(Chapter 1-Chapter 3)The Initial Interview: A Preview Chapter 2: Logistic Preparations:
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What to Do Before the Interview
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,Chapter 3: The Therapeutic Alliance: What It Is, Why It's Important, and How to Establish It
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MULTIPLE CHOICE
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1. Which outcome, focused on recovery, would be expected in the plan of care for a
sd sd sd sd sd sd sd sd sd sd sd sd sd sd
patient living in the community and diagnosed with serious and persistent mental
sd sd sd sd sd sd sd sd sd sd sd sd
illness? Within 3 months, the patient will:
sd sd sd sd sd sd sd
a. deny suicidal ideation.
sd sd
b. report a sense of well-being.
sd sd sd sd
c. take medications as prescribed.
sd sd sd
d. attend clinic appointments on sd sd sd
time. ANS: B
sd sd sd
Recovery emphasizes managing symptoms, reducing psychosocial disability, and improving
sd sd sd sd sd sd sd sd
role performance. The goal of recovery is to empower the individual with mental illness to
sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd
achieve a sense of meaning and satisfaction in life and to function at the highest possible
sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd
level of wellness. The incorrect options focus on the classic medical model rather than
sd sd sd sd sd sd sd sd sd sd sd sd sd sd
recovery.
sd
2. A patient is hospitalized for depression and suicidal ideation after their spouse asks
sd sd sd sd sd sd sd sd sd sd sd sd
sd for a divorce. Select the nurses most caring comment.
sd sd sd sd sd sd sd sd
a. Lets discuss some means of coping other than suicide when you have these feelings.
sd sd sd sd sd sd sd sd sd sd sd sd sd
b. I understand why youre so depressed. When I got divorced, I was devastated too.
sd sd sd sd sd sd sd sd sd sd sd sd sd
c. You should forget about your marriage and move on with your life.
sd sd sd sd sd sd sd sd sd sd sd
d. How did you get so depressed that hospitalization was
sd sd sd sd sd sd sd sd
necessary? ANS: A
sd sd sd
The nurses communication should evidence caring and a commitment to work with the
sd sd sd sd sd sd sd sd sd sd sd sd
patient. This commitment lets the patient know the nurse will help. Probing and advice are
sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd
not helpful or therapeutic interventions.
sd sd sd sd sd
3. In the shift-change report, an off-going nurse criticizes a patient who wears heavy
sd sd sd sd sd sd sd sd sd sd sd sd
makeup. Which comment by the nurse who receives the report best demonstrates
sd sd sd sd sd sd sd sd sd sd sd sd
advocacy?
sd
a. This is a psychiatric hospital. Craziness is what we are all about.
sd sd sd sd sd sd sd sd sd sd sd
b. Lets all show acceptance of this patient by wearing lots of makeup too.
sd sd sd sd sd sd sd sd sd sd sd sd
,c. Your comments are inconsiderate and inappropriate. Keep the report objective.
sd sd sd sd sd sd sd sd sd
d. Our patients need our help to learn behaviors that will help them get along in
sd sd sd sd sd sd sd sd sd sd sd sd sd sd
society. ANS: D
sd sd sd
Accepting patients needs for self-expression and seeking to teach skills that will contribute
sd sd sd sd sd sd sd sd sd sd sd sd
to their well-being demonstrate respect and are important parts of advocacy. The on-
sd sd sd sd sd sd sd sd sd sd sd sd sd
coming nurse needs to take action to ensure that others are not prejudiced against the
sd sd sd sd sd sd sd sd sd sd sd sd sd sd
patient. Humor can be appropriate within the privacy of a shift report but not at the
sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd
expense of respect for patients.
sd sd sd sd sd
Judging the off-going nurse in a critical way will create conflict. Nurses must show
sd sd sd sd sd sd sd sd sd sd sd sd sd
compassion for each other.
sd sd sd sd
4. A nurse assesses a newly admitted patient diagnosed with major depressive disorder.
sd sd sd sd sd sd sd sd sd sd sd
sd Which statement is an example of attending?
sd sd sd sd sd sd
a. We all have stress in life. Being in a psychiatric hospital isnt the end of the world.
sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd
b. Tell me why you felt you had to be hospitalized to receive treatment for your
sd sd sd sd sd sd sd sd sd sd sd sd sd sd
depression.
sd
c. You will feel better after we get some antidepressant medication started for you.
sd sd sd sd sd sd sd sd sd sd sd sd
d. Id like to sit with you a while so you may feel more comfortable talking with
sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd
me. ANS: D
sd sd sd
Attending is a technique that demonstrates the nurses commitment to the relationship and
sd sd sd sd sd sd sd sd sd sd sd sd
reduces feelings of isolation. This technique shows respect for the patient and demonstrates
sd sd sd sd sd sd sd sd sd sd sd sd sd
caring. Generalizations, probing, and false reassurances are non-therapeutic.
sd sd sd sd sd sd sd sd
5. A patient shows the nurse an article from the Internet about a health problem. Which
sd sd sd sd sd sd sd sd sd sd sd sd sd sd
characteristic of the web sites address most alerts the nurse that the site may have biased
sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd
and prejudiced information?
sd sd sd
a. Address ends in .org. sd sd sd
b. Address ends in .com. sd sd sd
c. Address ends in .gov. sd sd sd
d. Address ends in sd sd
.net. ANS: B
sd sd sd
Financial influences on a site are a clue that the information may be biased. .com at the
sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd
end of the address indicates that the site is a commercial one. .gov indicates that the site
sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd
is maintained by a government entity. .org indicates that the site is nonproprietary; the site
sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd
may or may not have reliable information, but it does not profit from its activities. .net
sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd
can have multiple
sd sd sd
, meanings.
6. A nurse says, When I was in school, I learned to call upset patients by name to get their
sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd
attention; however, I read a descriptive research study that says that this approach does
sd sd sd sd sd sd sd sd sd sd sd sd sd sd
sd not work. I plan to stop calling patients by name. Which statement is the best appraisal of
sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd
this nurses comment?
sd sd sd
a. One descriptive research study rarely provides enough evidence to change practice.
sd sd sd sd sd sd sd sd sd sd
b. Staff nurses apply new research findings only with the help from clinical nurse
sd sd sd sd sd sd sd sd sd sd sd sd
specialists.
sd
c. New research findings should be incorporated into clinical algorithms before using them
sd sd sd sd sd sd sd sd sd sd sd
in practice.
sd sd
d. The nurse misinterpreted the results of the study. Classic tenets of practice do not
sd sd sd sd sd sd sd sd sd sd sd sd sd
change. ANS: A
sd sd sd
Descriptive research findings provide evidence for practice but must be viewed in relation
sd sd sd sd sd sd sd sd sd sd sd sd
to other studies before practice changes. One study is not enough. Descriptive studies are
sd sd sd sd sd sd sd sd sd sd sd sd sd sd
low on the hierarchy of evidence. Clinical algorithms use flow charts to manage problems
sd sd sd sd sd sd sd sd sd sd sd sd sd sd
and do not specify one response to a clinical problem. Classic tenets of practice should
sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd
change as research findings provide evidence for change.
sd sd sd sd sd sd sd sd
7. Two nursing students discuss career plans after graduation. One student wants to enter
sd sd sd sd sd sd sd sd sd sd sd sd
psychiatric nursing. The other student asks, Why would you want to be a psychiatric nurse?
sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd
All they do is talk. You will lose your skills. Select the best response by the student
sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd
interested in psychiatric nursing.
sd sd sd sd
a. Psychiatric nurses practice in safer environments than other specialties. Nurse-to-patient
sd sd sd sd sd sd sd sd sd
ratios must be better because of the nature of patients problems.
sd sd sd sd sd sd sd sd sd sd sd
b. Psychiatric nurses use complex communication skills, as well as critical thinking, to
sd sd sd sd sd sd sd sd sd sd sd
solve multidimensional problems. Im challenged by those situations.
sd sd sd sd sd sd sd sd
c. I think I will be good in the mental health field. I do not like clinical rotations in
sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd
school, so I do not want to continue them after I graduate.
sd sd sd sd sd sd sd sd sd sd sd sd
d. Psychiatric nurses do not have to deal with as much pain and suffering as medical
sd sd sd sd sd sd sd sd sd sd sd sd sd sd
surgical nurses. That appeals to me.
sd sd sd sd sd sd
ANS: B sd
The practice of psychiatric nursing requires a different set of skills than medical surgical
sd sd sd sd sd sd sd sd sd sd sd sd sd
nursing, although substantial overlap does exist. Psychiatric nurses must be able to help
sd sd sd sd sd sd sd sd sd sd sd sd sd
patients with medical and mental health problems, reflecting the holistic perspective these
sd sd sd sd sd sd sd sd sd sd sd sd
nurses must have.
sd sd sd
sd sd sd sd sd sd sd sd sd sd
What to Do Before the Interview
sd sd sd sd sd sd
,Chapter 3: The Therapeutic Alliance: What It Is, Why It's Important, and How to Establish It
sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd
MULTIPLE CHOICE
sd sd
1. Which outcome, focused on recovery, would be expected in the plan of care for a
sd sd sd sd sd sd sd sd sd sd sd sd sd sd
patient living in the community and diagnosed with serious and persistent mental
sd sd sd sd sd sd sd sd sd sd sd sd
illness? Within 3 months, the patient will:
sd sd sd sd sd sd sd
a. deny suicidal ideation.
sd sd
b. report a sense of well-being.
sd sd sd sd
c. take medications as prescribed.
sd sd sd
d. attend clinic appointments on sd sd sd
time. ANS: B
sd sd sd
Recovery emphasizes managing symptoms, reducing psychosocial disability, and improving
sd sd sd sd sd sd sd sd
role performance. The goal of recovery is to empower the individual with mental illness to
sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd
achieve a sense of meaning and satisfaction in life and to function at the highest possible
sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd
level of wellness. The incorrect options focus on the classic medical model rather than
sd sd sd sd sd sd sd sd sd sd sd sd sd sd
recovery.
sd
2. A patient is hospitalized for depression and suicidal ideation after their spouse asks
sd sd sd sd sd sd sd sd sd sd sd sd
sd for a divorce. Select the nurses most caring comment.
sd sd sd sd sd sd sd sd
a. Lets discuss some means of coping other than suicide when you have these feelings.
sd sd sd sd sd sd sd sd sd sd sd sd sd
b. I understand why youre so depressed. When I got divorced, I was devastated too.
sd sd sd sd sd sd sd sd sd sd sd sd sd
c. You should forget about your marriage and move on with your life.
sd sd sd sd sd sd sd sd sd sd sd
d. How did you get so depressed that hospitalization was
sd sd sd sd sd sd sd sd
necessary? ANS: A
sd sd sd
The nurses communication should evidence caring and a commitment to work with the
sd sd sd sd sd sd sd sd sd sd sd sd
patient. This commitment lets the patient know the nurse will help. Probing and advice are
sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd
not helpful or therapeutic interventions.
sd sd sd sd sd
3. In the shift-change report, an off-going nurse criticizes a patient who wears heavy
sd sd sd sd sd sd sd sd sd sd sd sd
makeup. Which comment by the nurse who receives the report best demonstrates
sd sd sd sd sd sd sd sd sd sd sd sd
advocacy?
sd
a. This is a psychiatric hospital. Craziness is what we are all about.
sd sd sd sd sd sd sd sd sd sd sd
b. Lets all show acceptance of this patient by wearing lots of makeup too.
sd sd sd sd sd sd sd sd sd sd sd sd
,c. Your comments are inconsiderate and inappropriate. Keep the report objective.
sd sd sd sd sd sd sd sd sd
d. Our patients need our help to learn behaviors that will help them get along in
sd sd sd sd sd sd sd sd sd sd sd sd sd sd
society. ANS: D
sd sd sd
Accepting patients needs for self-expression and seeking to teach skills that will contribute
sd sd sd sd sd sd sd sd sd sd sd sd
to their well-being demonstrate respect and are important parts of advocacy. The on-
sd sd sd sd sd sd sd sd sd sd sd sd sd
coming nurse needs to take action to ensure that others are not prejudiced against the
sd sd sd sd sd sd sd sd sd sd sd sd sd sd
patient. Humor can be appropriate within the privacy of a shift report but not at the
sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd
expense of respect for patients.
sd sd sd sd sd
Judging the off-going nurse in a critical way will create conflict. Nurses must show
sd sd sd sd sd sd sd sd sd sd sd sd sd
compassion for each other.
sd sd sd sd
4. A nurse assesses a newly admitted patient diagnosed with major depressive disorder.
sd sd sd sd sd sd sd sd sd sd sd
sd Which statement is an example of attending?
sd sd sd sd sd sd
a. We all have stress in life. Being in a psychiatric hospital isnt the end of the world.
sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd
b. Tell me why you felt you had to be hospitalized to receive treatment for your
sd sd sd sd sd sd sd sd sd sd sd sd sd sd
depression.
sd
c. You will feel better after we get some antidepressant medication started for you.
sd sd sd sd sd sd sd sd sd sd sd sd
d. Id like to sit with you a while so you may feel more comfortable talking with
sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd
me. ANS: D
sd sd sd
Attending is a technique that demonstrates the nurses commitment to the relationship and
sd sd sd sd sd sd sd sd sd sd sd sd
reduces feelings of isolation. This technique shows respect for the patient and demonstrates
sd sd sd sd sd sd sd sd sd sd sd sd sd
caring. Generalizations, probing, and false reassurances are non-therapeutic.
sd sd sd sd sd sd sd sd
5. A patient shows the nurse an article from the Internet about a health problem. Which
sd sd sd sd sd sd sd sd sd sd sd sd sd sd
characteristic of the web sites address most alerts the nurse that the site may have biased
sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd
and prejudiced information?
sd sd sd
a. Address ends in .org. sd sd sd
b. Address ends in .com. sd sd sd
c. Address ends in .gov. sd sd sd
d. Address ends in sd sd
.net. ANS: B
sd sd sd
Financial influences on a site are a clue that the information may be biased. .com at the
sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd
end of the address indicates that the site is a commercial one. .gov indicates that the site
sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd
is maintained by a government entity. .org indicates that the site is nonproprietary; the site
sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd
may or may not have reliable information, but it does not profit from its activities. .net
sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd
can have multiple
sd sd sd
, meanings.
6. A nurse says, When I was in school, I learned to call upset patients by name to get their
sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd
attention; however, I read a descriptive research study that says that this approach does
sd sd sd sd sd sd sd sd sd sd sd sd sd sd
sd not work. I plan to stop calling patients by name. Which statement is the best appraisal of
sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd
this nurses comment?
sd sd sd
a. One descriptive research study rarely provides enough evidence to change practice.
sd sd sd sd sd sd sd sd sd sd
b. Staff nurses apply new research findings only with the help from clinical nurse
sd sd sd sd sd sd sd sd sd sd sd sd
specialists.
sd
c. New research findings should be incorporated into clinical algorithms before using them
sd sd sd sd sd sd sd sd sd sd sd
in practice.
sd sd
d. The nurse misinterpreted the results of the study. Classic tenets of practice do not
sd sd sd sd sd sd sd sd sd sd sd sd sd
change. ANS: A
sd sd sd
Descriptive research findings provide evidence for practice but must be viewed in relation
sd sd sd sd sd sd sd sd sd sd sd sd
to other studies before practice changes. One study is not enough. Descriptive studies are
sd sd sd sd sd sd sd sd sd sd sd sd sd sd
low on the hierarchy of evidence. Clinical algorithms use flow charts to manage problems
sd sd sd sd sd sd sd sd sd sd sd sd sd sd
and do not specify one response to a clinical problem. Classic tenets of practice should
sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd
change as research findings provide evidence for change.
sd sd sd sd sd sd sd sd
7. Two nursing students discuss career plans after graduation. One student wants to enter
sd sd sd sd sd sd sd sd sd sd sd sd
psychiatric nursing. The other student asks, Why would you want to be a psychiatric nurse?
sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd
All they do is talk. You will lose your skills. Select the best response by the student
sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd
interested in psychiatric nursing.
sd sd sd sd
a. Psychiatric nurses practice in safer environments than other specialties. Nurse-to-patient
sd sd sd sd sd sd sd sd sd
ratios must be better because of the nature of patients problems.
sd sd sd sd sd sd sd sd sd sd sd
b. Psychiatric nurses use complex communication skills, as well as critical thinking, to
sd sd sd sd sd sd sd sd sd sd sd
solve multidimensional problems. Im challenged by those situations.
sd sd sd sd sd sd sd sd
c. I think I will be good in the mental health field. I do not like clinical rotations in
sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd
school, so I do not want to continue them after I graduate.
sd sd sd sd sd sd sd sd sd sd sd sd
d. Psychiatric nurses do not have to deal with as much pain and suffering as medical
sd sd sd sd sd sd sd sd sd sd sd sd sd sd
surgical nurses. That appeals to me.
sd sd sd sd sd sd
ANS: B sd
The practice of psychiatric nursing requires a different set of skills than medical surgical
sd sd sd sd sd sd sd sd sd sd sd sd sd
nursing, although substantial overlap does exist. Psychiatric nurses must be able to help
sd sd sd sd sd sd sd sd sd sd sd sd sd
patients with medical and mental health problems, reflecting the holistic perspective these
sd sd sd sd sd sd sd sd sd sd sd sd
nurses must have.
sd sd sd
