 2022

5. Which of the following best describes the Voice of Lifeworld? A. It is usually focused on specific details. B. We learn to speak it gradually as we become accustomed to medical settings. C. It is typically focused more on feelings than on evidence. D. Health professionals are usually more adept at it than patients are.

C. It is typically focused more on feelings than on evidence.

10. Experts suggest which of the following communication strategies for encouraging patients to speak openly about their feelings? A. Use highly focused questions. B. Ask patients to speak quickly. C. Listen for distress markers. D. Make it clear who is the boss.

C. Listen for distress markers.

7. The model of collaborative interpretation relies on all of the following factors EXCEPT: A. Patients must be willing to take an active role in health care transactions. B. Caregivers must treat patients like partners involved in a cooperative process. C. Patients and caregivers must agree that physicians are more capable of making medical decisions than patients are. D. Environments and procedures should encourage both patients' and professionals' input.

C. Patients and caregivers must agree that physicians are more capable of making medical decisions than patients are.

12. Which of the following is most true based on research described in your textbook? A. Most doctors allow patients to talk for about 5 minutes and then the doctors take over. B. Physicians could use more training on how to limit patient's lengthy disclosures. C. Physicians have traditionally done most of the talking in medical encounters. D. Patients usually talk more than doctors do.

C. Physicians have traditionally done most of the talking in medical encounters.

15. After a therapy session, Chuy can barely sleep because he is in so much pain. But rather than say something to his therapist, Chuy continues to go along with whatever instructions he is given. This is a good example of the: A. Tyranny of the urgent B. Elasticity model of patient compliance C. Rhetoric of passivity D. Communication anxiety theory

C. Rhetoric of passivity

10. All of the following are tips for avoiding or minimizing transgressions EXCEPT: A. Take stock of personal needs and social expectations. B. Establish clear boundaries for talk and touch. C. Send ambiguous messages. D. Seek the counsel of friends and coworkers.

C. Send ambiguous messages.

7. According to Kathy Charmaz's stages of identity management, what stages do people with chronic illnesses usually experience? A. Denial, anger, acceptance, coping, redefined self B. Precontemplation, contemplation, decision-making, acting C. Supernormal identity, restored self, contingent personal identity, salvaged self D. Denial, resentment, soul searching, return to previous self

C. Supernormal identity, restored self, contingent personal identity, salvaged self

12. In the Willie King story described in your book, a Tampa surgeon amputated the wrong leg because: A. The doctor refused to believe what the nurses were telling him. B. The patient was confused and indicated the wrong leg to the health care team. C. The leg was listed incorrectly on the surgery schedule and draped for surgery before the doctor entered the operating room. D. The doctor read the chart wrong.

C. The leg was listed incorrectly on the surgery schedule and draped for surgery before the doctor entered the operating room.

12. Patricia is frustrated when her client's family members refuse to help with at-home treatment. She would like to give them a piece of her mind, but she realizes that alienating the family would be a bad idea since both she and her client need the family members' help. The idea that we construct meaning in a process of ongoing, reciprocal influence is best described as: A. The sociobiological perspective B. Social exchange theory C. The transactional model of communication D. All of the above

C. The transactional model of communication

17. Which of the following best illustrates the idea that meaning is shared—that is, it exists in participants' mutual interpretations? A. The sonographer seeks to put a patient at ease by saying, "I'll be right here." The patient smiles in gratitude. B. The doctor correctly concludes that her assistant is worried based on the assistant's worried expression. C. A therapist who has known a particular patient for a long time says "Not you again!" when the patient walks in. Both laugh. D. All of the above

D. All of the above

5. Research shows that, compared with their patients, physicians typically more during medical interactions. A. Talk B. Ask questions C. Interrupt D. All of the above

D. All of the above

9. Which of the following is a form of health communication? A. An exam room conversation between a patient and a caregiver B. Instructions on a medical bottle C. Two friends talking about the way to cure hay fever D. All of the above

D. All of the above

11. Several of your coworkers are disappointed when they are appointed to interdisciplinary teams because they believe the teams will take too much time. However, you are able to point out that interdisciplinary teamwork presents one or more of the following advantages: A. It helps reduces costly oversights and duplications B. It helps people see the larger picture C. It stimulates specialization D. Both A and B

D. Both A and B

4. All of the following are required by informed consent laws EXCEPT: A. Patients must be informed about treatment risks, benefits, and options. B. Patients must be deemed capable of understanding the information provided to them. C. Patients must be informed that they can cease medical treatments if they wish. D. Patients who consent to medical treatments waive their right to sue for malpractice.

D. Patients who consent to medical treatments waive their right to sue for malpractice.

9. The difference between an HMO and a PPO is: A. Patients who are members of a PPO have less opportunity to choose their own caregivers than do members of an HMO. B. HMOs are affected by managed care, whereas PPOs are not. C. HMOs are usually managed by physicians, whereas PPOs are usually managed by health care administrators and business graduates. D. Physicians and other caregivers work directly for an HMO, whereas they maintain their own offices as affiliates of a PPO.

D. Physicians and other caregivers work directly for an HMO, whereas they maintain their own offices as affiliates of a PPO.

2. Dr. Brown feels that the patient might be unable to cope with the news that she is dying. Traditionally, doctors were allowed to withhold information if they felt that disclosing the information would make the situation worse. What is this called? A. Physician reticence B. Medical modicum C. The Safe Secret Rule D. Therapeutic privilege

D. Therapeutic privilege

11. You thought Ms. Patterson would not be upset to hear that her niece was in the hospital. But as you began to tell her, you could tell she was distraught, so you moved closer and gave her some time to react to the news. The principle of communication that says that communicators exert mutual influence on each other such that the way one behaves suggests how the other should behave is called: A. Codependence B. Relativity C. The Principle of Reactivity D. Transaction

D. Transaction

Open-ended Questions

• Questions that can't be answered by "yes/no" or one-word answers -people to answer more fully and more honestly. -• Designed to be intriguing