Chapter 09: Establishing the Therapeutic Relationship

Chapter 09: Establishing the Therapeutic Relationship

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE

1. To increase the likelihood of successful pharmacotherapy, when teaching a patient about using a medication, the primary care nurse practitioner (NP) should:

ANS:  A

It is important that the patient “owns the problem” and has a part in the solution. Providing education about the medication, stressing the importance of following medication instructions, and distributing package inserts may be useful, but it is essential that patients take an active role in their care.

DIF:    Cognitive Level: Applying (Application)                           REF:   104

2. A patient has recurrent symptoms and tells the primary care NP that she can’t remember to take her medication all the time. The NP should:

ANS:  D

If the attitude is that the patient has a problem for the health care provider to solve, then the provider owns the problem and often hastens to solve it. When patients own their problems, they are more likely to engage in their care and treatment. Giving shortened regimens, providing written information, and administrating medication in the clinic are examples of the provider solving the problem for the patient.

DIF:    Cognitive Level: Applying (Application)                           REF:   104

3. A primary care NP prepares to teach a patient about the management of a chronic condition. The patient says, “I don’t want to know all of that. Just tell me what to take and when.” The NP should initially:

ANS:  A

The patient has stated expectations about care and treatment for the condition. The NP should begin by respecting that and providing the amount of information the patient wants. As the therapeutic relationship grows, the NP may elicit more active participation and understanding.

DIF:    Cognitive Level: Applying (Application)                           REF:   104

4. A parent brings a child who has moderate-persistent asthma to the clinic and tells the primary care NP that none of the child’s medications are working. The parent says, “Everybody tells me something different. I don’t know what to do.” The NP suspects that the parent is not administering the medications appropriately. The NP should initially:

ANS:  A

Clinical providers must refine listening and questioning skills and focus on the patient and the environment. It is important to begin with a thorough history and to elicit the patient’s understanding of a disease or a medication to identify potential problems. Providing written action plans, reviewing past providers’ prescriptions, and explaining medications are useful only after the NP determines what the problem is.

DIF:     Cognitive Level: Applying (Application)