The Psychiatric Interview 4th Edition Carlat Test Bank
0 0 0 0 0 0 0
(Chapter0 1-
Chapter0 3)The0 Initial0 Interview:0 A0 Preview0 Chapter0 2:0 Logistic0 Preparations:0 What0 to0Do0Before0the0
Interview
Chapter0 3:0 The0 Therapeutic0 Alliance:0 What0 It0 Is,0 Why0 It's0 Important,0 and0 How0to0 Establish0 It0MULT
IPLE0CHOICE
1. Which0outcome,0focused0on0recovery,0would0be0expected0in0the0plan0of0care0for0a0patient0li
ving0in0the0community0and0diagnosed0with0serious0and0persistent0mental0illness?0Within030mo
nths,0the0patient0will:
a. deny0 suicidal0 ideation.
b. report0a0 sense0 of0well-being.
c. take0 medications0 as0 prescribed.
d. attend0clinic0appointments0on0time.0
ANS:0B
Recovery0 emphasizes0 managing0 symptoms,0 reducing0 psychosocial0 disability,0 and0 improving0 role0pe
rformance.0The0 goal0 of0 recovery0 is0 to0 empower0 the0 individual0 with0 mental0 illness0 to0 achieve0 a0sense0
of0meaning0 and0 satisfaction0 in0life0 and0 to0 function0at0 the0 highest0 possible0 level0 of0 wellness.0The0incor
rect0options0focus0on0the0classic0medical0model0rather0than0recovery.
2. A0 patient0 is0 hospitalized0 for0 depression0 and0 suicidal0 ideation0 after0their0 spouse0 asks0 for0 a0d
ivorce.0Select0the0nurses0most0caring0comment.
a. Lets0 discuss0 some0 means0of0coping0 other0 than0 suicide0 when0 you0 have0 these0 feelings.
b. I0understand0 why0 youre0 so0 depressed.0 When0 I0 got0 divorced,0 I0 was0 devastated0 too.
c. You0 should0 forget0 about0 your0 marriage0 and0 move0 on0 with0 your0 life.
d. How0 did0 you0 get0 so0 depressed0 that0 hospitalization0 was0 necessary?0
ANS:0A
The0 nurses0 communication0 should0 evidence0 caring0and0 a0 commitment0 to0 work0 with0 the0 patient.0Th
is0 commitment0 lets0the0 patient0 know0the0 nurse0 will0 help.0 Probing0 and0advice0 are0 not0 helpful0 or0ther
apeutic0interventions.
3. In0 the0 shift-change0 report,0 an0 off-
going0 nurse0 criticizes0 a0 patient0 who0 wears0 heavy0 makeup.0Which0comment0by0the0 nurse0 who0 re
ceives0the0report0 best0demonstrates0 advocacy?
a. This0 is0a0 psychiatric0 hospital.0 Craziness0 is0 what0 we0 are0 all0 about.
b. Lets0 all0 show0 acceptance0of0 this0 patient0 by0wearing0 lots0 of0 makeup0too.
,c. Your0 comments0 are0 inconsiderate0 and0 inappropriate.0 Keep0 the0 report0 objective.
d. Our0 patients0 need0 our0 help0 to0 learn0 behaviors0 that0 will0 help0 them0 get0 along0 in0 society.0
ANS:0D
Accepting0patients0 needs0 for0 self-
expression0 and0 seeking0 to0teach0 skills0 that0 will0 contribute0 to0their0 well-
being0 demonstrate0 respect0 and0 are0 important0 parts0 of0 advocacy.0 The0 on-
coming0 nurse0needs0 to0take0 action0 to0 ensure0 that0 others0 are0 not0 prejudiced0 against0 the0 patient.0 Hum
or0 can0be0appropriate0 within0 the0privacy0of0a0 shift0 report0 but0not0 at0the0 expense0 of0respect0 for0 patie
nts.
Judging0the0 off-
going0 nurse0 in0 a0critical0 way0 will0 create0 conflict.0 Nurses0 must0 show0 compassion0for0each0other.
4. A0 nurse0 assesses0 a0 newly0 admitted0 patient0 diagnosed0 with0 major0 depressive0 disorder.0 Which0s
tatement0is0an0example0of0attending?
a. We0 all0 have0 stress0 in0 life.0 Being0in0a0 psychiatric0 hospital0 isnt0the0end0of0 the0 world.
b. Tell0 me0 why0 you0 felt0 you0 had0 to0 be0 hospitalized0 to0 receive0 treatment0 for0 your0 depression.
c. You0 will0 feel0 better0 after0we0 get0 some0antidepressant0 medication0 started0 for0 you.
d. Id0like0 to0 sit0 with0 you0 a0 while0 so0 you0 may0 feel0 more0comfortable0talking0 with0me.0
ANS:0D
Attending0 is0 a0 technique0 that0 demonstrates0 the0 nurses0 commitment0 to0 the0 relationship0 and0reduces
0 feelings0 of0 isolation.0 This0 technique0 shows0 respect0 for0 the0 patient0 and0 demonstrates0caring.0Gener
alizations,0probing,0and0false0reassurances0are0 non-therapeutic.
5. A0patient0 shows0the0 nurse0an0article0 from0 the0 Internet0 about0 a0 health0 problem.0Which0charac
teristic0 of0 the0 web0 sites0 address0 most0 alerts0 the0 nurse0 that0the0 site0 may0 have0 biased0 and0prejudic
ed0information?
a. Address0ends0 in0 .org.
b. Address0ends0 in0 .com.
c. Address0ends0 in0 .gov.
d. Address0 ends0 in0 .net.0
ANS:0B
Financial0 influences0on0a0 site0are0 a0clue0that0 the0information0may0be0 biased.0 .com0 at0 the0 end0 of0the0
address0 indicates0that0the0 site0 is0 a0 commercial0 one.0 .gov0 indicates0 that0 the0 site0 is0 maintained0by0a0 g
overnment0entity.0 .org0 indicates0 that0 the0 site0 is0 nonproprietary;0 the0 site0 may0or0 may0not0have0 relia
ble0information,0but0 it0 does0not0 profit0 from0its0activities.0 .net0can0 have0 multiple
,meanings.
6. A0nurse0 says,0 When0 I0was0 in0school,0 I0learned0to0call0upset0patients0 by0name0to0get0 their0attention
;0 however,0 I0 read0 a0 descriptive0 research0 study0 that0 says0 that0 this0approach0 does0 not0 work.0I0plan0 to0s
top0calling0patients0 by0name.0Which0 statement0is0the0 best0appraisal0 of0this0 nurses0comment?
a. One0 descriptive0 research0 study0 rarely0 provides0 enough0 evidence0 to0 change0 practice.
b. Staff0 nurses0 apply0new0 research0 findings0 only0with0 the0 help0 from0 clinical0 nurse0 specialists.
c. New0 research0 findings0 should0 be0 incorporated0 into0clinical0 algorithms0 before0 using0 them0 in0p
ractice.
d. The0 nurse0 misinterpreted0 the0 results0 of0 the0 study.0 Classic0 tenets0 of0 practice0 do0 not0 change.0
ANS:0A
Descriptive0 research0 findings0 provide0 evidence0 for0practice0 but0 must0 be0 viewed0 in0relation0 to0othe
r0 studies0 before0 practice0 changes.0 One0 study0is0 not0 enough.0 Descriptive0 studies0 are0low0 on0the0 hier
archy0of0 evidence.0 Clinical0 algorithms0 use0 flow0 charts0 to0 manage0 problems0 and0 do0 not0specify0 on
e0 response0 to0a0 clinical0 problem.0 Classic0 tenets0 of0 practice0 should0 change0 as0 research0findings0pro
vide0evidence0for0change.
7. Two0 nursing0students0discuss0 career0 plans0after0 graduation.0One0 student0 wants0to0enter0psychia
tric0 nursing.0 The0 other0 student0 asks,0 Why0 would0 you0 want0 to0 be0 a0 psychiatric0 nurse?0 All0they0do0 i
s0talk.0 You0 will0 lose0 your0 skills.0 Select0 the0best0 response0by0the0 student0 interested0 in0psychiatric0n
ursing.
a. Psychiatric0 nurses0 practice0 in0 safer0 environments0 than0 other0 specialties.0 Nurse-to-
patient0 ratios0must0be0better0because0of0the0nature0of0patients0problems.
b. Psychiatric0 nurses0 use0 complex0communication0 skills,0 as0 well0 as0 critical0 thinking,0 to0 solve0
multidimensional0problems.0Im0challenged0by0those0situations.
c. I0think0 I0will0 be0 good0 in0 the0 mental0health0 field.0 I0do0not0 like0clinical0rotations0 in0 school,0 so0 I0d
o0not0want0to0continue0them0after0I0graduate.
d. Psychiatric0 nurses0 do0 not0have0 to0 deal0 with0 as0 much0pain0 and0 suffering0 as0 medical0 surgical0n
urses.0That0appeals0to0me.
ANS:0 B
The0 practice0 of0 psychiatric0 nursing0 requires0 a0 different0 set0 of0 skills0 than0 medical0 surgical0 nursing,0alt
hough0substantial0 overlap0does0exist.0 Psychiatric0 nurses0 must0 be0able0 to0help0 patients0 with0medical0 a
nd0 mental0 health0 problems,0 reflecting0 the0 holistic0 perspective0 these0 nurses0 must0 have.
, Nurse-
patient0 ratios0 and0 workloads0 in0 psychiatric0 settings0 have0 increased,0 similar0 to0 other0specialties.0 Ps
ychiatric0 nursing0involves0 clinical0 practice,0 not0 simply0documentation.
Psychosocial0 pain0 is0 real0and0 can0cause0 as0much0 suffering0 as0 physical0 pain.
8. Which0 research0evidence0 would0 most0 influence0 a0 group0 of0 nurses0 to0 change0 their0 practice?
a. Expert0 committee0 report0 of0 recommendations0 for0 practice
b. Systematic0 review0 of0 randomized0 controlled0 trials
c. Nonexperimental0 descriptive0 study
d. Critical0pathway0
ANS:0B
Research0 findings0 are0 graded0 using0 a0 hierarchy0 of0 evidence.0 A0 systematic0 review0 of0 randomized0c
ontrolled0 trials0 is0 Level0 A0 and0 provides0 the0 strongest0 evidence0 for0 changing0practice.0 Expert0com
mittee0 recommendations0 and0 descriptive0 studies0 lend0 less0 powerful0 and0 influential0 evidence.0A0cri
tical0pathway0is0not0 evidence;0it0incorporates0research0findings0 after0 they0have0 been0analyzed.
9. A0 bill0 introduced0 in0 Congress0 would0 reduce0 funding0 for0 the0 care0 of0 people0 diagnosed0 with0me
ntal0 illnesses.0 A0 group0 of0 nurses0 write0 letters0 to0 their0 elected0 representatives0 in0 opposition0 to0the0l
egislation.0Which0role0have0the0nurses0fulfilled?
a. Advocacy
b. Attending
c. Recovery
d. Evidence-
based0 practice0ANS:0A
An0 advocate0 defends0 or0 asserts0 anothers0 cause,0 particularly0 when0 the0 other0 person0 lacks0 the0ability
0 to0 do0 that0 for0 himself0 or0 herself.0 Examples0 of0 individual0 advocacy0 include0 helping0 patients0underst
and0their0 rights0 or0 make0 decisions.0 On0 a0 community0 scale,0 advocacy0 includes0 political0activity,0 pub
lic0 speaking,0 and0 publication0 in0 the0 interest0 of0 improving0 the0 individuals0 with0 mental0illness;0 the0le
tter-
writing0 campaign0 advocates0 for0 that0 cause0 on0 behalf0 of0 patients0 who0 are0 unable0to0articulate0their0o
wn0needs.
10. An0 informal0 group0 of0 patients0 discuss0 their0 perceptions0 of0 nursing0 care.0 Which0 comment0 best
0 0 0 0 0 0 0
(Chapter0 1-
Chapter0 3)The0 Initial0 Interview:0 A0 Preview0 Chapter0 2:0 Logistic0 Preparations:0 What0 to0Do0Before0the0
Interview
Chapter0 3:0 The0 Therapeutic0 Alliance:0 What0 It0 Is,0 Why0 It's0 Important,0 and0 How0to0 Establish0 It0MULT
IPLE0CHOICE
1. Which0outcome,0focused0on0recovery,0would0be0expected0in0the0plan0of0care0for0a0patient0li
ving0in0the0community0and0diagnosed0with0serious0and0persistent0mental0illness?0Within030mo
nths,0the0patient0will:
a. deny0 suicidal0 ideation.
b. report0a0 sense0 of0well-being.
c. take0 medications0 as0 prescribed.
d. attend0clinic0appointments0on0time.0
ANS:0B
Recovery0 emphasizes0 managing0 symptoms,0 reducing0 psychosocial0 disability,0 and0 improving0 role0pe
rformance.0The0 goal0 of0 recovery0 is0 to0 empower0 the0 individual0 with0 mental0 illness0 to0 achieve0 a0sense0
of0meaning0 and0 satisfaction0 in0life0 and0 to0 function0at0 the0 highest0 possible0 level0 of0 wellness.0The0incor
rect0options0focus0on0the0classic0medical0model0rather0than0recovery.
2. A0 patient0 is0 hospitalized0 for0 depression0 and0 suicidal0 ideation0 after0their0 spouse0 asks0 for0 a0d
ivorce.0Select0the0nurses0most0caring0comment.
a. Lets0 discuss0 some0 means0of0coping0 other0 than0 suicide0 when0 you0 have0 these0 feelings.
b. I0understand0 why0 youre0 so0 depressed.0 When0 I0 got0 divorced,0 I0 was0 devastated0 too.
c. You0 should0 forget0 about0 your0 marriage0 and0 move0 on0 with0 your0 life.
d. How0 did0 you0 get0 so0 depressed0 that0 hospitalization0 was0 necessary?0
ANS:0A
The0 nurses0 communication0 should0 evidence0 caring0and0 a0 commitment0 to0 work0 with0 the0 patient.0Th
is0 commitment0 lets0the0 patient0 know0the0 nurse0 will0 help.0 Probing0 and0advice0 are0 not0 helpful0 or0ther
apeutic0interventions.
3. In0 the0 shift-change0 report,0 an0 off-
going0 nurse0 criticizes0 a0 patient0 who0 wears0 heavy0 makeup.0Which0comment0by0the0 nurse0 who0 re
ceives0the0report0 best0demonstrates0 advocacy?
a. This0 is0a0 psychiatric0 hospital.0 Craziness0 is0 what0 we0 are0 all0 about.
b. Lets0 all0 show0 acceptance0of0 this0 patient0 by0wearing0 lots0 of0 makeup0too.
,c. Your0 comments0 are0 inconsiderate0 and0 inappropriate.0 Keep0 the0 report0 objective.
d. Our0 patients0 need0 our0 help0 to0 learn0 behaviors0 that0 will0 help0 them0 get0 along0 in0 society.0
ANS:0D
Accepting0patients0 needs0 for0 self-
expression0 and0 seeking0 to0teach0 skills0 that0 will0 contribute0 to0their0 well-
being0 demonstrate0 respect0 and0 are0 important0 parts0 of0 advocacy.0 The0 on-
coming0 nurse0needs0 to0take0 action0 to0 ensure0 that0 others0 are0 not0 prejudiced0 against0 the0 patient.0 Hum
or0 can0be0appropriate0 within0 the0privacy0of0a0 shift0 report0 but0not0 at0the0 expense0 of0respect0 for0 patie
nts.
Judging0the0 off-
going0 nurse0 in0 a0critical0 way0 will0 create0 conflict.0 Nurses0 must0 show0 compassion0for0each0other.
4. A0 nurse0 assesses0 a0 newly0 admitted0 patient0 diagnosed0 with0 major0 depressive0 disorder.0 Which0s
tatement0is0an0example0of0attending?
a. We0 all0 have0 stress0 in0 life.0 Being0in0a0 psychiatric0 hospital0 isnt0the0end0of0 the0 world.
b. Tell0 me0 why0 you0 felt0 you0 had0 to0 be0 hospitalized0 to0 receive0 treatment0 for0 your0 depression.
c. You0 will0 feel0 better0 after0we0 get0 some0antidepressant0 medication0 started0 for0 you.
d. Id0like0 to0 sit0 with0 you0 a0 while0 so0 you0 may0 feel0 more0comfortable0talking0 with0me.0
ANS:0D
Attending0 is0 a0 technique0 that0 demonstrates0 the0 nurses0 commitment0 to0 the0 relationship0 and0reduces
0 feelings0 of0 isolation.0 This0 technique0 shows0 respect0 for0 the0 patient0 and0 demonstrates0caring.0Gener
alizations,0probing,0and0false0reassurances0are0 non-therapeutic.
5. A0patient0 shows0the0 nurse0an0article0 from0 the0 Internet0 about0 a0 health0 problem.0Which0charac
teristic0 of0 the0 web0 sites0 address0 most0 alerts0 the0 nurse0 that0the0 site0 may0 have0 biased0 and0prejudic
ed0information?
a. Address0ends0 in0 .org.
b. Address0ends0 in0 .com.
c. Address0ends0 in0 .gov.
d. Address0 ends0 in0 .net.0
ANS:0B
Financial0 influences0on0a0 site0are0 a0clue0that0 the0information0may0be0 biased.0 .com0 at0 the0 end0 of0the0
address0 indicates0that0the0 site0 is0 a0 commercial0 one.0 .gov0 indicates0 that0 the0 site0 is0 maintained0by0a0 g
overnment0entity.0 .org0 indicates0 that0 the0 site0 is0 nonproprietary;0 the0 site0 may0or0 may0not0have0 relia
ble0information,0but0 it0 does0not0 profit0 from0its0activities.0 .net0can0 have0 multiple
,meanings.
6. A0nurse0 says,0 When0 I0was0 in0school,0 I0learned0to0call0upset0patients0 by0name0to0get0 their0attention
;0 however,0 I0 read0 a0 descriptive0 research0 study0 that0 says0 that0 this0approach0 does0 not0 work.0I0plan0 to0s
top0calling0patients0 by0name.0Which0 statement0is0the0 best0appraisal0 of0this0 nurses0comment?
a. One0 descriptive0 research0 study0 rarely0 provides0 enough0 evidence0 to0 change0 practice.
b. Staff0 nurses0 apply0new0 research0 findings0 only0with0 the0 help0 from0 clinical0 nurse0 specialists.
c. New0 research0 findings0 should0 be0 incorporated0 into0clinical0 algorithms0 before0 using0 them0 in0p
ractice.
d. The0 nurse0 misinterpreted0 the0 results0 of0 the0 study.0 Classic0 tenets0 of0 practice0 do0 not0 change.0
ANS:0A
Descriptive0 research0 findings0 provide0 evidence0 for0practice0 but0 must0 be0 viewed0 in0relation0 to0othe
r0 studies0 before0 practice0 changes.0 One0 study0is0 not0 enough.0 Descriptive0 studies0 are0low0 on0the0 hier
archy0of0 evidence.0 Clinical0 algorithms0 use0 flow0 charts0 to0 manage0 problems0 and0 do0 not0specify0 on
e0 response0 to0a0 clinical0 problem.0 Classic0 tenets0 of0 practice0 should0 change0 as0 research0findings0pro
vide0evidence0for0change.
7. Two0 nursing0students0discuss0 career0 plans0after0 graduation.0One0 student0 wants0to0enter0psychia
tric0 nursing.0 The0 other0 student0 asks,0 Why0 would0 you0 want0 to0 be0 a0 psychiatric0 nurse?0 All0they0do0 i
s0talk.0 You0 will0 lose0 your0 skills.0 Select0 the0best0 response0by0the0 student0 interested0 in0psychiatric0n
ursing.
a. Psychiatric0 nurses0 practice0 in0 safer0 environments0 than0 other0 specialties.0 Nurse-to-
patient0 ratios0must0be0better0because0of0the0nature0of0patients0problems.
b. Psychiatric0 nurses0 use0 complex0communication0 skills,0 as0 well0 as0 critical0 thinking,0 to0 solve0
multidimensional0problems.0Im0challenged0by0those0situations.
c. I0think0 I0will0 be0 good0 in0 the0 mental0health0 field.0 I0do0not0 like0clinical0rotations0 in0 school,0 so0 I0d
o0not0want0to0continue0them0after0I0graduate.
d. Psychiatric0 nurses0 do0 not0have0 to0 deal0 with0 as0 much0pain0 and0 suffering0 as0 medical0 surgical0n
urses.0That0appeals0to0me.
ANS:0 B
The0 practice0 of0 psychiatric0 nursing0 requires0 a0 different0 set0 of0 skills0 than0 medical0 surgical0 nursing,0alt
hough0substantial0 overlap0does0exist.0 Psychiatric0 nurses0 must0 be0able0 to0help0 patients0 with0medical0 a
nd0 mental0 health0 problems,0 reflecting0 the0 holistic0 perspective0 these0 nurses0 must0 have.
, Nurse-
patient0 ratios0 and0 workloads0 in0 psychiatric0 settings0 have0 increased,0 similar0 to0 other0specialties.0 Ps
ychiatric0 nursing0involves0 clinical0 practice,0 not0 simply0documentation.
Psychosocial0 pain0 is0 real0and0 can0cause0 as0much0 suffering0 as0 physical0 pain.
8. Which0 research0evidence0 would0 most0 influence0 a0 group0 of0 nurses0 to0 change0 their0 practice?
a. Expert0 committee0 report0 of0 recommendations0 for0 practice
b. Systematic0 review0 of0 randomized0 controlled0 trials
c. Nonexperimental0 descriptive0 study
d. Critical0pathway0
ANS:0B
Research0 findings0 are0 graded0 using0 a0 hierarchy0 of0 evidence.0 A0 systematic0 review0 of0 randomized0c
ontrolled0 trials0 is0 Level0 A0 and0 provides0 the0 strongest0 evidence0 for0 changing0practice.0 Expert0com
mittee0 recommendations0 and0 descriptive0 studies0 lend0 less0 powerful0 and0 influential0 evidence.0A0cri
tical0pathway0is0not0 evidence;0it0incorporates0research0findings0 after0 they0have0 been0analyzed.
9. A0 bill0 introduced0 in0 Congress0 would0 reduce0 funding0 for0 the0 care0 of0 people0 diagnosed0 with0me
ntal0 illnesses.0 A0 group0 of0 nurses0 write0 letters0 to0 their0 elected0 representatives0 in0 opposition0 to0the0l
egislation.0Which0role0have0the0nurses0fulfilled?
a. Advocacy
b. Attending
c. Recovery
d. Evidence-
based0 practice0ANS:0A
An0 advocate0 defends0 or0 asserts0 anothers0 cause,0 particularly0 when0 the0 other0 person0 lacks0 the0ability
0 to0 do0 that0 for0 himself0 or0 herself.0 Examples0 of0 individual0 advocacy0 include0 helping0 patients0underst
and0their0 rights0 or0 make0 decisions.0 On0 a0 community0 scale,0 advocacy0 includes0 political0activity,0 pub
lic0 speaking,0 and0 publication0 in0 the0 interest0 of0 improving0 the0 individuals0 with0 mental0illness;0 the0le
tter-
writing0 campaign0 advocates0 for0 that0 cause0 on0 behalf0 of0 patients0 who0 are0 unable0to0articulate0their0o
wn0needs.
10. An0 informal0 group0 of0 patients0 discuss0 their0 perceptions0 of0 nursing0 care.0 Which0 comment0 best
