THE PSYCHIATRIC INTERVIEW
4TH EDITION
Daniel J. Carlat
,(Chapter 1-Chapter 3)
Chapter 1: The Initial Interview: A Preview
Chapter 2: Logistic Preparations: What toDo Before the Interview
Chapter 3: The Therapeutic Alliance: What It Is, Why It's Important, and
How to Establish It
MULTIPLE CHOICE
1. Which outcome, focused on recovery, would be expected in the plan of care for a
PATIENT living in the community and diagnosed with serious and persistent mental illness?
Within 3 months, the PATIENT will:
a. deny suicidal ideation.
b. report a sense of well-being.
c. take medications as prescribed.
d. attend clinic appointments on time.
ANSWER: B
Recovery emphasizes managing symptoms, reducing psychosocial disability, and improving
role performance. The goal of recovery is to empower the individual with mental illness to
achieve a sense of meaning and satisfaction in life and to function at the highest possible level
of wellness. The incorrect options focus on the classic medical model rather than recovery.
2. A PATIENT is hospitalized for depression and suicidal ideation after their spouse asks
for a divorce. Select the nurses most caring comment.
a. Lets discuss some means of coping other than suicide when you have these feelings.
b. I understand why youre so depressed. When I got divorced, I was devastated too.
c. You should forget about your marriage and move on with your life.
d. How did you get so depressed that hospitalization was necessary?
ANSWER: A
The nurses communication should evidence caring and a commitment to work with the
PATIENT. This commitment lets the PATIENT know the nurse will help. Probing and advice
are not helpful or therapeutic interventions.
3. In the shift-change report, an off-going nurse criticizes a PATIENT who wears heavy
makeup. Which comment by the nurse who receives the report best demonstrates advocacy?
a. This is a psychiatric hospital. Craziness is what we are all about.
b. Lets all show acceptance of this PATIENT by wearing lots of makeup too.
,c. Your comments are inconsiderate and inappropriate. Keep the report objective.
d. Our PATIENTs need our help to learn behaviors that will help them get along in
society.
e. ANSWER: D
Accepting PATIENTs needs for self-expression and seeking to teach skills that will contribute
to their well-being demonstrate respect and are important parts of advocacy. The on-coming
nurse needs to take action to ensure that others are not prejudiced against the PATIENT.
Humor can be appropriate within the privacy of a shift report but not at the expense of
respect for PATIENTs.
Judging the off-going nurse in a critical way will create conflict. Nurses must show
compassion for each other.
4. A nurse assesses a newly admitted PATIENT diagnosed with major depressive disorder.
Which statement is an example of attending?
a. We all have stress in life. Being in a psychiatric hospital isnt the end of the world.
b. Tell me why you felt you had to be hospitalized to receive treatment for your depression.
c. You will feel better after we get some antidepressant medication started for you.
d. Id like to sit with you a while so you may feel more comfortable talking with me.
ANSWER: D
Attending is a technique that demonstrates the nurses commitment to the relationship and
reduces feelings of isolation. This technique shows respect for the PATIENT and
demonstrates caring. Generalizations, probing, and false reassurances are non-therapeutic.
5. A PATIENT shows the nurse an article from the Internet about a health problem. Which
characteristic of the web sites address most alerts the nurse that the site may have biased and
prejudiced information?
a. Address ends in .org.
b. Address ends in .com.
c. Address ends in .gov.
d. Address ends in .net.
ANSWER: B
Financial influences on a site are a clue that the information may be biased. .com at the end
of the address indicates that the site is a commercial one. .gov indicates that the site is
maintained by a government entity. .org indicates that the site is nonproprietary; the site may
or may not have reliable information, but it does not profit from its activities. .net can have
multiple
,meanings.
6. A nurse says, When I was in school, I learned to call upset PATIENTs by name to get their
attention; however, I read a descriptive research study that says that this approach does not work.
I plan to stop calling PATIENTs by name. Which statement is the best appraisal of this nurses
comment?
a. One descriptive research study rarely provides enough evidence to change practice.
b. Staff nurses apply new research findings only with the help from clinical nurse specialists.
c. New research findings should be incorporated into clinical algorithms before using them in
practice.
d. The nurse misinterpreted the results of the study. Classic tenets of practice do not change.
ANSWER: A
Descriptive research findings provide evidence for practice but must be viewed in relation to
other studies before practice changes. One study is not enough. Descriptive studies are low on
the hierarchy of evidence. Clinical algorithms use flow charts to manage problems and do not
specify one response to a clinical problem. Classic tenets of practice should change as
research findings provide evidence for change.
7. Two nursing students discuss career plans after graduation. One student wants to enter
psychiatric nursing. The other student asks, Why would you want to be a psychiatric nurse? All
they do is talk. You will lose your skills. Select the best response by the student interested in
psychiatric nursing.
a. Psychiatric nurses practice in safer environments than other specialties. Nurse-to-PATIENT
ratios must be better because of the nature of PATIENTs problems.
b. Psychiatric nurses use complex communication skills, as well as critical thinking, to solve
multidimensional problems. Im challenged by those situations.
c. I think I will be good in the mental health field. I do not like clinical rotations in school, so I
do not want to continue them after I graduate.
d. Psychiatric nurses do not have to deal with as much pain and suffering as medical surgical
nurses. That appeals to me.
ANSWER: B
,Nurse-PATIENT ratios and workloads in psychiatric settings have increased, similar to other
specialties. Psychiatric nursing involves clinical practice, not simply documentation.
Psychosocial pain is real and can cause as much suffering as physical pain.
8. Which research evidence would most influence a group of nurses to change their practice?
a. Expert committee report of recommendations for practice
b. Systematic review of randomized controlled trials
c. Nonexperimental descriptive study
d. Critical pathway
ANSWER: B
Research findings are graded using a hierarchy of evidence. A systematic review of
randomized controlled trials is Level A and provides the strongest evidence for changing
practice. Expert committee recommendations and descriptive studies lend less powerful and
influential evidence. A critical pathway is not evidence; it incorporates research findings after
they have been analyzed.
9. A bill introduced in Congress would reduce funding for the care of people diagnosed with
mental illnesses. A group of nurses write letters to their elected representatives in opposition to
the legislation. Which role have the nurses fulfilled?
a. Advocacy
b. Attending
c. Recovery
d. Evidence-based practice
ANSWER: A
An advocate defends or asserts anothers cause, particularly when the other person lacks the
ability to do that for himself or herself. Examples of individual advocacy include helping
PATIENTs understand their rights or make decisions. On a community scale, advocacy
includes political activity, public speaking, and publication in the interest of improving the
individuals with mental illness; the letter-writing campaign advocates for that cause on behalf
of PATIENTs who are unable to articulate their own needs.
10. An informal group of PATIENTs discuss their perceptions of nursing care. Which comment best
,indicates a PATIENTs perception that his or her nurse is caring?
a. My nurse always asks me which type of juice I want to help me swallow my medication.
b. My nurse explained my treatment plan to me and asked for my ideas about how to make it
better.
c. My nurse told me that if I take all the medicines the doctor prescribes I will get discharged
soon.
d. My nurse spends time listening to me talk about my problems. That helps me feel like Im not
alone.
ANSWER: D
Caring evidences empathic understanding, as well as competency. It helps change pain and
suffering into a shared experience, creating a human connection that alleviates feelings of
isolation. The incorrect options give examples of statements that demonstrate advocacy or
giving advice.
11. A PATIENT who immigrated to the United States from Honduras was diagnosed with
schizophrenia. The PATIENT took an antipsychotic medication for 3 weeks but showed no
improvement. Which resource should the treatment team consult for information on more
effective medications for this PATIENT?
a. Clinical algorithm
b. Clinical pathway
c. Clinical practice guideline
d. International Statistical Classification of Diseases and Related Health Problems (ICD)
ANSWER: A
A clinical algorithm is a guideline that describes diagnostic and/or treatment approaches
drawn from large databases of information. These guidelines help the treatment team make
decisions cognizant of an individual PATIENTs needs, such as ethnic origin, age, or gender. A
clinical pathway is a map of interventions and treatments related to a specific disorder.
Clinical practice guidelines summarize best practices about specific health problems. The ICD
classifies diseases.
12. Which historical nursing leader helped focus practice to recognize the importance of science
in psychiatric nursing?
a. Abraham Maslow
b. Hildegard Peplau
c. Kris Martinsen
,d. Harriet Bailey
ANSWER: B
Although all these leaders included science as an important component of practice, Hildegard
Peplau most influenced its development in psychiatric nursing. Maslow was not a nurse, but
his theories influence how nurses prioritize problems and care. Bailey wrote a textbook in the
1930s on psychiatric nursing interventions. Kris Martinsen emphasized the importance of
caring in nursing practice.
13. A nurse consistently strives to demonstrate caring behaviors during interactions with
PATIENTs. Which reaction by a PATIENT indicates this nurse is effective? A PATIENT reports
feeling:
a. distrustful of others.
b. connected with others.
c. uneasy about the future.
d. discouraged with efforts to improve.
ANSWER: B
A PATIENT is likely to respond to caring with a sense of connectedness with others. The
absence of caring can make PATIENTs feel distrustful, disconnected, uneasy, and
discouraged.
MULTIPLE RESPONSE
1. An experienced nurse says to a new graduate, When youve practiced as long as I have, you
will instantly know how to take care of psychotic PATIENTs. What is the new graduates best
analysis of this comment? Select all that apply.
a. The experienced nurse may have lost sight of PATIENTs individuality, which may
compromise the integrity of practice.
b. New research findings must be continually integrated into a nurses practice to provide the
most effective care.
c. Experience provides mental health nurses with the tools and skills needed for effective
professional practice.
d. Experienced psychiatric nurses have learned the best ways to care for psychotic
PATIENTs through trial and error.
e. Effective psychiatric nurses should be continually guided by an intuitive sense of
PATIENTs needs.
ANSWER: A, B
,Evidence-based practice involves using research findings to provide the most effective nursing
care. Evidence is continually emerging; therefore, nurses cannot rely solely on experience.
The effective nurse also maintains respect for each PATIENT as an individual.
Overgeneralization compromises that perspective. Intuition and trial and error are
unsystematic approaches to care.
2. Which PATIENT statements identify qualities of nursing practice with high therapeutic
value? (Select all that apply.) My nurse:
a. talks in language I can understand.
b. helps me keep track of my medications.
c. is willing to go to social activities with me.
d. lets me do whatever I choose without interfering.
e. looks at me as a whole person with different needs.
ANSWER: A, B, E
Each correct answer demonstrates caring is an example of appropriate nursing foci:
communicating at a level understandable to the PATIENT, using holistic principles to guide
care, and providing medication supervision. The incorrect options suggest a laissez-faire
attitude on the part of the nurse, when the nurse should instead provide thoughtful feedback
and help PATIENTs test alternative solutions or violate boundaries.
1. An example of an environmental factor that would cause a nurse to modify a planned critical
interaction occurs when the:
a PATIENT expresses a personal dislike for the nurse
.
b PATIENT is in total denial about her condition
.
c Nurse lacks the degree of knowledge required for the interaction
.
d Nurse learns that the PATIENTs mother has been hospitalized with a stroke
.
ANSWER: D
Environmental factors include timing. Timing of critical interventions is important. It should
occur when the individual can give full attention to the topic. It would be inappropriate to
,continue with the plan in the face of the PATIENTs distress related to her mothers illness. The
remaining options reflect other types of factors that influence communication such as attitudes,
knowledge, and relationships.
2. The nurse suspects that the PATIENTs communication is being negatively influenced by
personal attitude when he is heard stating:
a They think Im mentally ill but Im not; I just get a little depressed at times.
.
b I cant concentrate on anything besides getting out of here and back to my kids.
.
c Obviously my therapist cant understand where Im coming from because our
. lives are so different.
d There isnt anyone here in this hospital I can trust enough to talk to about why I
. abuse alcohol and drugs.
ANSWER: C
Attitude determines how one person responds to another. It includes ones biases, past
experiences, and openness. People of different socioeconomic backgrounds may have difficulty
surmounting this barrier. The remaining options reflect factors that can negatively influence
communication but they are environmental, knowledge, and relationship oriented.
3. The nature of the communication characterized in this exchange between a nurse and a
chronically depressed PATIENT is:
Nurse: Is it true that you enjoy knitting?
PATIENT: Yes, Ive done it for years and am pretty good at it.
Nurse: Im just a beginner. Do you think you could give me some tips?
PATIENT: I guess so. What would you like to know?
a Therapeutic
.
, b Collegial
.
c Social
.
d Intrapersonal
.
ANSWER: C
Although the conversation takes place between the nurse and a PATIENT, it is of a social
nature. It is superficial and benefits both parties mutually by encouraging a relationship based on
mutual interest. No expectation of help exists. Therapeutic communication promotes PATIENT
growth and is PATIENT-focused. Collegial conversation occurs for the purpose of professional
collaboration.
Intrapersonal communication takes place within the individual.
4. A PATIENT expresses a sense of genuineness in the nurse providing care when sharing
with family members that:
a I believe the nurse can feel what Im feeling.
.
b I always know what the nurse expects of me; the explanations are always clear.
.
c I can tell the nurse is sincere because the face supports what the mouth is
. saying.
d I may not always like what the nurse has to say but I can always depend on
. what Im told.
ANSWER: C
Genuineness is demonstrated by congruence between verbal and nonverbal behavior. Empathy is
seeing things from the PATIENTs viewpoint. Clearly stating expectations is a characteristic of
clarity. Trustworthiness can be described as dependability.
5. When providing discharge teaching to a PATIENT for whom English is a second language,
what technique will the nurse use to assess the PATIENTs understanding of the information being
shared verbally?
4TH EDITION
Daniel J. Carlat
,(Chapter 1-Chapter 3)
Chapter 1: The Initial Interview: A Preview
Chapter 2: Logistic Preparations: What toDo Before the Interview
Chapter 3: The Therapeutic Alliance: What It Is, Why It's Important, and
How to Establish It
MULTIPLE CHOICE
1. Which outcome, focused on recovery, would be expected in the plan of care for a
PATIENT living in the community and diagnosed with serious and persistent mental illness?
Within 3 months, the PATIENT will:
a. deny suicidal ideation.
b. report a sense of well-being.
c. take medications as prescribed.
d. attend clinic appointments on time.
ANSWER: B
Recovery emphasizes managing symptoms, reducing psychosocial disability, and improving
role performance. The goal of recovery is to empower the individual with mental illness to
achieve a sense of meaning and satisfaction in life and to function at the highest possible level
of wellness. The incorrect options focus on the classic medical model rather than recovery.
2. A PATIENT is hospitalized for depression and suicidal ideation after their spouse asks
for a divorce. Select the nurses most caring comment.
a. Lets discuss some means of coping other than suicide when you have these feelings.
b. I understand why youre so depressed. When I got divorced, I was devastated too.
c. You should forget about your marriage and move on with your life.
d. How did you get so depressed that hospitalization was necessary?
ANSWER: A
The nurses communication should evidence caring and a commitment to work with the
PATIENT. This commitment lets the PATIENT know the nurse will help. Probing and advice
are not helpful or therapeutic interventions.
3. In the shift-change report, an off-going nurse criticizes a PATIENT who wears heavy
makeup. Which comment by the nurse who receives the report best demonstrates advocacy?
a. This is a psychiatric hospital. Craziness is what we are all about.
b. Lets all show acceptance of this PATIENT by wearing lots of makeup too.
,c. Your comments are inconsiderate and inappropriate. Keep the report objective.
d. Our PATIENTs need our help to learn behaviors that will help them get along in
society.
e. ANSWER: D
Accepting PATIENTs needs for self-expression and seeking to teach skills that will contribute
to their well-being demonstrate respect and are important parts of advocacy. The on-coming
nurse needs to take action to ensure that others are not prejudiced against the PATIENT.
Humor can be appropriate within the privacy of a shift report but not at the expense of
respect for PATIENTs.
Judging the off-going nurse in a critical way will create conflict. Nurses must show
compassion for each other.
4. A nurse assesses a newly admitted PATIENT diagnosed with major depressive disorder.
Which statement is an example of attending?
a. We all have stress in life. Being in a psychiatric hospital isnt the end of the world.
b. Tell me why you felt you had to be hospitalized to receive treatment for your depression.
c. You will feel better after we get some antidepressant medication started for you.
d. Id like to sit with you a while so you may feel more comfortable talking with me.
ANSWER: D
Attending is a technique that demonstrates the nurses commitment to the relationship and
reduces feelings of isolation. This technique shows respect for the PATIENT and
demonstrates caring. Generalizations, probing, and false reassurances are non-therapeutic.
5. A PATIENT shows the nurse an article from the Internet about a health problem. Which
characteristic of the web sites address most alerts the nurse that the site may have biased and
prejudiced information?
a. Address ends in .org.
b. Address ends in .com.
c. Address ends in .gov.
d. Address ends in .net.
ANSWER: B
Financial influences on a site are a clue that the information may be biased. .com at the end
of the address indicates that the site is a commercial one. .gov indicates that the site is
maintained by a government entity. .org indicates that the site is nonproprietary; the site may
or may not have reliable information, but it does not profit from its activities. .net can have
multiple
,meanings.
6. A nurse says, When I was in school, I learned to call upset PATIENTs by name to get their
attention; however, I read a descriptive research study that says that this approach does not work.
I plan to stop calling PATIENTs by name. Which statement is the best appraisal of this nurses
comment?
a. One descriptive research study rarely provides enough evidence to change practice.
b. Staff nurses apply new research findings only with the help from clinical nurse specialists.
c. New research findings should be incorporated into clinical algorithms before using them in
practice.
d. The nurse misinterpreted the results of the study. Classic tenets of practice do not change.
ANSWER: A
Descriptive research findings provide evidence for practice but must be viewed in relation to
other studies before practice changes. One study is not enough. Descriptive studies are low on
the hierarchy of evidence. Clinical algorithms use flow charts to manage problems and do not
specify one response to a clinical problem. Classic tenets of practice should change as
research findings provide evidence for change.
7. Two nursing students discuss career plans after graduation. One student wants to enter
psychiatric nursing. The other student asks, Why would you want to be a psychiatric nurse? All
they do is talk. You will lose your skills. Select the best response by the student interested in
psychiatric nursing.
a. Psychiatric nurses practice in safer environments than other specialties. Nurse-to-PATIENT
ratios must be better because of the nature of PATIENTs problems.
b. Psychiatric nurses use complex communication skills, as well as critical thinking, to solve
multidimensional problems. Im challenged by those situations.
c. I think I will be good in the mental health field. I do not like clinical rotations in school, so I
do not want to continue them after I graduate.
d. Psychiatric nurses do not have to deal with as much pain and suffering as medical surgical
nurses. That appeals to me.
ANSWER: B
,Nurse-PATIENT ratios and workloads in psychiatric settings have increased, similar to other
specialties. Psychiatric nursing involves clinical practice, not simply documentation.
Psychosocial pain is real and can cause as much suffering as physical pain.
8. Which research evidence would most influence a group of nurses to change their practice?
a. Expert committee report of recommendations for practice
b. Systematic review of randomized controlled trials
c. Nonexperimental descriptive study
d. Critical pathway
ANSWER: B
Research findings are graded using a hierarchy of evidence. A systematic review of
randomized controlled trials is Level A and provides the strongest evidence for changing
practice. Expert committee recommendations and descriptive studies lend less powerful and
influential evidence. A critical pathway is not evidence; it incorporates research findings after
they have been analyzed.
9. A bill introduced in Congress would reduce funding for the care of people diagnosed with
mental illnesses. A group of nurses write letters to their elected representatives in opposition to
the legislation. Which role have the nurses fulfilled?
a. Advocacy
b. Attending
c. Recovery
d. Evidence-based practice
ANSWER: A
An advocate defends or asserts anothers cause, particularly when the other person lacks the
ability to do that for himself or herself. Examples of individual advocacy include helping
PATIENTs understand their rights or make decisions. On a community scale, advocacy
includes political activity, public speaking, and publication in the interest of improving the
individuals with mental illness; the letter-writing campaign advocates for that cause on behalf
of PATIENTs who are unable to articulate their own needs.
10. An informal group of PATIENTs discuss their perceptions of nursing care. Which comment best
,indicates a PATIENTs perception that his or her nurse is caring?
a. My nurse always asks me which type of juice I want to help me swallow my medication.
b. My nurse explained my treatment plan to me and asked for my ideas about how to make it
better.
c. My nurse told me that if I take all the medicines the doctor prescribes I will get discharged
soon.
d. My nurse spends time listening to me talk about my problems. That helps me feel like Im not
alone.
ANSWER: D
Caring evidences empathic understanding, as well as competency. It helps change pain and
suffering into a shared experience, creating a human connection that alleviates feelings of
isolation. The incorrect options give examples of statements that demonstrate advocacy or
giving advice.
11. A PATIENT who immigrated to the United States from Honduras was diagnosed with
schizophrenia. The PATIENT took an antipsychotic medication for 3 weeks but showed no
improvement. Which resource should the treatment team consult for information on more
effective medications for this PATIENT?
a. Clinical algorithm
b. Clinical pathway
c. Clinical practice guideline
d. International Statistical Classification of Diseases and Related Health Problems (ICD)
ANSWER: A
A clinical algorithm is a guideline that describes diagnostic and/or treatment approaches
drawn from large databases of information. These guidelines help the treatment team make
decisions cognizant of an individual PATIENTs needs, such as ethnic origin, age, or gender. A
clinical pathway is a map of interventions and treatments related to a specific disorder.
Clinical practice guidelines summarize best practices about specific health problems. The ICD
classifies diseases.
12. Which historical nursing leader helped focus practice to recognize the importance of science
in psychiatric nursing?
a. Abraham Maslow
b. Hildegard Peplau
c. Kris Martinsen
,d. Harriet Bailey
ANSWER: B
Although all these leaders included science as an important component of practice, Hildegard
Peplau most influenced its development in psychiatric nursing. Maslow was not a nurse, but
his theories influence how nurses prioritize problems and care. Bailey wrote a textbook in the
1930s on psychiatric nursing interventions. Kris Martinsen emphasized the importance of
caring in nursing practice.
13. A nurse consistently strives to demonstrate caring behaviors during interactions with
PATIENTs. Which reaction by a PATIENT indicates this nurse is effective? A PATIENT reports
feeling:
a. distrustful of others.
b. connected with others.
c. uneasy about the future.
d. discouraged with efforts to improve.
ANSWER: B
A PATIENT is likely to respond to caring with a sense of connectedness with others. The
absence of caring can make PATIENTs feel distrustful, disconnected, uneasy, and
discouraged.
MULTIPLE RESPONSE
1. An experienced nurse says to a new graduate, When youve practiced as long as I have, you
will instantly know how to take care of psychotic PATIENTs. What is the new graduates best
analysis of this comment? Select all that apply.
a. The experienced nurse may have lost sight of PATIENTs individuality, which may
compromise the integrity of practice.
b. New research findings must be continually integrated into a nurses practice to provide the
most effective care.
c. Experience provides mental health nurses with the tools and skills needed for effective
professional practice.
d. Experienced psychiatric nurses have learned the best ways to care for psychotic
PATIENTs through trial and error.
e. Effective psychiatric nurses should be continually guided by an intuitive sense of
PATIENTs needs.
ANSWER: A, B
,Evidence-based practice involves using research findings to provide the most effective nursing
care. Evidence is continually emerging; therefore, nurses cannot rely solely on experience.
The effective nurse also maintains respect for each PATIENT as an individual.
Overgeneralization compromises that perspective. Intuition and trial and error are
unsystematic approaches to care.
2. Which PATIENT statements identify qualities of nursing practice with high therapeutic
value? (Select all that apply.) My nurse:
a. talks in language I can understand.
b. helps me keep track of my medications.
c. is willing to go to social activities with me.
d. lets me do whatever I choose without interfering.
e. looks at me as a whole person with different needs.
ANSWER: A, B, E
Each correct answer demonstrates caring is an example of appropriate nursing foci:
communicating at a level understandable to the PATIENT, using holistic principles to guide
care, and providing medication supervision. The incorrect options suggest a laissez-faire
attitude on the part of the nurse, when the nurse should instead provide thoughtful feedback
and help PATIENTs test alternative solutions or violate boundaries.
1. An example of an environmental factor that would cause a nurse to modify a planned critical
interaction occurs when the:
a PATIENT expresses a personal dislike for the nurse
.
b PATIENT is in total denial about her condition
.
c Nurse lacks the degree of knowledge required for the interaction
.
d Nurse learns that the PATIENTs mother has been hospitalized with a stroke
.
ANSWER: D
Environmental factors include timing. Timing of critical interventions is important. It should
occur when the individual can give full attention to the topic. It would be inappropriate to
,continue with the plan in the face of the PATIENTs distress related to her mothers illness. The
remaining options reflect other types of factors that influence communication such as attitudes,
knowledge, and relationships.
2. The nurse suspects that the PATIENTs communication is being negatively influenced by
personal attitude when he is heard stating:
a They think Im mentally ill but Im not; I just get a little depressed at times.
.
b I cant concentrate on anything besides getting out of here and back to my kids.
.
c Obviously my therapist cant understand where Im coming from because our
. lives are so different.
d There isnt anyone here in this hospital I can trust enough to talk to about why I
. abuse alcohol and drugs.
ANSWER: C
Attitude determines how one person responds to another. It includes ones biases, past
experiences, and openness. People of different socioeconomic backgrounds may have difficulty
surmounting this barrier. The remaining options reflect factors that can negatively influence
communication but they are environmental, knowledge, and relationship oriented.
3. The nature of the communication characterized in this exchange between a nurse and a
chronically depressed PATIENT is:
Nurse: Is it true that you enjoy knitting?
PATIENT: Yes, Ive done it for years and am pretty good at it.
Nurse: Im just a beginner. Do you think you could give me some tips?
PATIENT: I guess so. What would you like to know?
a Therapeutic
.
, b Collegial
.
c Social
.
d Intrapersonal
.
ANSWER: C
Although the conversation takes place between the nurse and a PATIENT, it is of a social
nature. It is superficial and benefits both parties mutually by encouraging a relationship based on
mutual interest. No expectation of help exists. Therapeutic communication promotes PATIENT
growth and is PATIENT-focused. Collegial conversation occurs for the purpose of professional
collaboration.
Intrapersonal communication takes place within the individual.
4. A PATIENT expresses a sense of genuineness in the nurse providing care when sharing
with family members that:
a I believe the nurse can feel what Im feeling.
.
b I always know what the nurse expects of me; the explanations are always clear.
.
c I can tell the nurse is sincere because the face supports what the mouth is
. saying.
d I may not always like what the nurse has to say but I can always depend on
. what Im told.
ANSWER: C
Genuineness is demonstrated by congruence between verbal and nonverbal behavior. Empathy is
seeing things from the PATIENTs viewpoint. Clearly stating expectations is a characteristic of
clarity. Trustworthiness can be described as dependability.
5. When providing discharge teaching to a PATIENT for whom English is a second language,
what technique will the nurse use to assess the PATIENTs understanding of the information being
shared verbally?
