g g g g g g g
(Chapterg1-
Chapterg3)ThegInitialgInterview:gAgPreviewgChapterg2:gLogisticgPreparations:gWhatgtogDogBeforegt
hegInterview
Chapterg3:gThegTherapeuticgAlliance:gWhatgItgIs,gWhygIt'sgImportant,gandgHowgtogEstablishgItgMULTI
PLEgCHOICE
1. Whichgoutcome,gfocusedgongrecovery,gwouldgbegexpectedgingthegplangofgcaregforgagpatientgliv
inggingthegcommunitygandgdiagnosedgwithgseriousgandgpersistentgmentalgillness?gWithing3gmont
hs,gthegpatientgwill:
a. denyg suicidalg ideation.
b. reportg ag senseg ofg well-being.
c. takegmedicationsg asg prescribed.
d. attendgclinicgappointmentsgongtime.g
ANS:gB
Recoverygemphasizesgmanaginggsymptoms,greducinggpsychosocialgdisability,gandgimprovinggroleg
performance.gTheggoalgofgrecoverygisgtogempowergthegindividualgwithgmentalgillnessgtogachievegagse
nsegofgmeaninggandgsatisfactionginglifegandgtogfunctiongatgtheghighestgpossibleglevelgofgwellness.gThe
g incorrectgoptionsgfocusgongthegclassicgmedicalgmodelgrathergthangrecovery.
2. Agpatientgisghospitalizedgforgdepressiongandgsuicidalgideationgaftergtheirgspousegasksgforgagdi
vorce.gSelectgthegnursesgmostgcaringgcomment.
a. Letsg discussg someg meansg ofg copingg otherg thang suicideg wheng youg haveg theseg feelings.
b. Ig understandg whyg youreg sog depressed.g Wheng Ig gotg divorced,g Ig wasg devastatedg too.
c. Youg shouldg forgetg aboutg yourg marriageg andg moveg ong withg yourg life.
d. Howgdidgyouggetgsogdepressedgthatghospitalizationgwasgnecessary?g
ANS:gA
Thegnursesgcommunicationgshouldgevidencegcaringgandgagcommitmentgtogworkgwithgthegpatient.gTh
isgcommitmentgletsgthegpatientgknowgthegnursegwillghelp.gProbinggandgadvicegaregnotghelpfulgorgther
apeuticginterventions.
3. Ingthegshift-changegreport,gangoff-
goinggnursegcriticizesgagpatientgwhogwearsgheavygmakeup.gWhichgcommentgbygthegnursegwhogrec
eivesgthegreportgbestgdemonstratesgadvocacy?
a. Thisg isg ag psychiatricg hospital.g Crazinessg isg whatg weg areg allg about.
b. Letsg allg showg acceptanceg ofg thisg patientg byg wearingg lotsg ofg makeupg too.
,c. Yourg commentsg areg inconsiderateg andg inappropriate.g Keepg theg reportg objective.
d. Ourgpatientsgneedgourghelpgtoglearngbehaviorsgthatgwillghelpgthemggetgalonggingsociety.gA
NS:gD
Acceptinggpatientsgneedsgforgself-
expressiongandgseekinggtogteachgskillsgthatgwillgcontributegtogtheirgwell-
beinggdemonstrategrespectgandgaregimportantgpartsgofgadvocacy.gThegon-
cominggnursegneedsgtogtakegactiongtogensuregthatgothersgaregnotgprejudicedgagainstgthegpatient.gHu
morgcangbegappropriategwithingthegprivacygofgagshiftgreportgbutgnotgatgthegexpensegofgrespectgforgpat
ients.
Judginggthegoff-
goinggnursegingagcriticalgwaygwillgcreategconflict.gNursesgmustgshowgcompassiongforgeachgother.
4. Agnursegassessesgagnewlygadmittedgpatientgdiagnosedgwithgmajorgdepressivegdisorder.gWhichgst
atementgisgangexamplegofgattending?
a. Weg allg haveg stressg ing life.gBeingg ing ag psychiatricg hospitalg isntg theg endg ofg theg world.
b. Tellg meg whyg youg feltg youg hadg tog beg hospitalizedg tog receiveg treatmentg forg yourg depression.
c. Youg willg feelg betterg afterg weg getg someg antidepressantg medicationg startedg forg you.
d. Idglikegtogsitgwithgyougagwhilegsogyougmaygfeelgmoregcomfortablegtalkinggwithgme.gA
NS:gD
Attendinggisgagtechniquegthatgdemonstratesgthegnursesgcommitmentgtogthegrelationshipgandgreduces
g feelingsgofgisolation.gThisgtechniquegshowsgrespectgforgthegpatientgandgdemonstratesgcaring.gGene
ralizations,gprobing,gandgfalsegreassurancesgaregnon-therapeutic.
5. AgpatientgshowsgthegnursegangarticlegfromgthegInternetgaboutgaghealthgproblem.gWhichgcharact
eristicgofgthegwebgsitesgaddressgmostgalertsgthegnursegthatgthegsitegmayghavegbiasedgandgprejudice
dginformation?
a. Addressg endsg ing .org.
b. Addressg endsg ing .com.
c. Addressg endsg ing .gov.
d. Addressgendsging.net.g
ANS:gB
Financialginfluencesgongagsitegaregagcluegthatgtheginformationgmaygbegbiased.g.comgatgthegendgofgtheg
addressgindicatesgthatgthegsitegisgagcommercialgone.g.govgindicatesgthatgthegsitegisgmaintainedgbygagg
overnmentgentity.g.orggindicatesgthatgthegsitegisgnonproprietary;gthegsitegmaygorgmaygnotghavegrelia
bleginformation,gbutgitgdoesgnotgprofitgfromgitsgactivities.g.netgcanghavegmultiple
,meanings.
6. Agnursegsays,gWhengIgwasgingschool,gIglearnedgtogcallgupsetgpatientsgbygnamegtoggetgtheirgattention;g
however,g Ig readg ag descriptiveg researchg studyg thatg saysg thatg thisg approachg doesg notg work.gIgplangtogst
opgcallinggpatientsgbygname.gWhichgstatementgisgthegbestgappraisalgofgthisgnursesgcomment?
a. Oneg descriptiveg researchg studyg rarelyg providesg enoughg evidenceg tog changeg practice.
b. Staffg nursesg applyg newg researchg findingsg onlyg withg theg helpg fromg clinicalg nurseg specialists.
c. Newgresearchgfindingsgshouldgbegincorporatedgintogclinicalgalgorithmsgbeforegusinggthemgingpr
actice.
d. Thegnursegmisinterpretedgthegresultsgofgthegstudy.gClassicgtenetsgofgpracticegdognotgchange.gA
NS:gA
Descriptivegresearchgfindingsgprovidegevidencegforgpracticegbutgmustgbegviewedgingrelationgtogothe
rgstudiesgbeforegpracticegchanges.gOnegstudygisgnotgenough.gDescriptivegstudiesgareglowgongtheghier
archygofgevidence.gClinicalgalgorithmsgusegflowgchartsgtogmanagegproblemsgandgdognotgspecifygone
g responsegtogagclinicalgproblem.gClassicgtenetsgofgpracticegshouldgchangegasgresearchgfindingsgprovi
degevidencegforgchange.
7. Twognursinggstudentsgdiscussgcareergplansgafterggraduation.gOnegstudentgwantsgtogentergpsychiat
ricgnursing.gThegothergstudentgasks,gWhygwouldgyougwantgtogbegagpsychiatricgnurse?gAllgtheygdogisgt
alk.gYougwillglosegyourgskills.gSelectgthegbestgresponsegbygthegstudentginterestedgingpsychiatricgnursi
ng.
a. Psychiatricgnursesgpracticegingsafergenvironmentsgthangothergspecialties.gNurse-to-
patientgratiosgmustgbegbettergbecausegofgthegnaturegofgpatientsgproblems.
b. Psychiatricgnursesgusegcomplexgcommunicationgskills,gasgwellgasgcriticalgthinking,gtogsolvegm
ultidimensionalgproblems.gImgchallengedgbygthosegsituations.
c. IgthinkgIgwillgbeggoodgingthegmentalghealthgfield.gIgdognotglikegclinicalgrotationsgingschool,gsogIgdo
g notgwantgtogcontinuegthemgaftergIggraduate.
d. Psychiatricgnursesgdognotghavegtogdealgwithgasgmuchgpaingandgsufferinggasgmedicalgsurgicalgnu
rses.gThatgappealsgtogme.
ANS:g B
Thegpracticegofgpsychiatricgnursinggrequiresgagdifferentgsetgofgskillsgthangmedicalgsurgicalgnursing,ga
lthoughgsubstantialgoverlapgdoesgexist.gPsychiatricgnursesgmustgbegablegtoghelpgpatientsgwithgmedica
lgandgmentalghealthgproblems,greflectinggthegholisticgperspectivegthesegnursesgmustghave.
, Nurse-
patientgratiosgandgworkloadsgingpsychiatricgsettingsghavegincreased,gsimilargtogothergspecialties.gPsy
chiatricgnursingginvolvesgclinicalgpractice,gnotgsimplygdocumentation.
Psychosocialg paing isg realg andg cang causeg asg muchg sufferingg asg physicalg pain.
8. Whichg researchg evidenceg wouldg mostg influenceg ag groupg ofg nursesg tog changeg theirg practice?
a. Expertg committeeg reportg ofg recommendationsg forg practice
b. Systematicg reviewg ofg randomizedg controlledg trials
c. Nonexperimentalg descriptiveg study
d. Criticalgpathway
g ANS:gB
Researchgfindingsgareggradedgusinggaghierarchygofgevidence.gAgsystematicgreviewgofgrandomizedgc
ontrolledgtrialsgisgLevelgAgandgprovidesgthegstrongestgevidencegforgchanginggpractice.gExpertgcom
mitteegrecommendationsgandgdescriptivegstudiesglendglessgpowerfulgandginfluentialgevidence.g Agcr
iticalgpathwaygisgnotgevidence;gitgincorporatesgresearchgfindingsgaftergtheyghavegbeeng analyzed.
9. AgbillgintroducedgingCongressgwouldgreducegfundinggforgthegcaregofgpeoplegdiagnosedgwithgment
algillnesses.gAggroupgofgnursesgwriteglettersgtogtheirgelectedgrepresentativesgingoppositiongtogtheglegi
slation.gWhichgroleghavegthegnursesgfulfilled?
a. Advocacy
b. Attending
c. Recovery
d. Evidence-
basedgpracticegANS:gA
Ang advocateg defendsg org assertsg anothersg cause,g particularlyg wheng theg otherg persong lacksg thegabil
itygtogdogthatgforghimselfgorgherself.gExamplesgofgindividualgadvocacygincludeghelpinggpatientsgunde
rstandgtheirgrightsgorgmakegdecisions.gOngagcommunitygscale,gadvocacygincludesgpoliticalgactivity,gp
ublicgspeaking,gandgpublicationgingtheginterestgofgimprovinggthegindividualsgwithgmentalgillness;gtheg
letter-
writinggcampaigngadvocatesgforgthatgcausegongbehalfgofgpatientsgwhogaregunableg togarticulategtheirg
owngneeds.
10. Ang informalg groupg ofg patientsg discussg theirg perceptionsg ofg nursingg care.g Whichg commentg best