The Psychiatric Interview 4th Edition Carlat Test Bank
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.
ANS: 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?
ANS: 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.
ANS: 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.
ANS: 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.
ANS: 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.
ANS: 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.
ANS: B
The practice of psychiatric nursing requires a different set of skills than medical surgical nursing,
although substantial overlap does exist. Psychiatric nurses must be able to help patients with
medical and mental health problems, reflecting the holistic perspective these nurses must have.
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
ANS: 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
ANS: 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.
ANS: 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)
ANS: 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
ANS: 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.
ANS: 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.
ANS: 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.
ANS: 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
.
b
.
c
.
d
.
ANS: D
Patient expresses a personal dislike for the nurse
Patient is in total denial about her condition
Nurse lacks the degree of knowledge required for the interaction
Nurse learns that the patients mother has been hospitalized with a stroke
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
.
b
.
c
.
d
.
They think Im mentally ill but Im not; I just get a little depressed at times.
I cant concentrate on anything besides getting out of here and back to my kids.
Obviously my therapist cant understand where Im coming from because our
lives are so different.
There isnt anyone here in this hospital I can trust enough to talk to about why I
abuse alcohol and drugs.
ANS: 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
.
b
.
c
.
d
.
Therapeutic
Collegial
Social
Intrapersonal
a
.
b
.
c
.
d
.
Therapeutic
Collegial
Social
Intrapersonal
ANS: 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
.
b
.
c
.
d
.
ANS: C
I believe the nurse can feel what Im feeling.
I always know what the nurse expects of me; the explanations are always clear.
I can tell the nurse is sincere because the face supports what the mouth is
saying.
I may not always like what the nurse has to say but I can always depend on
what Im told.
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?
a
.
b
.
c
.
d
.
Continuously evaluating the patients nonverbal cues
Periodically asking the patient if they have any questions
Asking the patient to repeat the information they are given
Providing the information in concise, written form
ANS: A
Individuals from different cultures or even different generations often misunderstand and
misinterpret an unfamiliar language. Being aware of and critically examining cues that result
from nonverbal responses is an excellent technique to check their interpretations. Asking if they
have questions is an ineffective technique in light of the language barrier. Repeating the
information is no guarantee that the patient understands the information. Providing the
information in written form reinforces the material but does not ensure understanding especially
if the patient has deficiencies related to reading the language.
6. When communicating with a psychotic, schizophrenic patient, the nurse avoids the use of
slang phrases most importantly because:
a
.
b
.
c
.
Such phrases have different meanings for different people.
Such phrases will likely trigger anxiety and frustration in the patient.
The use of such phrases is not appropriate when communicating therapeutically
with a patient.
d
.
This patients altered thought processes will serve to make understanding such
phrases very unlikely.
ANS: D
Precise verbal communication is important because spoken words often mean different things to
different people. Figures of speech, jokes, clichs, colloquialisms, and other terms or special
phrases carry a variety of meanings especially to individuals with altered thought processes. A
person with schizophrenia interprets concretely and literally whereas psychosis generally brings
about loose associations. Although all the options are reasons to avoid the use of slang phrases,
the primary reason in this case in to avoid confusing the patient.
7. The nurse is considering the need for both effective means of communication and safety when
caring for a patient with impulse control issues and poor social skills. Which nursing intervention
is most appropriate to address these needs?
a
.
b
.
c
.
d
.
Reminding the patient with each interaction what space boundaries are
considered safe and desired
Asking the patient to describe and set space boundaries that feel safe and
facilitate effective communication
Clearly setting space boundaries for the patient so both patient and staff feel
safe and can communicate more effectively
Discussing the need for space boundaries and how they help both the patient
and the staff feel safe and aide in communicating effectively
ANS: D
Space as a concept of boundaries and safety is important to understand because the nurse and the
patient need to respect the distance that each needs. For successful communication to occur, both
parties need to feel safe. Some patients have problems with their boundaries and invade other
patients own safe zones; patients who perceive this as threatening react aggressively to such
boundary violations. The nurse may need to help the patient understand the need for appropriate
distances in order for everyone to feel safe and to communicate effectively. Reminding the
patient of what the boundaries are without first discussing the importance of space boundaries is
not an effective technique. Having the patient set the boundaries does not take into consideration
the needs of others, whereas staff setting the boundaries without patient involvement ignores the
needs of the patient and prevents the patient from understanding of the situation.
8. During the termination phase of the nurse-patient relationship with a dependent patient, the
nurse evaluates the effectiveness of coping techniques learned by:
a
.
b
.
Role playing with the patient in order to practice being assertive
Asking the patient to define the difference between being assertive and being
aggressive.
c
.
Discussing how her father effectively used both assertiveness and
aggressiveness to control her
d
.
Asking, When you used assertiveness to deal with your father during his visit,
how did it work?
a
.
b
.
c
.
d
.
Role playing with the patient in order to practice being assertive
Asking the patient to define the difference between being assertive and being
aggressive.
Discussing how her father effectively used both assertiveness and
aggressiveness to control her
Asking, When you used assertiveness to deal with your father during his visit,
how did it work?
ANS: D
Evaluation is a task of the termination phase. Asking such a question encourages patients to
evaluate actions and look at the outcomes of behaviors. Role playing to practice the technique,
defining the relevant terms, and discussing the effects of the fathers behavior would occur during
the working phase of the relationship and does not encourage evaluation of the newly learned
skills.
9. The nurse has developed a plan in which nursing interventions are used to reinforce the
patients healthy behaviors. Which statement by the nurse will positively reinforce the patients
efforts regarding the plan?
a
.
b
.
c
.
d
.
ANS: B
How can a stress reduction plan help you at home?
It sounds like you have the incentive to make healthy choices.
When you tried to follow the plan, how well did it work for you?
It sounds as though making healthy choices is very important to you.
This answer offers a positive response to a patient who is trying out new behaviors. This nursing
response will serve to encourage the patients efforts. The remaining options do not provide
positive reinforcement but rather are attempts to gather more information or clarify the patients
motivation to change.
10. A patient indicates that he is about to share information about his illness that is shocking and
embarrassing. Which nursing intervention has priority in this situation in facilitating the
communication process?
a
.
b
.
c
.
d
.
Reassuring the patient that talking will be therapeutic
Assuring the patient the information will be kept confidential
Responding to the patients information in an accepting manner
Providing the patient with a private place for the discussion to occur
ANS: C
Responding to the patients information in a nonjudgmental, accepting manner will encourage
continued therapeutic communication. The remaining options, although appropriate, will not
have the same generalized affect on the communication process as the correct option.
11. A patient whose history includes physically abusing his spouse and children has been
admitted to the unit for alcohol and drug dependency. Which nurse will likely experience
difficulty establishing a therapeutic relationship with this patient?
a
.
b
.
c
.
d
.
ANS: A
The nurse who has experienced physical abuse
The novice nurse who has never cared for an abuser
The experienced nurse who has seen too many abusers
The nurse who has been in treatment for abusing a spouse
The therapeutic use of the self begins with knowing yourself. Knowing yourself is a complex and
lifelong learning process. At the core of self-knowledge is the nurses ability to correctly identify
his or her own negative or unresolved issues including family backgrounds, dynamic cultural and
social issues, values, biases, and prejudices. Having been a victim of physical abuse places this
nurse in a situation that can be very harmful to the development of an affective nurse-patient
relationship. The novice nurse may lack some of the knowledge and experience necessary to be
effective but is not a likely to have intruding biases and prejudices. The experienced nurse is
more likely to have worked on the ability to provide effective care in spite of such experience
with this type of diagnosis whereas, the nurse having been treated for the diagnosis is most likely
to show empathy and caring.
12. A novice nurse asks, What is so wrong about being sympathetic with a patient who has also
lost a parent like I did? The psychiatric nurse manager responds:
a
.
b
.
c
.
d
.
There is a fine line between empathy and sympathy that when crossed makes
you less able to be therapeutic.
Rather than discussing the loss of your parent with the patient, you can talk to
me about it whenever you need to.
Ill provide you with some excellent materials that Im sure will help you to
understand why sympathy is less therapeutic.
Sympathy indicates that you are sharing your personal feelings and that changes
the focus of the communication from the patient to you.
ANS: D
Empathy should not be confused with sympathy. Sympathy is overinvolvement and sharing your
own feelings after hearing about another persons similar experience. It is not objective, and its
primary purpose is to decrease ones own personal distress. Although substituting sympathy for
empathy does lessen the ability to be therapeutic, that is not the best explanation for avoiding it.
Offering to discuss the nurses loss is a kind gesture but does not address the nurses question.
Providing materials on the subject would be an appropriate reinforcement but does not address
the question well.
13. A nurse has for the past 4 weeks been working with a psychotic patient who has been mute
and very withdrawn. The patient suddenly encroaches on the nurses personal space by touching
inappropriately. What is the most therapeutic response by the nurse to address this behavior?
a
.
b
.
c
.
d
.
Ignore it this time because the patient is, at last, responding.
Firmly communicate acceptable boundaries to the patient.
Gently touch the patients head and then observe the reaction.
Smile while telling the patient that people dont like being touched like that.
b
.
c
.
d
.
Firmly communicate acceptable boundaries to the patient.
Gently touch the patients head and then observe the reaction.
Smile while telling the patient that people dont like being touched like that.
ANS: B
The therapeutic response is to clearly communicate appropriate boundaries. There are times
when patients misinterpret the nurses nurturing as an invitation to an intimate relationship. In
these instances, boundaries must be firmly, but neutrally, explained. The behavior should not be
ignored since doing so may well result in the patient repeating the behavior with others, perhaps
with disastrous results. Touch is often misinterpreted by psychotic patients and in this case has
no therapeutic value. Nonverbal communication should always be congruent so as to avoid
confusing the patient.
14. Which statement indicates that a novice nurse understands the purpose of therapeutic
communication? My goal for communication with any patient is to:
a
.
b
.
c
.
d
.
maintain relationships.
mutually share information.
promote growth and change.
offer advice and make suggestions.
ANS: C
Therapeutic communication is intended to assist the patient to grow and change. The other
options are characteristics of social communication.
15. The expected outcome of conducting a periodic self-evaluation of ones own responses to
patients is for the nurse to continue:
a
.
b
.
c
.
d
.
Recognizing the nurses need for therapy
Recognizing personal problems and strengths
Maintaining distance from the patients problems
Maintaining professional boundaries with the patients
a
.
b
.
c
.
d
.
Recognizing the nurses need for therapy
Recognizing personal problems and strengths
Maintaining distance from the patients problems
Maintaining professional boundaries with the patients
ANS: B
Self-evaluation of responses to patients will reveal whether the nurse is responding with
objectivity versus subjectivity, acceptance or rejection, calmly or with anger, and with sympathy
or anxiety. The goal is not identify the nurses need for therapy or to maintain distance for patient
problems, but rather to remain objective about them. The purpose of a self-evaluation is to
recognize the nurses responses, not to maintain boundaries.
16. Which nursing response would indicate an empathetic approach to a patient who is depressed
over recent losses in her life?
a
.
b
.
c
.
d
.
Losing a job isnt always a bad thing.
I lost my parents last year and still feel sad.
Please tell me more about what you are feeling.
Lets not focus on whats sad but rather what is good about life.
ANS: C
Empathy or empathic understanding is the nurses ability to see things from the patients
viewpoint and to communicate this understanding to the patient. This response focuses on the
patients feelings and encourages further discussion. Minimizing the loss or suggesting a change
in focus sounds judgmental or patronizing and will likely cut off communication. Although selfdisclosure
can be therapeutic, this focuses on the nurses feelings.
17. A nurse is considering the therapeutic value of touch when planning care for an anxious
patient. What is the initial question the nurse should answer before initiating this technique?
a
.
b
.
c
.
d
.
How comfortable am I with touching this patient?
Will the patient find therapeutic touch supportive?
Does research support the use of therapeutic touch?
Has therapeutic touch proven to be therapeutic with anxious patients?
ANS: A
Touch will only communicate warmth and thus be therapeutic if the nurse is comfortable with it.
Although the other options are all appropriate, they do not have priority in this situation.
18. The nurse mentions, I like to use open-ended questions and statements because they result in
fuller, more revealing responses by the patient, and they stimulate discussion. What statement
would the nurse ask to best stimulate conversation with a patient about their family?
a
.
b
.
c
.
d
.
ANS: B
Where does your family live?
Tell me about your family.
Do you have a family nearby?
Would you like to talk about your family?
This broad opening will encourage discussion as well as allow the patient to decide what to
include about his or her family. The remaining options can all be answered with a yes or no
response and so do not stimulate communication.
19. A patient is struggling to explore and solve a problem. The nurse determines that it would be
therapeutic to offer alternatives. Which verbal introduction should the nurse incorporate in order
to achieve this objective?
a
.
b
.
c
.
d
.
Have you thought of
You should
Why dont you
I think you need to
ANS: A
This encourages the patient to consider alternatives without giving advice. The other options are
preludes to giving advice, which is not considered therapeutic.
20. A nurse is contemplating the use of self-disclosure. The expected outcome of this strategy is
that the patient will:
a
.
b
.
c
.
d
.
ANS: B
be informed about expected behaviors
express previously withheld feelings
foster a mutually supportive relationship with the nurse
recognize that the nurse can empathize through shared experiences
Self-disclosure should serve one or more of the following purposes: to model and educate; to
build the therapeutic alliance; to provide concrete reflection that encourages reality testing. The
nurse does not use self-disclosure foster a interdependent relationship that in any way gives
support to the nurse. Empathy does not rely upon shared experiences.
Chapter 4-Chapter 5 : Asking Questions I: How to Approach Threatening Topics
Chapter 5: Asking Questions II: Tricks for Improving Patient Recall Chapter 6: Asking
Questions III: How to Change Topics with Style
MULTIPLE CHOICE
1. A patient says to the nurse, I dreamed I was stoned. When I woke up, I felt emotionally
drained, as though I hadnt rested well. Which response should the nurse use to clarify the
patients comment?
a
.
b
.
c
.
d
.
It sounds as though you were uncomfortable with the content of your dream.
I understand what youre saying. Bad dreams leave me feeling tired, too.
So you feel as though you did not get enough quality sleep last night?
Can you give me an example of what you mean by stoned?
ANS: D
The technique of clarification is therapeutic and helps the nurse examine the meaning of the
patients statement. Asking for a definition of stoned directly asks for clarification. Restating that
the patient is uncomfortable with the dreams content is parroting, a non-therapeutic technique.
The other responses fail to clarify the meaning of the patients comment.
2. A patient diagnosed with schizophrenia tells the nurse, The CIA is monitoring us through the
fluorescent lights in this room. Be careful what you say. Which response by the nurse would be
most therapeutic?
a
.
b
.
c
.
d
.
Lets talk about something other than the CIA.
It sounds like youre concerned about your privacy.
The CIA is prohibited from operating in health care facilities.
You have lost touch with reality, which is a symptom of your illness.