Deck 3: Therapeutic Communications

Question 1

Without proper terminology and verbal communications skills, the receiver will be unable to ________ the message.

A) decode
B) resend
C) encode
D) receive

Answer 1

decode

Question 2

When you detect an inconsistency in a patient's story, which of the following techniques should you use?

A) Clarification
B) Interpretation
C) Confrontation
D) Facilitation

Answer 2

Confrontation

Question 3

Which of the following actions can you take to establish rapport with a patient early in the interview?

A) Ask as many questions as possible.
B) Maintain control of the interview at all times.
C) Respond to her condition with empathy.
D) Do not show emotion.

Answer 3

Respond to her condition with empathy.

Question 4

Which of the following statements regarding effective history taking is TRUE?

A) Use a combination of open- and closed-ended questions.
B) Never ask potentially embarrassing questions.
C) Always use open-ended questions.
D) Always use closed questions.

Question 5

Which of the following qualities should characterize your verbal interaction with a patient when obtaining the history?

A) Speak softly.
B) Speak loudly.
C) Use a calm, reassuring voice.
D) Demand the patient's attention.

Question 6

When you ask your patient questions to eliminated confusion, you are using the technique called:

A) reflection.
B) interpretation.
C) facilitation.
D) clarification.

Question 7

Which of the following establishes the foundation for gathering good information?

A) Using active listening
B) Providing appropriate reassurance
C) Asking only open-ended questions
D) Using common sense

Question 8

The history begins with an open-ended question about your patient's:

A) general health.
B) chief complaint.
C) severity of symptoms.
D) past medical history.

Question 9

Part of active listening includes maintaining eye contact and using appropriate gestures in a process known as:

A) articulation.
B) facilitation.
C) formulation.
D) reflection.

Question 10

The active listening technique of reflection involves:

A) repeating the patient's words back to him to check for understanding.
B) confronting the patient if you feel he is hiding something relevant.
C) not allowing the patient to stray from the current problem.
D) asking closed-ended questions to keep the patient on track.

Question 11

Which of the following statements can show your empathy toward the patient?

A) "What is your name?"
B) "You say that your chest doesn't hurt, but you keep rubbing it."
C) "Are you sure that you take a diuretic?"
D) "That must have been very difficult."

Question 12

All of the following encourage patient communication EXCEPT:

A) using medical jargon.
B) asking the patient for clarification.
C) maintaining eye contact.
D) listening closely to everything the patient says.

Question 13

Which of the following statements regarding patient communication is TRUE?

A) Avoid using interpreters.
B) Use language appropriate to the patient's level of understanding.
C) Cultural differences make no difference in professional communication.
D) Use medical terminology to keep things on a professional level.

Question 14

Which of the following actions would you take if confronted with a patient who is silent?

A) Assume that the patient is uncooperative.
B) Assume that the reason is emotional.
C) Encourage the patient to speak.
D) Stay silent to show empathy.

Question 15

When asking about a patient's health status, you should ask about all of the following EXCEPT:

A) religious beliefs.
B) use of tobacco.
C) immunizations.
D) surgeries or hospitalizations.

Question 16

Which of the following is an example of a closed question?

A) "What is your medical history?"
B) "Do you have any medical history?"
C) "What were you doing when the pain began?"
D) "How would you describe your discomfort?"

Question 17

Which of the following questions gathers information about a patient's current health status?

A) "Where does the pain go?"
B) "Do you also feel nauseous?"
C) "When did you have your appendix removed?"
D) "How many cigarettes do you smoke a day?"

Question 18

Encouraging your patient with your body language to provide more information is called:

A) interpretation.
B) clarification.
C) reflection.
D) facilitation.

Question 19

Which of the following is a challenge to your ability to solicit patient information?

A) Complaints of multiple symptoms
B) Patient's level of cognitive functioning
C) Intoxication
D) All of the above

Question 20

Which of the following nonverbal cues demonstrates your sincerity to the patient?

A) Offering a comforting touch or shaking the patient's hand
B) Averting your gaze to avoid making the patient uncomfortable
C) Touching a patient, even though he may appear uncomfortable being touched
D) Maintaining a distance of 4 to 6 feet from the patient

Question 21

Your partner has just asked Mrs. Jones, "Why didn't you call your physician's office for a prescription refill instead of calling 911?" This illustrates:

A) closed questioning.
B) empathetic communication.
C) an appearance of blaming the patient.
D) an attempt to educate the patient.

Question 22

"Public distance" refers to a space of how many feet between people?

A) 2 to 3
B) 3 to 6
C) 4 to 12
D) 12 or more

Question 23

"Social distance" is a distance of ________ feet between people.

A) 2 to 3
B) 3 to 6
C) 4 to 12
D) 12 or more

Question 24

Echoing a patient's message back to him in your own words is a technique known as:

A) explanation.
B) facilitation.
C) reflection.
D) clarification.

Question 25

En route to the hospital, your patient says, "You know, I haven't had a date since my spouse died six years ago. Why don't you take down my phone number and call me?" Which of the following is an appropriate response?

A) "I'm sure you understand my situation. I'm here to provide you with medical care and transportation to the hospital. It isn't proper for me to have anything but a professional relationship with you."
B) "That is an inappropriate request, and I expect that you'll not make any further suggestions that we might become personally involved."
C) "It isn't that I don't find you attractive; I certainly do, but it isn't proper for me to have a personal relationship with a patient."
D) "I can't call you because of professional ethics, but my phone number is listed in the book."

Question 26

Which of the following questions would provide the best quality and quantity of relevant information?

A) "What time do you normally eat breakfast?"
B) "When was the last time you had anything to eat or drink?"
C) "What have you had to eat and drink today?"
D) "Have you had breakfast?"

Question 27

When interviewing patients from cultures other than our own, it is difficult for us to avoid interpreting the situation from the viewpoint of our own culture. This is known as:

A) cultural imposition.
B) racism.
C) anthropomorphism.
D) ethnocentrism.

Question 28

Which of the following body positions best communicates that you care about your patient's problems?

A) Getting as close to the patient as physically possible
B) Maintaining a distance of 4 to 6 feet
C) Standing next to where the patient is sitting or lying down
D) Sitting next to the patient

Question 29

What questioning style used by the paramedic has the tendency to guide the patient's answers?

A) Distracting
B) Leading
C) Closed
D) Open-ended

Question 30

You are caring for a sick five-year-old child in the emergency department. The ED physician has ordered some intravenous medication to stop the child from vomiting. Which of the following is the best way to approach the child with the issue of starting an IV?

A) "I'm going to give you some medicine in your arm to help you stop throwing up. If you're a good boy and hold really still, it's not going to hurt a bit."
B) "I'm going to give you some medicine to help you stop throwing up, but the medicine has to go through a tube and into your arm. So it's going to feel like you're getting a shot, but it will just take a second, and then the medicine will make you feel better."
C) "I'm going to start an IV in your arm so I can give you some Phenergan for your nausea and vomiting. Be a big boy and don't cry, okay?"
D) Say nothing about the procedure. Once you have everything set up, tell the child, "Let me see your arm," then quickly perform the procedure.

Question 31

When in a situation requiring an interpreter, it is important to:

A) focus only on the current problem, not the medical history.
B) look at the interpreter, not the patient.
C) ask only one question at a time.
D) only use family members to interpret.

Question 32

All of the following actions can help make taking a history on a sensitive subject easier EXCEPT:

A) attending a lecture or seminar on these sensitive subjects to learn more about them.
B) using euphemisms and metaphors to ask embarrassing questions.
C) asking some opening question to these subjects as practice.
D) observing experienced clinicians ask these types of questions.

Question 33

Which of the following is the best way to address your patient?

A) Stay neutral; do not use the patient's name.
B) Ask the patient what he would like to be called.
C) Avoid using the patient's name by using terms such as "dude" or "partner."
D) Always use formal titles such as "Mr. Orphey."

Question 34

Which of the following is an example of an open-ended question?

A) "Does your pain radiate to the shoulder?"
B) "Where do you hurt?"
C) "Do you have any allergies to medicine?"
D) "Do you take high blood pressure medicine?"

Question 35

Which of the following statements does NOT accurately describe depression?

A) It is a common medical problem.
B) It is commonly misdiagnosed or ignored.
C) It often presents with insomnia and physical complaints.
D) It is seldom lethal.

Question 36

When questioning a teenage female patient complaining of abdominal pain, you should:

A) avoid direct questions about possible pregnancy.
B) get the parents' consent to ask her about possible pregnancy.
C) question her in private.
D) question her in the presence of the mother, but not the father.

Question 37

Which of the following may result in a failure of communication between a paramedic and a patient?

A) External distractions
B) Prejudice
C) Lack of privacy
D) All of the above

Question 38

"Please tell me about your abdominal pain" is an example of a(n) ________ question.

A) closed
B) distracting
C) open-ended
D) leading

Question 39

An "intimate zone" reflects about how many feet between two people?

A) 0 to 1.5
B) 1.5 to 2
C) 2 to 2.5
D) 2.5 to 3

Question 40

You have overheard a hospital technician in the emergency department talking with a patient who has pancreatic cancer. The technician said, "Don't worry; everything will be all right." This is an example of:

A) distraction.
B) false reassurance.
C) empathy.
D) lack of concern.

Question 41

A five-year-old child is introduced to you as Robert Smith. The proper way for you to address him is:

A) "Hey, little guy!"
B) "Hi, Bobby."
C) "Hello, Mr. Smith."
D) "Hi, Robert."

Question 42

Which of the following responses most clearly illustrates the feedback technique of confrontation?

A) "A number of things can cause vomiting. We don't have enough information yet to determine what might be the cause in your situation."
B) "I'm not sure I understand what you mean by 'feeling sick.'"
C) "So first you vomited, then you began having abdominal pain?"
D) "You said you aren't having any pain, but I notice you keep holding your stomach."

Question 43

Upon questioning your patient about whether he has been feeling any particular stress lately, he asks, "Do you think I'll have to wait very long in the emergency department?" This is most illustrative of:

A) confrontation.
B) using avoidance language.
C) distancing.
D) overuse of professional jargon.

Question 44

Which of the following nonverbal behaviors is likely to help you establish trust and rapport with a patient?

A) Using medical terminology to establish your professionalism
B) Assuring the patient that now that the ambulance is here everything is going to be okay
C) Using an authoritarian tone of voice when addressing the patient
D) Walking briskly to the patient without rushing or running

Question 45

You are called to a scene at which a pedestrian has fallen on the sidewalk. When you arrive, the man is sitting up and appears alert and responsive. However, as you attempt to start your interview in your normal manner, you note that he is reluctant to speak with you. How should you proceed?

A) Try to develop rapport by reviewing the reason you were dispatched on the call.
B) Call the medical direction physician and allow the patient to speak to him or her.
C) Confront the patient with your inability to help him if he does not tell you what is going on.
D) Ask the patient to sign a refusal of treatment and transport form.

Question 46

When you are taking a history, which of the following should typically drive the evolution of the questions asked of a patient after the first question?

A) Patient's medical history
B) Information from the patient's family
C) Patient's list of medications
D) Patient's chief complaint

Question 47

Which of the following responses illustrates the feedback technique of facilitation?

A) "You said you weren't having any pain, but I see you're trying not to use your right arm."
B) "I see. What happened after that?"
C) "I'm not sure I understand. What do you mean when you say, 'It's a hard pain?'"
D) "So you got up to go to the bathroom and tripped over something in the hallway?"