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pter 1-Chapter 3)
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Chapter 1: The Initial Interview: A Preview
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Chapter 2: Logistic Preparations: What toDo 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 uo
1. Which outcome, focused on recovery, would be expected in the plan of care for a patie
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nt living in the community and diagnosed with serious and persistent mental illness? With
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in 3 months, the patient will:
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a. deny suicidal ideation.
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b. report a sense of well-being.
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c. take medications as prescribed.
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d. attend clinic appointments on time
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. ANS: B
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Recovery emphasizes managing symptoms, reducing psychosocial disability, and improving ro
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,le performance. The goal of recovery is to empower the individual with mental illness to achi
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eve a sense of meaning and satisfaction in life and to function at the highest possible level of
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wellness. The incorrect options focus on the classic medical model rather than recovery.
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2. A patient is hospitalized for depression and suicidal ideation after their spouse asks for
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a divorce. Select the nurses most caring comment.
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a. Lets discuss some means of coping other than suicide when you have these feelings.
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b. I understand why youre so depressed. When I got divorced, I was devastated too.
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c. You should forget about your marriage and move on with your life.
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d. How did you get so depressed that hospitalization was necessary
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? ANS: A
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The nurses communication should evidence caring and a commitment to work with the patient
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. This commitment lets the patient know the nurse will help. Probing and advice are not helpf
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ul or therapeutic interventions.
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3. In the shift-change report, an off-
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going nurse criticizes a patient who wears heavy makeup. Which comment by the nurse wh
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o receives the report best demonstrates advocacy?
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a. This is a psychiatric hospital. Craziness is what we are all about.
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b. Lets all show acceptance of this patient by wearing lots of makeup too.
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, c. Your comments are inconsiderate and inappropriate. Keep the report objective.
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d. Our patients need our help to learn behaviors that will help them get along in socie
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ty. ANS: Duo uo
Accepting patients needs for self- uo uo uo uo
expression and seeking to teach skills that will contribute to their well-
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being demonstrate respect and are important parts of advocacy. The on-
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coming nurse needs to take action to ensure that others are not prejudiced against the patient.
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Humor can be appropriate within the privacy of a shift report but not at the expense of resp
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ect for patients.
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Judging the off- uo uo
going nurse in a critical way will create conflict. Nurses must show compassion for each othe
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r.
4. A nurse assesses a newly admitted patient diagnosed with major depressive disorder. Whic
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h statement is an example of attending?
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a. We all have stress in life. Being in a psychiatric hospital isnt the end of the world.
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b. Tell me why you felt you had to be hospitalized to receive treatment for your depression.
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c. You will feel better after we get some antidepressant medication started for you.
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d. Id like to sit with you a while so you may feel more comfortable talking with
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me. ANS: D uo uo
Attending is a technique that demonstrates the nurses commitment to the relationship and red
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uces feelings of isolation. This technique shows respect for the patient and demonstrates cari
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ng. Generalizations, probing, and false reassurances are non-therapeutic.
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5. A patient shows the nurse an article from the Internet about a health problem. Which ch
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aracteristic of the web sites address most alerts the nurse that the site may have biased and
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prejudiced information?
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a. Address ends in .org. uo uo uo
b. Address ends in .com. uo uo uo
c. Address ends in .gov. uo uo uo
d. Address ends in .net uo uo uo
. ANS: B
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Financial influences on a site are a clue that the information may be biased. .com at the end
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of the address indicates that the site is a commercial one. .gov indicates that the site is maint
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ained by a government entity. .org indicates that the site is nonproprietary; the site may or m
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ay not have reliable information, but it does not profit from its activities. .net can have multi
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ple