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vtt113 exam 2
| Question | Answer |
|---|---|
| A cat is scheduled for surgery. How many days before the scheduled procedure is it most appropriate to call to remind the client of the appointment and any presurgical protocols to follow? | 1 |
| Which of the following is best defined as the number or percentage of clients that accept recommendations made by the veterinary healthcare team? a. Client adaptation b. Client retention c. Client compliance d. Client etiquette | Client compliance |
| Good letter from vet practice is likely of which following characteristics? a. Sparse & encourage recipient to call for further details b. Short, states facts in unembellished fashion c. Short & curt d. Fully embellish details & include historic facts | Short, states facts in unembellished fashion |
| A practice owner wants an effective means of training all employees to give the same answers to frequently asked client questions. What is most appropriate method to employ? | Develop a client service manual and give it to all employees. |
| Of complaints that vet clients file w/ state vet boards, which is the most common topic? a. Blatant price gouging b. Inappropriate health information dispensed c. Inaccurate estimates d. Lack of appropriate follow-up care e. Aggressive advertising | Inaccurate estimates |
| Why do clients need sign estimate? a. Confirm $ responsible of estimate only b. Denote agree to procedure only c. Agree animal is tx'ed as rec'd d. Denote agree procedure & confirm $ responsible of charge e. Denote agree procedure- done as rec'd | Denote agree procedure & confirm $ responsible of charge |
| Effective client education is most likely to engender which of the following? a. Better health care for the animals treated b. Client compliance c. Greater profitability for the practice d. Client retention e. Client referrals | Client compliance |
| What is the most appropriate way for a practice owner to gauge how satisfied clients are with the services being offered by the practice? | Administer a client survey. |
| A client quietly brings to the practice manager’s attention an incident that occurred with a veterinary assistant. What is the most appropriate initial response to give the client? | Repeat back to the client the information as it was stated to make it clear that it was understood |
| Of the three components of message delivery, which plays a key role in client education, trust, and compliance? | Nonverbal |
| Practice owner wants build thriving practice. Which should be top training priority for staff development? a. Understand personality types b. Reviewing the office procedures manual c. Team member confidence d. Role-playing handling difficult clients | Team member confidence |
| Customer satisfaction is most likely to lead to which of the following? a. Improved client retention b. Greater client compliance c. Higher net profits d. Healthier patients e. Improved client education | Improved client retention |
| To effectively assist grieving clients, the veterinary technician is most effective when he or she does what? | educates and reassures the clients that their feelings are normal. |
| Dr. Kübler-Ross describes the grief process as consisting of which five stages? | Denial, bargaining, anger, depression, and resolution |
| When working through the grief process, a. the five stages outlined always proceed in the same order. b. each stage takes an equal amount of time. c. each stage is experienced only once. d. None are correct | None are correct |
| After client is given pet's diagnosis and told the prognosis is poor, client may enter a stage of denial, often reflected by the client asking seemingly inappropriate questions. When a client is experiencing denial, it is important to keep in mind what? | clients will often begin to process the seriousness of the situation only after arriving home, and may call the clinic with important questions |
| ___________ occurs when the patient or client suffers during the dying process, due to unexpected occurrences. | Dysthanasia |
| When confronted with client in anger stage of grief process, it's important for vet professional to a. take mental step back & deep breath. b. take nondefensive attitude. c. allow client time to voice his/her anger by just listening. d. All correct | All correct |
| When dealing w/client who is grieving over loss of pet, it's important for vet techs to a. separate feelings from those of clients. b. advise client to get new pet as soon as possible. c. explain to client that anger isn't useful. d. All are correct | separate feelings from those of clients. |
| While discussing euthanasia with a client, the veterinary professional should do what? | should avoid using the phrases put to sleep or put away. |
| During process of euthanasia, often reflex actions occur. Client should be warned beforehand all of following are reflex actions, not signs of pain or distress, and might happen except a. urination. b. defecation. c. closing of the eyes. d. twitching | closing of the eyes. |
| Why are vet pros often important support when client's pet dies? a. Because they understand role pet played in clients' life b. Because client isn't embarrassed by grief over animal c. Because they understand stages of grief process d. All correct | All correct |
| Many factors complicate grief process, important for CVT to lookout for each. Which doesn't complicate grief process? a. Vet team supports client/pet b. Multiple loss within time frame c. Loss of pet on special day (bday) d. Witness violent pet death | Vet team supports client/pet |
| Which is the most common drug used to euthanize companion animals? | Sodium pentobarbital |
| What best describes the primary purpose of a patient medical record? | Provide a historical account of a patient’s healthcare |
| Bc medical records maybe used as evidence in malpractice suit, what's best to include? | Copy of any written communication between the practice and the client |
| An illegible and incomplete medical record can be viewed by a court of law as what? | Admission of professional incompetence |
| A veterinary technician makes an error on a medical record. What is the most appropriate way for the technician to correct it? | Strike out the error with one line, make the correction, and place his/her initials next to it |
| A good medical record filing system organizes the files by what system? | Alphabetically by clients’ last names or by client numbers |
| What is the most appropriate way for the clinic staff to organize the medical records of a client with numerous pets? | All in one client file but separated by tabs denoting each pet’s name |
| What is an ideal way to call team members’ attention to a special note in a medical record? | Place a color-coded sticker on the record. |
| A client who is contemplating buying a cat from a neighbor, who also happens to be a client of the practice, calls to ask if the practice will provide a copy of the medical records for the cat. What is the most appropriate response? | “The client from whom you will buy the cat will have to come in to sign a release form.” |
| A client calls a practice to request the medical records for a cat that has recently been diagnosed with asthma and that will be taken to a veterinary specialist. What is the most appropriate response? | “We will be happy to send copies of the records to the specialist.” |
| Every patient of a practice must have a medical record that is legible, well organized, and complete. What is an additional criterion? | record is easily retrievable |
| 14yr F mix K9 seen by St. is brought in. VA know pt for WEs apprx. 2/yr. VA check record & dial O's H phone #, D/C. Rem C work @ store, reach C. Abt D/C #, C hasn't lived there for 2 yrs. Besides update record w/C’s new phone #, what's appropriate CoA? | Reiterate to the staff that client contact information should be verified at every client visit. |
| What is the name of a summary sheet that includes patient name, gender, species, breed, age, diet, allergies, vaccinations, and current medications? | Master problem sheet |
| The veterinarian is monitoring a patient for Cushing’s disease. What document would be particularly helpful to review? | Diagnostic flow sheet |
| What is the most commonly used format for medical records? | Problem-oriented medical records |
| For SOAP form, which for inclusion in S sect of POMR? A- Antifungal med given tx of fungal infect, B- O report pt lethargic/not eating well, C- Respiration abnormal, D- Ortho analysis show slight limp in L pelvic limb E- Labs indicate marked hypocalcemia | O report pt lethargic/not eating well |
| For SOAP form, which inclusion in A sect of POMR? a. Dr. check flock; note sev birds die unex. night; b. F rep. poor milk letdown in 5 cows; c. C has abx rx for tx dog’s bactPN; d. Pt's hind FL reflex ltd; e. W/ R/V (labs/clinic find), Dr det pt. has IL | W/ R/V (labs/clinic find), Dr det pt. has IL |
| For SOAP form, which inclusion in O sect of POMR? a. F rep. sev birds die unex night; b. F rep. poor milk letdown in 5 cows; c. C's E on LCD req care for OB dog; d. Palp of lump over R mand of pt elicit pain; e. W/R/V (lab/clin find), Dr dx pt's ADENOCA | Palp of lump over R mand of pt elicit pain |
| For SOAP form, which inclusion in P sect of POMR? a. Dog’s wound will undergo surg DEB; b. Vet dx'es cat w/ RF; c. Sheep F rep skin sloughing & excess wool shed in 25% of herd; d. Radiogrs of horse’s L pelvic limb shw bony growths; e. C req WE of ferret. | Dog’s wound will undergo surg DEB |
| What best describes an inactive medical record? a. has not been updated in past month b. has not been updated in past year c. a ct who has been sent to collections for a past due balance d. a pt who has moved to another state within past 6 mnths | has not been updated in the past year |
| Most states req that inactive medical records be held for at least 3-yr period. After 3 yrs, what's most appropriate way to discard inactive record? a. With the regular trash. b. With the regulated waste. c. Shred them d. Place them in a recycle bin. | Shred them. |
| Radiograph of pt should include vet hospital’s name & address, ct’s & pt’s names, and date radiograph was taken. What add. info is most appropriate to include? a. Suspected dx b. Left/right indicator c. Ct’s phone # d. Hospital’s hrs of operation | Left/right indicator |
| A vet has written following pharmacotherapy on medical record: 5mg diazepam PO. What does this mean in layman’s terms? | 5 milligrams of the drug diazepam given orally (by mouth) |
| A veterinarian has written the following pharmacotherapy on a medical record: sodium bicarbonate (2 mEq, IV). What does this mean in layman’s terms? | 2 milliequivalent of sodium bicarbonate given intravenously |
| What are three concepts of client leadership? | communication, service, grief |
| In client leadership, what does the vet team provide? | education, resources, expertise, appropriate treatments |
| When it comes to client leadership, vet team makes difficult decisions and are an advocate for the importance of what care? | preventative |
| Where does client communication occur? | happen in every area- front office, exam room |
| What is one of the most important aspects of client leadership that ensure clients fully understand procedure and are educated through various life stages? | client communication |
| What are some examples of written communication used in client leadership? | client education materials (sent home after every visit), postop instructions for surgical pts |
| What are the 3 parts to a message? | verbal, paraverbal, nonverbal |
| Verbal refers to what? | word choice |
| Paraverbal refers to what? | enunciation of words |
| Nonverbal refers to what? | body language |
| What are important aspects of verbal skills in client leadership? | communicate well, choose professional words ("vaccines" versus "shots"), avoid filler word ("um") |
| What are some paraverbal skills used in client communication? | lower deeper tones; tone of voice |
| Body language plays a part of nonverbal skills, what does this include? | body posture, hand gestures, facial expressions, eye contact |
| What body language generally indicates defensiveness and unwillingness to accept recommendations or advice? How do you improve this? | folded arms; hand client something to hold and make sure all client concerns are addressed |
| What body posture should you display to clients as a vet team member? | heads up, straight body posture, shoulders back |
| What is important to consider in email etiquette with a client? | keep it short, friendly, professional; make sure to address client by name, answer questions |
| What is the number or percentage of clients who accept recommendations made by the team? | client compliance |
| How can you increase client compliance? | client education materials, verbal/written communication, report cards/patient compliance check sheets can be used |
| What are some reminders that a vet clinic might send out? | vaccinations, examinations, testing |
| For a phone call, when do you call for reminder of appointment? | day before |
| What other reminders would you give a phone call for? | yearly exams, rescheduling appts |
| What should all clients be provided with before procedures/services, is a major part of communication, and failure to provide one is the most common client complaint? | estimate (treatment plan) |
| T/F: Vets should be left out of financial decisions. | true |
| When discussing treatment options, what is important to keep in mind? | teach, don't sell; discuss options w/confidence; use models/brochures; stand beside client not across from them |
| What is one of the most important aspects of vet med where an acceptable one must be met for every patient, and developed for all diseases & procedures? | standards of care |
| What is central to client compliance? | ensuring client understanding |
| What are some different methods you can use to teach clients? | visual aids, verbal communication, customized brochures, skeletal models and radiographs |
| What are the different communication styles and personalities that clients can have? | driver-oriented, analytic oriented, amiable oriented, expressive oriented |
| Clients want appreciation for what? | selecting practice, recommending new clients, care they are providing for pet |
| What is important to remember when handling client complaints? | handle appropriately, professionally, and quickly (do not become defensive, take client immediately to exam room, listen to what client says while maintaining eye contact, repeat what is said to ensure no miscommunication, offer solutions) |
| What can play a large role in client satisfaction? | client perception |
| What can happen when clients must wait an extended period? | client compliance drops |
| Small animal practices will lose what % of clients each year? | 10-15% |
| Goal for client retention is to retain what percent range of clients over a 3 year period? | 70-75% |
| What institute has done research that reinforces idea of pet as family member and there's mutual benefits of pet ownership/parenthood? | human-animal bond research institute |
| How will the techs and nurses help clients work through pet loss and grief? | expanded unit of care (must include pet's family), bond centered care (support bond between pet & pet-parent) |
| What are the problems compounded in vet med? | human-animal bond, animals' inability to communicate wishes, reluctance of many vet pros to trust/acknowledge the client's knowledge & intuition about pet needs |
| What is difference in medical versus bond-centered paradigm? | medical focused on diagnosis, treatment, prevention of disease; bond focused on comfort, meaning, support for patient/client in recognition of death inevitability |
| What are the core competencies of the International Association for Animal Hospice and Palliative Care? | education, medical care, advocacy |
| In the core competency of education a key component is no judgement; how do we establish this? | open-ended questions, generous listening (no impart knowledge/reassurance- JUST listen), empathy |
| When discussing euthanasia and natural death, what is important? | quality of life assessment, understand client wishes during procedure, educate client about euthanasia experience, offer if natural death is option |
| What are some things techs do when assisting with euthanasia? | place iv catheter, narrate process, manage patient during euthanasia |
| What are some things you can prepare for euthanasia to make it a more comforting experience? | potential home care, use of blankets/beds/absorbent pads, in the clinic setting designate a space as "comfort room" |
| How is a patient's body prepared for aftercare? | burial, transport to cremation facility, allow client time with body after death |
| What might memorialization tasks include? | paw prints, trim hair, any other special requests |
| What is the five freedoms plus one? | hunger & thirst, discomfort, disease/pain/injury, fear & distress, express normal behavior, to die a good death |
| Is there an absolute right time for euthanasia? | no, let pet make decision (client intuition) |
| A common method for euthanasia in small animals is non-inhalant pharmaceuticals such as what? | sodium pentobarbital, magnesium chloride, potassium chloride, intrathecal lidocaine |
| Two-step euthanasia preferred and consists of what prior to euthanasia? | pre-sedation, anesthesia |
| What is commonly used for pre-sedation in small animals? | alpha-2 agonist plus opioid (sometimes w/acepromazine) |
| What pre-sedation drug might be used for aggressive or dangerous dogs? | dormosedan gel |
| What term refers to patient or client suffering during dying process, unexpected occurrences, client may feel guilt/anger/fear? | dysthanasia |
| What are the three Cs that are important to euthanasia? | compassion, confidence, control |
| The human-animal bond does not end with death, client may experience what? | grief, mourning |
| What is a natural response to loss that has no distinction between loss of pet and human, where techs are equipped to provide unique profound kind of help? | grief |
| What is the act of grieving where there is not timeline or "getting over" loss? | mourning |
| What term describes the normal feeling when confronted by the thought of death and intensifies when faced with terminal diagnosis? | anticipatory grief |
| What are some emotional responses that are a part of grief? | sadness/loneliness, anger, guilt & shame, relief (early sign of resolution) |
| What type of grief is where you would refer to human mental health professional? | complicated |
| What type of grief is where a social circle doesn't support person in grief, may need extra support from vet staff, and human mental health professional involvement? | disenfranchised |
| How can we help animals in response to death companion/friend? | support with extra affection and attention (decision to allow witness death up to client) |
| Techs face a critical need for self care when faced with euthanasias; without appropriate response what can happen? | burnout, compassion fatigue |
| VCPR exists when vet.... | takes responsibility for clinical judgements & client agrees to comply; is personally familiar with keeping and care of animal; is readily available or has arranged for emergency care/follow-up cases in cases of adverse reactions or treatment failure |
| What is a permanent written account of the professional interaction and services rendered at a vet clinic? | medical record |
| What are the purposes of a medical record? | provide accurate historical account, means of communication, serve as documentation for referrals, evidence in court of law, asset to vet practice |
| Medical records must be... | complete, legible, accessible at all times |
| T/F: Only certain communications with owners need to be documented in the medical record. | false, any written communication with owner must be in medical record |
| What should be done to improve legibility of paper medical records? | use of labels, stickers, or stamps; consider upgrade to electronic |
| How should you correct a medical record? | because it's a legal document, to correct a mistake put a one-line strikethrough and add correction- make sure to initial error |
| What are two different filing systems you could choose for filing a client records? | alphabetical (O's last name then first), numerically (client's #) |
| What should a client's file include? | client/patient information form, consent forms, patient check-in sheets, treatment plans, discharge sheets |
| What are some possible colorful warning stickers you might see in practice? | caution, vaccine reaction, anesthetic alert |
| What can be found in electronic medical records? | lab work, radiographs, ultrasound results, previous medical charts, consent forms, miscellaneous documents, any in-print signed consent forms & lab work must be scanned to client record |
| What term describes a period of time where security for online medical records prevents record alteration after 24hrs? | lockout |
| What are some advantages to paperless medical records? | can be accessed from any computer; records are never lost, misplaced, or misfiled |
| What is a disadvantage to paperless medical records? | computer systems can fail, records may become inaccessible until the system has been repaired |
| What is the most common failure of electronic records? | is lack of commitment to system backups |
| What are the two options for data restoration? | secondary server, backup storage offsite |
| T/F: Medical records are confidential, and can only be released with owner's consent. | true |
| Should the owner sign a release for releasing medical records to grooming or other veterinary facilities? | yes, practice could be held liable (privacy act protects clients) |
| What act has a purpose of protecting clients, and requires written request/consent to release medical records? | privacy act of 1974 |
| When clients are referred to a specialist, what should they do? | authorize release of records, lab results, and radiographs |
| Does the client own the original medical record? | no, it belongs to practice- client is entitled to copy of records at any time |
| Establishing a medical record must follow what specific criteria? | each patient has own medical record, easily retrievable, complete/well organized, follows SOAP format, composed as legal documents, legible |
| What information is required for a complete medical record? | client/patient information sheet, previous medical history, vaccination history, primary complaints, physical exam, diagnosis, lab reports, treatments, prognosis, surgical reports, treatment plans (estimates) and consent forms |
| What does POMR stand for? | problem-oriented medical record |
| What is the S in SOAP? | subjective |
| What is the O in SOAP? | objective |
| What is the A in SOAP? | assessment |
| What is the P in SOAP? | plan |
| Subjective in SOAP refers to how the animal what? | appears from casual observation |
| Objective in SOAP refers to what? | physiological data (TPR, vomitus, urination, defecation), lab data (such as blood analysis), notes on surgical site/catheter placement/swelling/drainage |
| Assessment in SOAP refers to what? | determining overall status of patient, tentative diagnosis is developed |
| Plan in SOAP refers to what? | course of action for the day |
| What are some common errors and omissions you might encounter with SOAP & POMR medical records? | lack of lab work interpretation, progress notes while patient is hospitalized, preoperative physical examinations, anesthetic drugs, initials of author's |
| How should medication be documented? | amount, drug name, concentration, route of administration (ex: "0.2mL Cefazolin (100 mg/mL) given IV") |
| How should administration of fluids be documented? | identify: type of fluid administered, how many mL/kg/hr, route |
| What should you include when recording dispensed medication in record? | drug name, strength, route, frequency, duration (ex:"Amoxicillin 250mg PO BID for 14 days") |
| In Illinois, how long must you keep medical records? | minimum of 5 years |
| What term describes when a client has not been seen for a year or more? | inactive |
| Medical records should be able to be easily accessed for a minimum of how many years? | 3 |
| What percentage of information from discharge instructions will clients most likely remember? | 20% |
| What can be done to ensure that clients understand discharge instructions? | print out materials for them to take home, review instructions verbally, keep copy in record, have owner sign acknowledgement |
| What are the most common medical record violations seen? | euthanasia without consent, routine definition, no PE, client refusals, illegible |
| What diagnostic tool should be a permanent part of the medical record? | radiographs |
| Radiographs must be correctly labeled with what? | hospital name & address, client's last name, patient's name, date, right or left indicator |
| What is a practice manager's role pertaining to medical records? | manage medical record protocols, ensure records are maintained, implement changes when needed, review entries, evaluate efficiency of medical records management |
| What happens during a medical records audit? | pull random records to complete audit- ensure entries are correct, invoices reflect services delivered |
| What amount of money is the average loss uncovered by a medical records audit? | $64,000/yr |
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