Deck 1: Establishing the Therapeutic Alliance

Question 1

You are covering for a colleague who is sick today and you have to see a patient of hers who, based on what your colleague has told you, is very difficult. You are anxious about seeing her because you are expecting the treatment interaction to be unpleasant. Which of the following techniques should you use to help avoid a "difficult" encounter with the patient?

A) Ask the nurse to go into the room first and see whether the patient is in a good mood.
B) Use active listening techniques to identify the patient's underlying needs.
C) Ask the physical therapy technician to do bed exercises with her today.
D) Have everything planned ahead of time so that she has no opportunity to complain.
Short Answer

Answer 1

B

Question 2

Patient education is an integral part of many therapeutic interventions, and not all patients learn information the same way. List three different ways you might give patients information to facilitate learning.

Answer 2

Match the content and instructional method to the patient's age, developmental stage, knowledge base and health condition. Inquire about the patient's preferred way of learning. Provide important information in multiple formats. Pace the information provided. Engage the patient physically and cognitively when possible. Provide feedback. Practice recall of information and performance of activities in settings that are realistic. Encourage patients' questions and comments.

Question 3

Which of the following has been described as "the last acceptable form of prejudice"?

A) HIV/AIDS bias
B) Mental illness bias
C) Obesity bias
D) Substance abuse bias

Answer 3

C

Question 4

You are working with a 17-year-old high school football player who was diagnosed with spinal cord injury 5 months ago. Which of the following responses might you expect in this stage of his disease?

A) Evidence of dissociation with a sense that the accident happened to someone else
B) Lack of acknowledgment of the situation
C) An interest in doing all he can to get better
D) Anxiety, alarm, and a feeling of imminent crisis

Question 5

Which of the following factors is most likely to motivate patients to engage in ongoing healthful behaviors?

A) Awareness that significant change is needed
B) Freedom from demands of work and home
C) Knowing the benefits of healthful behaviors
D) A high sense of self-esteem

Question 6

Based on common biases in the U.S. health-care community, which of the following patients is likely to be at greatest risk for experiencing negative bias?

A) A 10-year-old boy with chickenpox
B) A 28-year-old obese Mexican woman with chest pain
C) A 43-year-old female athlete with a fractured leg
D) A 72-year-old Caucasian man with osteoarthritis of the knee

Question 7

You are working with a 57-year-old man who just had a transtibial amputation. You have instructed the patient how to do a number of exercises you would like him to engage in when he goes home next week. What is the most effective way to encourage his adherence to the exercise program?

A) Include exercises that he can do lying down and sitting up in the chair.
B) Include exercises that require assistance from his wife.
C) Include exercises that will require only 10 min each day.
D) Include exercises that will further his goal of walking with a prosthesis.

Question 8

When communicating with your patients in an adult rehabilitation unit, it is important to do which of the following?

A) Ask each patient with whom you are working whether they understand what you have told them.
B) Read the chart before seeing the patient so that you can refer to him or her by first name.
C) Refer to the patient by last name (preceded by "Mr.," "Mrs.," "Ms.," or "Miss") rather than just by diagnosis or room number.
D) Use appropriate medical terms with your patients as you explain therapeutic interventions.

Question 9

You have just received a referral to evaluate a 93-year-old woman who has had a stroke. When you go in to see her, it is clear that she is upset and wants to talk. She mentions her concern about dying and seems to want to talk about spiritual matters. What would be the best response in this situation?

A) Allow her to express her concerns and offer additional resources.
B) Tell her that it is hospital policy that you can only discuss therapy with her.
C) Tell her that you will go get the physician to speak with her.
D) Tell her what you believe so she can choose the best spiritual path.

Question 10

Health-care biases must be recognized to be changed. Which of the following actions would be most helpful in changing our beliefs?

A) Be aware of behaviors in others that might reflect bias.
B) Look for reinforcement of our beliefs within our peer group.
C) Reflect annually on our attitudes and beliefs about others.
D) Seek out commonalities with those we perceive as different.

Question 11

Which of the following statements is true about interactions with patients?

A) Our attitudes are expressed at a conscious level as well as an unconscious level.
B) Our past experiences have little to do with our present therapeutic relationships.
C) Our past experiences shape our attitudes toward our patients, but not our beliefs.
D) Unchallenged assumptions about our patients generally are favorable.

Question 12

List three behaviors that might indicate underlying negative beliefs that could hinder your clinical effectiveness.

Question 13

List three tips for effective listening in a health-care encounter.

Question 14

For which of the following patients are patient's rights most closely regulated?

A) A 6-month-old boy having surgery for shunt placement
B) A 22-year-old woman from Russia having scoliosis surgery
C) A 63-year-old man who is terminally ill with lung cancer
D) A 75-year-old woman who just had her hip replaced after a fall

Question 15

You just took a job working in a nursing home that employs a few very experienced therapists. You are surprised by some of the problems encountered by the therapy staff, such as poor productivity and frequent absenteeism. Which of the following factors most likely accounts for these problems?

A) The patients are very high-maintenance and difficult to work with.
B) The productivity requirements are very high, and no one can meet them.
C) The therapy staff is experiencing burnout due to a heavy caseload.
D) The therapy staff is older and more prone to illness and family issues.

Question 16

When you communicate with your patients, you convey information with your words as well as your body. Which of the following statements about "body language" is true?

A) It is more difficult to interpret than spoken words.
B) It is used as a primary means of communicating information.
C) It is used to communicate interpersonal attitudes.
D) It makes up about 25% of our communication with patients.

Question 17

Establishing good rapport enhances patients' perceptions of being valued and respected. List two benefits of patients' enhanced perceptions of value and respect.

Question 18

Which of the following examples is indicative of acculturation in the United States?

A) A Jewish couple from Israel attends an orthodox temple.
B) A Swedish couple travels 20 miles to shop at a Danish market.
C) A rural Vietnamese youth sings in a local rock group.
D) An elderly Latino speaks only Spanish at home.

Question 19

Culture is best defined as

A) a group of people living in a specific area.
B) the fact or state of belonging to a social group.
C) the geographical characteristics associated with a group.
D) the beliefs, customs, and norms of a particular group.