The Psychiatric Interview 4th Edition Carlat Test Bank
5 5 5 5 5 5 5
(Chapter5 1-
Chapter5 3)The5 Initial5 Interview:5 A5 Preview5 Chapter5 2:5 Logistic5 Preparations:5 What5 to5Do5Before5the5
Interview
Chapter5 3:5 The5 Therapeutic5 Alliance:5 What5 It5 Is,5 Why5 It's5 Important,5 and5 How5to5 Establish5 It5MULT
IPLE5CHOICE
1. Which5outcome,5focused5on5recovery,5would5be5expected5in5the5plan5of5care5for5a5patient5li
ving5in5the5community5and5diagnosed5with5serious5and5persistent5mental5illness?5Within535mo
nths,5the5patient5will:
a. deny5 suicidal5 ideation.
b. report5a5 sense5 of5well-being.
c. take5 medications5 as5 prescribed.
d. attend5clinic5appointments5on5time.5
ANS:5B
Recovery5 emphasizes5 managing5 symptoms,5 reducing5 psychosocial5 disability,5 and5 improving5 role5pe
rformance.5The5 goal5 of5 recovery5 is5 to5 empower5 the5 individual5 with5 mental5 illness5 to5 achieve5 a5sense5
of5meaning5 and5 satisfaction5 in5life5 and5 to5 function5at5 the5 highest5 possible5 level5 of5 wellness.5The5incor
rect5options5focus5on5the5classic5medical5model5rather5than5recovery.
2. A5 patient5 is5 hospitalized5 for5 depression5 and5 suicidal5 ideation5 after5their5 spouse5 asks5 for5 a5d
ivorce.5Select5the5nurses5most5caring5comment.
a. Lets5 discuss5 some5 means5of5coping5 other5 than5 suicide5 when5 you5 have5 these5 feelings.
b. I5understand5 why5 youre5 so5 depressed.5 When5 I5 got5 divorced,5 I5 was5 devastated5 too.
c. You5 should5 forget5 about5 your5 marriage5 and5 move5 on5 with5 your5 life.
d. How5 did5 you5 get5 so5 depressed5 that5 hospitalization5 was5 necessary?5
ANS:5A
The5 nurses5 communication5 should5 evidence5 caring5and5 a5 commitment5 to5 work5 with5 the5 patient.5Th
is5 commitment5 lets5the5 patient5 know5the5 nurse5 will5 help.5 Probing5 and5advice5 are5 not5 helpful5 or5ther
apeutic5interventions.
3. In5 the5 shift-change5 report,5 an5 off-
going5 nurse5 criticizes5 a5 patient5 who5 wears5 heavy5 makeup.5Which5comment5by5the5 nurse5 who5 re
ceives5the5report5 best5demonstrates5 advocacy?
a. This5 is5a5 psychiatric5 hospital.5 Craziness5 is5 what5 we5 are5 all5 about.
b. Lets5 all5 show5 acceptance5of5 this5 patient5 by5wearing5 lots5 of5 makeup5too.
,c. Your5 comments5 are5 inconsiderate5 and5 inappropriate.5 Keep5 the5 report5 objective.
d. Our5 patients5 need5 our5 help5 to5 learn5 behaviors5 that5 will5 help5 them5 get5 along5 in5 society.5
ANS:5D
Accepting5patients5 needs5 for5 self-
expression5 and5 seeking5 to5teach5 skills5 that5 will5 contribute5 to5their5 well-
being5 demonstrate5 respect5 and5 are5 important5 parts5 of5 advocacy.5 The5 on-
coming5 nurse5needs5 to5take5 action5 to5 ensure5 that5 others5 are5 not5 prejudiced5 against5 the5 patient.5 Hum
or5 can5be5appropriate5 within5 the5privacy5of5a5 shift5 report5 but5not5 at5the5 expense5 of5respect5 for5 patie
nts.
Judging5the5 off-
going5 nurse5 in5 a5critical5 way5 will5 create5 conflict.5 Nurses5 must5 show5 compassion5for5each5other.
4. A5 nurse5 assesses5 a5 newly5 admitted5 patient5 diagnosed5 with5 major5 depressive5 disorder.5 Which5s
tatement5is5an5example5of5attending?
a. We5 all5 have5 stress5 in5 life.5 Being5in5a5 psychiatric5 hospital5 isnt5the5end5of5 the5 world.
b. Tell5 me5 why5 you5 felt5 you5 had5 to5 be5 hospitalized5 to5 receive5 treatment5 for5 your5 depression.
c. You5 will5 feel5 better5 after5we5 get5 some5antidepressant5 medication5 started5 for5 you.
d. Id5like5 to5 sit5 with5 you5 a5 while5 so5 you5 may5 feel5 more5comfortable5talking5 with5me.5
ANS:5D
Attending5 is5 a5 technique5 that5 demonstrates5 the5 nurses5 commitment5 to5 the5 relationship5 and5reduces
5 feelings5 of5 isolation.5 This5 technique5 shows5 respect5 for5 the5 patient5 and5 demonstrates5caring.5Gener
alizations,5probing,5and5false5reassurances5are5 non-therapeutic.
5. A5patient5 shows5the5 nurse5an5article5 from5 the5 Internet5 about5 a5 health5 problem.5Which5charac
teristic5 of5 the5 web5 sites5 address5 most5 alerts5 the5 nurse5 that5the5 site5 may5 have5 biased5 and5prejudic
ed5information?
a. Address5ends5 in5 .org.
b. Address5ends5 in5 .com.
c. Address5ends5 in5 .gov.
d. Address5 ends5 in5 .net.5
ANS:5B
Financial5 influences5on5a5 site5are5 a5clue5that5 the5information5may5be5 biased.5 .com5 at5 the5 end5 of5the5
address5 indicates5that5the5 site5 is5 a5 commercial5 one.5 .gov5 indicates5 that5 the5 site5 is5 maintained5by5a5 g
overnment5entity.5 .org5 indicates5 that5 the5 site5 is5 nonproprietary;5 the5 site5 may5or5 may5not5have5 relia
ble5information,5but5 it5 does5not5 profit5 from5its5activities.5 .net5can5 have5 multiple
,meanings.
6. A5nurse5 says,5 When5 I5was5 in5school,5 I5learned5to5call5upset5patients5 by5name5to5get5 their5attention
;5 however,5 I5 read5 a5 descriptive5 research5 study5 that5 says5 that5 this5approach5 does5 not5 work.5I5plan5 to5s
top5calling5patients5 by5name.5Which5 statement5is5the5 best5appraisal5 of5this5 nurses5comment?
a. One5 descriptive5 research5 study5 rarely5 provides5 enough5 evidence5 to5 change5 practice.
b. Staff5 nurses5 apply5new5 research5 findings5 only5with5 the5 help5 from5 clinical5 nurse5 specialists.
c. New5 research5 findings5 should5 be5 incorporated5 into5clinical5 algorithms5 before5 using5 them5 in5p
ractice.
d. The5 nurse5 misinterpreted5 the5 results5 of5 the5 study.5 Classic5 tenets5 of5 practice5 do5 not5 change.5
ANS:5A
Descriptive5 research5 findings5 provide5 evidence5 for5practice5 but5 must5 be5 viewed5 in5relation5 to5othe
r5 studies5 before5 practice5 changes.5 One5 study5is5 not5 enough.5 Descriptive5 studies5 are5low5 on5the5 hier
archy5of5 evidence.5 Clinical5 algorithms5 use5 flow5 charts5 to5 manage5 problems5 and5 do5 not5specify5 on
e5 response5 to5a5 clinical5 problem.5 Classic5 tenets5 of5 practice5 should5 change5 as5 research5findings5pro
vide5evidence5for5change.
7. Two5 nursing5students5discuss5 career5 plans5after5 graduation.5One5 student5 wants5to5enter5psychia
tric5 nursing.5 The5 other5 student5 asks,5 Why5 would5 you5 want5 to5 be5 a5 psychiatric5 nurse?5 All5they5do5 i
s5talk.5 You5 will5 lose5 your5 skills.5 Select5 the5best5 response5by5the5 student5 interested5 in5psychiatric5n
ursing.
a. Psychiatric5 nurses5 practice5 in5 safer5 environments5 than5 other5 specialties.5 Nurse-to-
patient5 ratios5must5be5better5because5of5the5nature5of5patients5problems.
b. Psychiatric5 nurses5 use5 complex5communication5 skills,5 as5 well5 as5 critical5 thinking,5 to5 solve5
multidimensional5problems.5Im5challenged5by5those5situations.
c. I5think5 I5will5 be5 good5 in5 the5 mental5health5 field.5 I5do5not5 like5clinical5rotations5 in5 school,5 so5 I5d
o5not5want5to5continue5them5after5I5graduate.
d. Psychiatric5 nurses5 do5 not5have5 to5 deal5 with5 as5 much5pain5 and5 suffering5 as5 medical5 surgical5n
urses.5That5appeals5to5me.
ANS:5 B
The5 practice5 of5 psychiatric5 nursing5 requires5 a5 different5 set5 of5 skills5 than5 medical5 surgical5 nursing,5alt
hough5substantial5 overlap5does5exist.5 Psychiatric5 nurses5 must5 be5able5 to5help5 patients5 with5medical5 a
nd5 mental5 health5 problems,5 reflecting5 the5 holistic5 perspective5 these5 nurses5 must5 have.
, Nurse-
patient5 ratios5 and5 workloads5 in5 psychiatric5 settings5 have5 increased,5 similar5 to5 other5specialties.5 Ps
ychiatric5 nursing5involves5 clinical5 practice,5 not5 simply5documentation.
Psychosocial5 pain5 is5 real5and5 can5cause5 as5much5 suffering5 as5 physical5 pain.
8. Which5 research5evidence5 would5 most5 influence5 a5 group5 of5 nurses5 to5 change5 their5 practice?
a. Expert5 committee5 report5 of5 recommendations5 for5 practice
b. Systematic5 review5 of5 randomized5 controlled5 trials
c. Nonexperimental5 descriptive5 study
d. Critical5pathway5
ANS:5B
Research5 findings5 are5 graded5 using5 a5 hierarchy5 of5 evidence.5 A5 systematic5 review5 of5 randomized5c
ontrolled5 trials5 is5 Level5 A5 and5 provides5 the5 strongest5 evidence5 for5 changing5practice.5 Expert5com
mittee5 recommendations5 and5 descriptive5 studies5 lend5 less5 powerful5 and5 influential5 evidence.5A5cri
tical5pathway5is5not5 evidence;5it5incorporates5research5findings5 after5 they5have5 been5analyzed.
9. A5 bill5 introduced5 in5 Congress5 would5 reduce5 funding5 for5 the5 care5 of5 people5 diagnosed5 with5me
ntal5 illnesses.5 A5 group5 of5 nurses5 write5 letters5 to5 their5 elected5 representatives5 in5 opposition5 to5the5l
egislation.5Which5role5have5the5nurses5fulfilled?
a. Advocacy
b. Attending
c. Recovery
d. Evidence-
based5 practice5ANS:5A
An5 advocate5 defends5 or5 asserts5 anothers5 cause,5 particularly5 when5 the5 other5 person5 lacks5 the5ability
5 to5 do5 that5 for5 himself5 or5 herself.5 Examples5 of5 individual5 advocacy5 include5 helping5 patients5underst
and5their5 rights5 or5 make5 decisions.5 On5 a5 community5 scale,5 advocacy5 includes5 political5activity,5 pub
lic5 speaking,5 and5 publication5 in5 the5 interest5 of5 improving5 the5 individuals5 with5 mental5illness;5 the5le
tter-
writing5 campaign5 advocates5 for5 that5 cause5 on5 behalf5 of5 patients5 who5 are5 unable5to5articulate5their5o
wn5needs.
10. An5 informal5 group5 of5 patients5 discuss5 their5 perceptions5 of5 nursing5 care.5 Which5 comment5 best
5 5 5 5 5 5 5
(Chapter5 1-
Chapter5 3)The5 Initial5 Interview:5 A5 Preview5 Chapter5 2:5 Logistic5 Preparations:5 What5 to5Do5Before5the5
Interview
Chapter5 3:5 The5 Therapeutic5 Alliance:5 What5 It5 Is,5 Why5 It's5 Important,5 and5 How5to5 Establish5 It5MULT
IPLE5CHOICE
1. Which5outcome,5focused5on5recovery,5would5be5expected5in5the5plan5of5care5for5a5patient5li
ving5in5the5community5and5diagnosed5with5serious5and5persistent5mental5illness?5Within535mo
nths,5the5patient5will:
a. deny5 suicidal5 ideation.
b. report5a5 sense5 of5well-being.
c. take5 medications5 as5 prescribed.
d. attend5clinic5appointments5on5time.5
ANS:5B
Recovery5 emphasizes5 managing5 symptoms,5 reducing5 psychosocial5 disability,5 and5 improving5 role5pe
rformance.5The5 goal5 of5 recovery5 is5 to5 empower5 the5 individual5 with5 mental5 illness5 to5 achieve5 a5sense5
of5meaning5 and5 satisfaction5 in5life5 and5 to5 function5at5 the5 highest5 possible5 level5 of5 wellness.5The5incor
rect5options5focus5on5the5classic5medical5model5rather5than5recovery.
2. A5 patient5 is5 hospitalized5 for5 depression5 and5 suicidal5 ideation5 after5their5 spouse5 asks5 for5 a5d
ivorce.5Select5the5nurses5most5caring5comment.
a. Lets5 discuss5 some5 means5of5coping5 other5 than5 suicide5 when5 you5 have5 these5 feelings.
b. I5understand5 why5 youre5 so5 depressed.5 When5 I5 got5 divorced,5 I5 was5 devastated5 too.
c. You5 should5 forget5 about5 your5 marriage5 and5 move5 on5 with5 your5 life.
d. How5 did5 you5 get5 so5 depressed5 that5 hospitalization5 was5 necessary?5
ANS:5A
The5 nurses5 communication5 should5 evidence5 caring5and5 a5 commitment5 to5 work5 with5 the5 patient.5Th
is5 commitment5 lets5the5 patient5 know5the5 nurse5 will5 help.5 Probing5 and5advice5 are5 not5 helpful5 or5ther
apeutic5interventions.
3. In5 the5 shift-change5 report,5 an5 off-
going5 nurse5 criticizes5 a5 patient5 who5 wears5 heavy5 makeup.5Which5comment5by5the5 nurse5 who5 re
ceives5the5report5 best5demonstrates5 advocacy?
a. This5 is5a5 psychiatric5 hospital.5 Craziness5 is5 what5 we5 are5 all5 about.
b. Lets5 all5 show5 acceptance5of5 this5 patient5 by5wearing5 lots5 of5 makeup5too.
,c. Your5 comments5 are5 inconsiderate5 and5 inappropriate.5 Keep5 the5 report5 objective.
d. Our5 patients5 need5 our5 help5 to5 learn5 behaviors5 that5 will5 help5 them5 get5 along5 in5 society.5
ANS:5D
Accepting5patients5 needs5 for5 self-
expression5 and5 seeking5 to5teach5 skills5 that5 will5 contribute5 to5their5 well-
being5 demonstrate5 respect5 and5 are5 important5 parts5 of5 advocacy.5 The5 on-
coming5 nurse5needs5 to5take5 action5 to5 ensure5 that5 others5 are5 not5 prejudiced5 against5 the5 patient.5 Hum
or5 can5be5appropriate5 within5 the5privacy5of5a5 shift5 report5 but5not5 at5the5 expense5 of5respect5 for5 patie
nts.
Judging5the5 off-
going5 nurse5 in5 a5critical5 way5 will5 create5 conflict.5 Nurses5 must5 show5 compassion5for5each5other.
4. A5 nurse5 assesses5 a5 newly5 admitted5 patient5 diagnosed5 with5 major5 depressive5 disorder.5 Which5s
tatement5is5an5example5of5attending?
a. We5 all5 have5 stress5 in5 life.5 Being5in5a5 psychiatric5 hospital5 isnt5the5end5of5 the5 world.
b. Tell5 me5 why5 you5 felt5 you5 had5 to5 be5 hospitalized5 to5 receive5 treatment5 for5 your5 depression.
c. You5 will5 feel5 better5 after5we5 get5 some5antidepressant5 medication5 started5 for5 you.
d. Id5like5 to5 sit5 with5 you5 a5 while5 so5 you5 may5 feel5 more5comfortable5talking5 with5me.5
ANS:5D
Attending5 is5 a5 technique5 that5 demonstrates5 the5 nurses5 commitment5 to5 the5 relationship5 and5reduces
5 feelings5 of5 isolation.5 This5 technique5 shows5 respect5 for5 the5 patient5 and5 demonstrates5caring.5Gener
alizations,5probing,5and5false5reassurances5are5 non-therapeutic.
5. A5patient5 shows5the5 nurse5an5article5 from5 the5 Internet5 about5 a5 health5 problem.5Which5charac
teristic5 of5 the5 web5 sites5 address5 most5 alerts5 the5 nurse5 that5the5 site5 may5 have5 biased5 and5prejudic
ed5information?
a. Address5ends5 in5 .org.
b. Address5ends5 in5 .com.
c. Address5ends5 in5 .gov.
d. Address5 ends5 in5 .net.5
ANS:5B
Financial5 influences5on5a5 site5are5 a5clue5that5 the5information5may5be5 biased.5 .com5 at5 the5 end5 of5the5
address5 indicates5that5the5 site5 is5 a5 commercial5 one.5 .gov5 indicates5 that5 the5 site5 is5 maintained5by5a5 g
overnment5entity.5 .org5 indicates5 that5 the5 site5 is5 nonproprietary;5 the5 site5 may5or5 may5not5have5 relia
ble5information,5but5 it5 does5not5 profit5 from5its5activities.5 .net5can5 have5 multiple
,meanings.
6. A5nurse5 says,5 When5 I5was5 in5school,5 I5learned5to5call5upset5patients5 by5name5to5get5 their5attention
;5 however,5 I5 read5 a5 descriptive5 research5 study5 that5 says5 that5 this5approach5 does5 not5 work.5I5plan5 to5s
top5calling5patients5 by5name.5Which5 statement5is5the5 best5appraisal5 of5this5 nurses5comment?
a. One5 descriptive5 research5 study5 rarely5 provides5 enough5 evidence5 to5 change5 practice.
b. Staff5 nurses5 apply5new5 research5 findings5 only5with5 the5 help5 from5 clinical5 nurse5 specialists.
c. New5 research5 findings5 should5 be5 incorporated5 into5clinical5 algorithms5 before5 using5 them5 in5p
ractice.
d. The5 nurse5 misinterpreted5 the5 results5 of5 the5 study.5 Classic5 tenets5 of5 practice5 do5 not5 change.5
ANS:5A
Descriptive5 research5 findings5 provide5 evidence5 for5practice5 but5 must5 be5 viewed5 in5relation5 to5othe
r5 studies5 before5 practice5 changes.5 One5 study5is5 not5 enough.5 Descriptive5 studies5 are5low5 on5the5 hier
archy5of5 evidence.5 Clinical5 algorithms5 use5 flow5 charts5 to5 manage5 problems5 and5 do5 not5specify5 on
e5 response5 to5a5 clinical5 problem.5 Classic5 tenets5 of5 practice5 should5 change5 as5 research5findings5pro
vide5evidence5for5change.
7. Two5 nursing5students5discuss5 career5 plans5after5 graduation.5One5 student5 wants5to5enter5psychia
tric5 nursing.5 The5 other5 student5 asks,5 Why5 would5 you5 want5 to5 be5 a5 psychiatric5 nurse?5 All5they5do5 i
s5talk.5 You5 will5 lose5 your5 skills.5 Select5 the5best5 response5by5the5 student5 interested5 in5psychiatric5n
ursing.
a. Psychiatric5 nurses5 practice5 in5 safer5 environments5 than5 other5 specialties.5 Nurse-to-
patient5 ratios5must5be5better5because5of5the5nature5of5patients5problems.
b. Psychiatric5 nurses5 use5 complex5communication5 skills,5 as5 well5 as5 critical5 thinking,5 to5 solve5
multidimensional5problems.5Im5challenged5by5those5situations.
c. I5think5 I5will5 be5 good5 in5 the5 mental5health5 field.5 I5do5not5 like5clinical5rotations5 in5 school,5 so5 I5d
o5not5want5to5continue5them5after5I5graduate.
d. Psychiatric5 nurses5 do5 not5have5 to5 deal5 with5 as5 much5pain5 and5 suffering5 as5 medical5 surgical5n
urses.5That5appeals5to5me.
ANS:5 B
The5 practice5 of5 psychiatric5 nursing5 requires5 a5 different5 set5 of5 skills5 than5 medical5 surgical5 nursing,5alt
hough5substantial5 overlap5does5exist.5 Psychiatric5 nurses5 must5 be5able5 to5help5 patients5 with5medical5 a
nd5 mental5 health5 problems,5 reflecting5 the5 holistic5 perspective5 these5 nurses5 must5 have.
, Nurse-
patient5 ratios5 and5 workloads5 in5 psychiatric5 settings5 have5 increased,5 similar5 to5 other5specialties.5 Ps
ychiatric5 nursing5involves5 clinical5 practice,5 not5 simply5documentation.
Psychosocial5 pain5 is5 real5and5 can5cause5 as5much5 suffering5 as5 physical5 pain.
8. Which5 research5evidence5 would5 most5 influence5 a5 group5 of5 nurses5 to5 change5 their5 practice?
a. Expert5 committee5 report5 of5 recommendations5 for5 practice
b. Systematic5 review5 of5 randomized5 controlled5 trials
c. Nonexperimental5 descriptive5 study
d. Critical5pathway5
ANS:5B
Research5 findings5 are5 graded5 using5 a5 hierarchy5 of5 evidence.5 A5 systematic5 review5 of5 randomized5c
ontrolled5 trials5 is5 Level5 A5 and5 provides5 the5 strongest5 evidence5 for5 changing5practice.5 Expert5com
mittee5 recommendations5 and5 descriptive5 studies5 lend5 less5 powerful5 and5 influential5 evidence.5A5cri
tical5pathway5is5not5 evidence;5it5incorporates5research5findings5 after5 they5have5 been5analyzed.
9. A5 bill5 introduced5 in5 Congress5 would5 reduce5 funding5 for5 the5 care5 of5 people5 diagnosed5 with5me
ntal5 illnesses.5 A5 group5 of5 nurses5 write5 letters5 to5 their5 elected5 representatives5 in5 opposition5 to5the5l
egislation.5Which5role5have5the5nurses5fulfilled?
a. Advocacy
b. Attending
c. Recovery
d. Evidence-
based5 practice5ANS:5A
An5 advocate5 defends5 or5 asserts5 anothers5 cause,5 particularly5 when5 the5 other5 person5 lacks5 the5ability
5 to5 do5 that5 for5 himself5 or5 herself.5 Examples5 of5 individual5 advocacy5 include5 helping5 patients5underst
and5their5 rights5 or5 make5 decisions.5 On5 a5 community5 scale,5 advocacy5 includes5 political5activity,5 pub
lic5 speaking,5 and5 publication5 in5 the5 interest5 of5 improving5 the5 individuals5 with5 mental5illness;5 the5le
tter-
writing5 campaign5 advocates5 for5 that5 cause5 on5 behalf5 of5 patients5 who5 are5 unable5to5articulate5their5o
wn5needs.
10. An5 informal5 group5 of5 patients5 discuss5 their5 perceptions5 of5 nursing5 care.5 Which5 comment5 best
