A 74-Year-Old Woman Comes to the Office for a New

question 423

Multiple Choice

A 74-year-old woman comes to the office for a new patient visit, accompanied by her son.  The patient's first language is Spanish, but she indicates that she is also comfortable speaking English.  She points to a nonhealing ulcer on her right forearm that has been present for approximately a year.  The patient is otherwise in good health and takes no medications.  She does not use tobacco, alcohol, or illicit drugs.
Physical examination shows an irregular, 1-cm erythematous scaly papule that is concerning for squamous cell carcinoma.  As the physician explains the diagnostic possibilities and need for a biopsy, it becomes apparent that the patient is having difficulty understanding the information presented in English.  The physician recommends using a medical interpreter, but the son suggests that his mother would be most comfortable if he served as her interpreter.  The patient's nurse also offers to interpret, stating that he knows some Spanish.
Which of the following is the most appropriate next step?

• A)Obtain medical interpreter services
• B)Provide written educational materials in Spanish
• C)Repeat the explanation in English using simpler terminology
• D)Use the patient's nurse as interpreter
• E)Use the patient's son as interpreter

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Definitions:

Posterior Vena Cava

The large vein that carries deoxygenated blood from the lower and middle body into the heart.

Hepatic Portal Vein

The hepatic portal vein is a blood vessel that carries blood from the gastrointestinal tract and spleen to the liver, transporting nutrients and toxins for processing.

Saphenous Vein

A large vein running along the length of the leg, often used for grafts in coronary artery bypass surgery.

Popliteal Vein

A vein located behind the knee that drains blood from the lower leg to the thigh.