Monday 28 January 2013

Usmle Step 1 MCQ’s # 49

Title: Usmle Step 1 MCQ’s # 49
Subject: Behavioral Science

Q NO 49: A 50-year-old woman presents for a follow-up visit alter being diagnosed with diabetes one month ago. At that visit, her physician verbally requested that she have some labs drawn before today’s appointment. The patient did not remember to have the labs drawn. Which of the following would be most likely to improve the patient’s compliance?

A. Ask the patient to make a behavioral change in addition to the laboratory work
B. Provide the patient with a written laboratory request with clear instructions
C. Peter the patient to a physician with expertise in “difficult patients”
D. Repeat the lab requests lowly and more loudly
E. Show photographs of patients who had an amputation due to uncontrolled diabetes

Explanation:
The correct answer is B. Providing written diagnostic and treatment recommendations, including requests for labs has been shown to increase compliance. Many patients become anxious and ire less likely to remember and follow verbal recommendations, particularly when receiving difficult news.
Compliance is increased with simple clear instructions, and instituting a behavioral change (choice A) will overwhelm the patient. It is best to institute one behavioral change t a time.
Referral to another physician (choice C) is not the plan of choice except under extreme circumstances (not in a case such as this), and is likely to distress the patient.
Repeating i verbal instruction (choice D) does not facilitate compliance and may increase noncompliance and frustration on the part of both patient and physician.
Scaring or intimidating patients (choice E) is not recommended to increase compliance and could also have i negative impact on the physician-patient relationship.

Source: http://www.usmleworldwide.com/blog/?p=1234

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