18 Oct Which of the following changes are expected in vision as part of the normal aging process?

Which of the following changes are expected in vision as part of the normal aging process?

 

Cataracts

 

Glaucoma

 

Macular Degeneration

 

Blurring of near vision

 

•             A light is pointed at a patient’s pupil, which contracts. It is also noted that the other pupil contracts as well, though it is not exposed to bright light. Which of the following terms describes this latter phenomenon?

 

Direct reaction

 

Consensual reaction

 

Near reaction

 

Accommodation

 

•             A patient complains of knee pain on your arrival in the room. What should your first sentence be after greeting the patient?

 

How much pain are you having?

 

Have you injured this knee in the past?

 

When did this first occur?

 

Could you please describe what happened?

 

•             Mrs. T. presents for her regular visit to the clinic. She is on your schedule because her regular provider is on vacation and she wanted to be seen. You have heard about her many times from your colleague and are aware that she is a very talkative person. Which of the following is a helpful technique to improve the quality of the interview for both the provider and the patient?

 

Allow the patient to speak uninterrupted for the duration of the appointment.

 

Briefly summarize what you heard from the patient in the first 5 minutes and then try to have her focus on one aspect of what she told you.

 

Set the time limit at the beginning of the interview and stick with it, no matter what occurs in the course of the interview.

 

Allow your impatience to show so that the patient picks up on your nonverbal cue that the appointment needs to end.

 

•             The following information is recorded in the health history: “The patient has had abdominal pain for 1 week. The pain lasts for 30 minutes at a time; it comes and goes. The severity is 7 to 9 on a scale of 1 to 10. It is accompanied by nausea and vomiting. It is located in the mid-epigastric area.” To which of these categories does it belong?

 

Chief complaint

 

Present illness

 

Personal and social history

 

Review of systems

 

•             Is the following information subjective or objective?

 

Mr. M. has a respiratory rate of 32 and a pulse rate of 120.

 

Subjective

 

Objective

 

•             A patient is assigned a visual acuity of 20/100 in her left eye. Which of the following is true?

 

She obtains a 20% correct score at 100 feet.

 

She can accurately name 20% of the letters at 20 feet.

 

She can see at 20 feet what a normal person could see at 100 feet.

 

She can see at 100 feet what a normal person could see at 20 feet.

 

•             Ms. Whiting is a 68-year-old who presents in for her usual follow-up visit. You notice a few flat, red, and purple lesions, about 6 centimeters in diameter, on the ulnar aspect of her forearms but nowhere else. She doesn’t mention them. They are tender when you examine them. What should you do?

 

Conclude that these are lesions she has had for a long time.

 

Wait for her to mention them before asking further questions.

 

Ask how she acquired them.

 

Conduct the visit as usual for the patient.

 

•             Mrs. R. is a 92-year-old retired teacher who presents to your clinic accompanied by her daughter. You ask Mrs. R. why she came to your clinic today. She looks at her daughter and doesn’t say anything in response to your question. This is an example of which type of challenging patient?

 

Talkative patient

 

Angry patient

 

Silent patient

 

Hearing-impaired patient

 

•             You have just asked a patient how he feels about his emphysema. He becomes silent, folds his arms across his chest, leans back in his chair, and then replies, “It is what it is.” How should you respond?

 

 “You seem bothered by this question.”

 

“Next, I would like to talk with you about your smoking habit.”

 

“Okay, let’s move on to your other problems.”

 

“You have adopted a practical attitude toward your problem.”