Question 1

Which statement describes motivational interviewing (MI)?&#10;A) A set of communication techniques to be mastered&#10;B) An easy new way to obtain assessment information&#10;C) A method to reduce the amount of time to provide care&#10;D) A communication style that uses the language of change

Accepted Answer

MI is a communication style that uses the language of change. It is more than a set of communication techniques to be mastered. Mastering MI takes time and attention, and is not easy to use. It is not used to obtain assessment information. MI is not a method to reduce the amount of time to provide care.

Question 2

How does the transtheoretical model of change affect motivational interviewing (MI)?&#10;A) It really has no impact on MI.&#10;B) It can be used in place of MI techniques.&#10;C) It helps patients resolve inner ambivalence and make plans to sustain behavior change.&#10;D) The influence of the model of change depends on the patient's willingness to change.

Accepted Answer

MI is commonly used along with stages of change (SOCs) to help patients resolve inner ambivalence and to make concrete plans to go from not thinking about changing to activating and sustaining behavior change. The transtheoretical model does affect MI; however, it is not used in place of MI techniques. The transtheoretical model does depend on the patient's willingness to change; however, this does not explain the impact on MI.

Question 3

Motivational interviewing (MI) would be least effective for which of the following health problems?&#10;A) Obesity&#10;B) Diabetes&#10;C) Appendicitis&#10;D) Smoking cessation

Accepted Answer

Appendicitis is an acute health problem that can occur without provocation. MI would not necessarily be needed or effective when caring for a patient with this health problem. Studies have been conducted on the outcomes when MI is used with metabolic disorders such as obesity and diabetes. Studies have been conducted on the outcomes when MI is used to support behavior change, which is required with smoking cessation.

Question 4

Which studies need to be conducted to improve the use of motivational interviewing (MI)?&#10;A) Demonstration of the use of MI by nurses&#10;B) Response of MI in people with heart disease&#10;C) Outcome of MI after nursing students are instructed how to use it&#10;D) Value of using MI when caring for patients with chronic illnesses

Accepted Answer

When a search was conducted of evidence-based databases regarding the use of MI, only 11 studies used nurses as study subjects and 19 studies provided no discussion about how the nurses who use MI were educated or trained. Studies have been done that demonstrate the use of MI in people with cardiovascular illnesses. Studies have been done with nursing students; however, no evidence supports the outcome of MI after nursing students are instructed how to use it. Studies have been done that demonstrate the value of using MI when caring for patients with chronic illnesses.

Question 5

Why would nurses not be educated and trained in motivational interviewing (MI)?&#10;A) Limited use&#10;B) Limited scope of patients&#10;C) Lack of interest by nurses&#10;D) No evidence of cost-benefit analyses

Accepted Answer

A significant limitation to having all nurses educated and trained in using MI is that there are few studies that address the cost-benefit analyses of adopting amore MI-adherent practice. The use of MI is not limited, and it can be used for many patient health problems. Nurses are interested in the potential benefits of using MI in their practice.

Question 6

What is the potential outcome if motivational interviewing is poorly delivered?&#10;A) Plan would be needed to hire replacement nursing staff&#10;B) An increase in patient resistance to treatment&#10;C) More patient discharges from in-hospital care&#10;D) Need to schedule more patient education sessions

Accepted Answer

Poorly delivered MI may increase resistance to treatment. There is no evidence to support that poorly delivered MI results in the need to hire more nursing staff, increases patient discharges from in-hospital care, or increases the need to schedule more patient education sessions.

Question 7

Which of the following is the most useful motivational interviewing (MI) intervention for a nurse to use?&#10;A) Teaching strategies&#10;B) Care plan preparation&#10;C) Outcome identification&#10;D) Reflective listening skills

Accepted Answer

The most useful MI intervention that nurses can readily learn and apply centers on learning reflective listening skills beyond the level typically taught in nursing schools. Teaching strategies, care plan preparation, and outcome identification are not identified as being MI interventions.

Question 8

Which motivational interviewing (MI) strategy asks a patient to rate the desire to change on a scale from 0 to 10?&#10;A) Readiness ruler&#10;B) Reflective listening&#10;C) Developing a change plan&#10;D) Strengthening change talk

Accepted Answer

The readiness ruler asks the patient to rate the desire to change on a scale from 0 to 10. There are five levels of reflective listening, none of which ask the patient to rate the desire to change on a scale from 0 to 10. Developing a change plan involves identifying the patient's desire, ability, reason, need, and commitment. Strengthening change talk supports goal setting without pressure.

Question 9

Which client statement indicates sustain talk when a nurse is counseling a patient about smoking cessation?&#10;A) &#34;I really don't like smelling smoke in my car.&#34;&#10;B) &#34;I feel fine and don't see the need to change.&#34;&#10;C) &#34;Maybe I can cut down the number of cigarettes I smoke each day.&#34;&#10;D) &#34;My house would be so much cleaner if I didn't smoke in the house anymore.&#34;

Accepted Answer

Sustain talk is any client statement that supports the status quo. The statement "I feel fine and don't see the need to change" is an example of sustain talk. The statement about not liking the smell of smoke in the car indicates a reason to stop smoking. Stating the possibility to cut down the number of cigarettes smoked each day indicates the ability to stop smoking. Stating that the house would be cleaner if smoking wasn't done in the house indicates a reason to stop smoking.

Question 10

Which national guideline would a nurse use for additional information on the use of motivational interviewing (MI)?&#10;A) Communicating with patients&#10;B) Steps to effective communication&#10;C) Guidelines for effective communication&#10;D) Healthy People 2020 at Work in the Community

Accepted Answer

A Healthy People initiative that uses MI is Healthy People 2020 at Work in the Community. Communicating with patients, steps to effective communication, and guidelines for effective communication are not national guidelines developed for MI.

Deck 6: Motivational Interviewing and Patient Activation