Back of the book questions

The LEARN acronym is a useful tool for treating patients from diverse backgrounds. What does the "A" stand for?

Acknowledge and discuss differences and similarities.

Language is an unavoidable barrier for many patients in the U.S. What role do ad hoc interpreters play in bridging the language gap?

Ad hoc interpreters may be helpful, but they lack the clinical foundation and experience of trained medical interpreters.

Women from which of the following groups are least likely to perceive themselves as overweight?

African American.

Which of the following groups are not required to fast during Ramadan, a major Muslim religious observance?

Anyone who is sick.

Which of the following questions may help identify social factors that would impact a patient's adherence?

Aside from your health, what else in your life is worrying you?

How should health professionals respond to the widened definitions of prediabetes and diabetes by the World Health Organization, the American Diabetes Association, and other organizations?

Assist patients in identifying evidence-based health care resources.

Which of the following is the best approach when referring a Mexican patient with type 2 diabetes to a dietitian for medical nutrition therapy?

Attempt to identify a bilingual dietitian familiar with the Mexican diet.

Patients who are very deferential toward physicians may respond in which of the following ways when prescribed medication?

Avoid asking about side effects

When encountering patients with misconceptions regarding insulin therapy for diabetes, how should the physician respond?

Clarify the role of insulin by highlighting cause and effect.

Many Latino patients incorrectly associate diabetes with which of the following symptoms?

Depression.

Which of the following statements is true about the nature of acculturation?

Differing patterns within families may lead to intergenerational conflict.

How might the perspectives of financially secure patients with respect to end-of-life care differ from those of disadvantaged patients?

Disadvantaged patients may interpret end-of-life care as an attempt to deny essential treatments.

How should physicians treat patients who they suspect are incapable of keeping follow-up appointments?

Discuss the importance of personal responsibility before administering follow-up care.

ETHNIC

E: Explanation T: Treatment H: Healers N: Negotiate I: Intervention C: Collaboration

Which of the following statements best describes the importance of addressing a patient's anger during an office visit?

Enhances the physician's alliance with the patient.

What approach should physicians use in taking care of uncooperative, self-abusing, or disruptive patients from a low socioeconomic group?

Ensure that personal biases do not taint clinical judgment.

Direct observed treatment (DOT) is the appropriate treatment for patients with multi-drug-resistant tuberculosis. What is the best approach for physicians to initially take when a patient requires DOT?

Ensure the patient understands the diagnosis, the importance of the treatment, and how this will impact his/her life.

Which of the following statements is correct regarding family and friends influence on a patients medication choices?

Family and friends may offer medical advice that contradicts the physician advice

Among Latino patients with diabetes, which of the following factors is most important in determining adherence to medication and instilling self-confidence?

Family support.

Which of the following is most likely to improve a patient's adherence to taking medications?

Having continuity of care during office visits

Which of the following groups describes the majority of users of complementary and alternative medicine in the U.S.?

Highly educated Caucasians.

Which of the following is likely to be an important benefit of exploring a patient's explanatory model of Illness?

Improved patient adherence and increased understanding of the patients perspective

Which of the following physician barriers can affect a patient's adherence?

Inadequate explanation of instructions.

Which of the following health care system barriers can affect a patient's adherence?

Inadequate health insurance.

Poor adherence results in which of the following outcomes?

Increased patient morbidities and mortalities.

ETHNIC is a framework for culturally competent clinical practice. Which of the following choices is not a component of this acronym?

Interpretation

Which of the following questions is taken from the "Treatment components of the ETHNIC acronym?

Is there anything you eat, drink, or do on a regular basis to stay healthy

In what context is it appropriate to use pejorative phrases when describing patients?

It is never acceptable to use pejorative phrases to describe patients.

From which of the following ethnic backgrounds are patients most likely to change their diet after being diagnosed with a health problem by their physician?

Latino/Hispanic.

Which of the following is an effective approach to prescribing medications for patients from diverse cultural backgrounds?

Learn about culturally relevant medicinal practices of patients before prescribing medications

Health disparities have been shown to exist in regard to organ transplantation. African American and Hispanic patients may encounter which of the following compared with their non-Hispanic white counterparts?

Lower rates of graft survival after receiving an organ transplant.

Which of the following services would be especially helpful for terminally ill Muslim patients?

Negotiating a plan for outside visitors, especially the Imam.

When communicating with a Muslim patient about end-of-life issues, which of the following statements best shows respect and mindfulness about Muslim beliefs?

No one knows when, where, or how someone will die.

When is it appropriate to ask a Muslim patient about his/her sexual activity?

Only in a sensitive manner when it is relevant to the care of the patient.

Physicians encounter many patients who may be unaccustomed to the U.S. health care system. How can physicians effectively take care of patients from diverse backgrounds?

Physicians should emphasize good communication in combination with understanding a patient's cultural context.

How should physicians respond to working professionals, in comparison to unemployed or low-income patients?

Physicians should promote patients' health regardless of their socioeconomic status.

A trusting physician-patient relationship is a key factor in improving patient adherence to prescribed medications. Which of the following might discourage a patient from taking his/her medications?

Prescribing complex treatments.

How should physicians and office staff respond to patients who chronically miss appointments?

Speak directly to the patient about the missed appointments.

Which of the following factors may contribute to the higher mortality rates seen in the homeless population?

Suboptimal access to health care.

Which of the following approaches is most effective in helping patients with type 2 diabetes to lose weight?

Suggest substituting healthy ingredients for meals and snacks based on the patient's cultural heritage and personal preferences.

How should physicians approach patients with type 2 diabetes patients who also regularly visit holistic healers (curanderos)?

Take a history of alternative medicines used by patients to avoid herb-drug interactions.

When employing a trained medical interpreter, which of the following is the ideal sitting position relative to the doctor and the patient?

The interpreter should sit next to, and slightly behind the patient and avoid eye contact with the physician.

Why might an immigrant patient be reluctant to participate in DOT?

The patient may be fearful because of the loss of privacy or cultural misunderstanding.

Physicians who provide pharmaceutical samples in their offices should be aware of which of the following statements?

There may be a significant price difference between samples and the generic version of the medication.

Which of the following skills do trained medical interpreters provide in the clinical setting?

They are generally proficient in explaining clinical terminology to patients in an understandable cultural context and with limited distortion.

When approaching patients about their use of complementary and alternative medicine (CAM), what is the physician's primary objective?

To promote the patient's adherence to prescribed medication in addition to CAM.

Moxibustion (or moxa), through heat generated by the burning of mugwort (a spongy herb), is used by traditional Chinese practitioners to treat many conditions. Which of the following Western treatments is most likely to be impacted by concurrent moxibustion?

Topical medications.

Assimilationists (relinquish their older culture for their new culture), separationists (hold tightly to their cultural values), and integrationists (maintain both cultures) characterize which model of acculturation?

Unidimensional. - "Zero-scum scheme model" ------- which individuals adopting host culture values and behaviors simultaneously discard or relinquish those of their native culture

When a patient expresses anger about a physician's colleague, which of the following statements would be the most appropriate response?

What concerns do you have about how you were treated?

Which of the following questions can be used to initiate the process of "LEARNing?"

What do you think your sickness does to you?

Which of the following questions is most effective in identifying a patient's ethnicity?

What ethnic identity best describes you?

Which of the following questions is an effective way to elicit a Patient's explanatory model of illness regarding tuberculosis symptoms?

What is your understanding of tuberculosis?

Under what conditions is the DOT program most successful?

When DOT is carried out in a way that is convenient for a patient to enable completion of the recommended therapy.

In Arab culture and Islam, which of the following parties may participate in medically related decisions for an adolescent patient?

a. Senior family members. b. The patient's father. c. The individual patient. ***d. All of the above.***

Which of the following factors might lead the parents of a Muslim or Arab adolescent patient to initially delay or refuse chemotherapy?

c. Desire to consult with extended family members and/or Imam first.

How should a health professional approach a colleague about his/her culturally insensitive behavior or remarks?

d. He/She should speak honestly, but respectfully, to the col- league.

When preparing to examine a Muslim woman or girl, it is appropriate to request that she do which of the following?

d. Remove her clothes, keeping on the hijab if she prefers, and put on a gown and drape.

Prior to the physical examination of a Muslim adolescent patient, which of the following statements should be clarified to the patient and his/her parent?

d. They can express concerns about any part of the exam at any time.