Therapeutic Communications For Health Care 3rd Ed By Tamparo -Test Bank

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Therapeutic Communications For Health Care 3rd Ed By Tamparo -Test Bank

Chapter 6: The Therapeutic Response to Fearful, Angry, Aggressive, Abused and Abusive Clients

 

MODIFIED TRUE/FALSE

 

  1. Often fearful clients willingly cooperate in their treatment regimen. _________________________

 

ANS:  F, will not cooperate

 

PTS:   1

 

  1. When clients experience intense panic, they may be immobilized to act and numbed by their emotions. _________________________

 

ANS:  T                                                     PTS:   1

 

  1. When a client is angry, it is natural and appropriate for health professionals to take the client’s comments personally and act accordingly. _________________________

 

ANS:  F, not appropriate

 

PTS:   1

 

  1. It is certain that when anger is not diminished and the conflict intensifies, aggression and verbal abuse are likely to follow. _________________________

 

ANS:  T                                                     PTS:   1

 

  1. The four types of abuse are intimate partner violence, child abuse, elder abuse, and rape. _________________________

 

ANS:  T                                                     PTS:   1

 

  1. Child abuse is more underreported than elder abuse. _________________________

 

ANS:  F, Elder, child

 

PTS:   1

 

  1. Rape is a sexual act and one of violence. _________________________

 

ANS:  F, is not, but is

 

PTS:   1

 

  1. Individuals who have been abused typically have few defense mechanisms for coping with anxiety and stress. _________________________

 

ANS:  T                                                     PTS:   1

 

  1. Children who have been physically abused may exhibit aggressive behavior and regress to an earlier stage of development. _________________________

 

ANS:  T                                                     PTS:   1

 

  1. Health professionals should try to communicate acceptance of the abuser’s feelings and the violent act. _________________________

 

ANS:  F, but not

 

PTS:   1

 

MULTIPLE CHOICE

 

  1. Definitions of fear include
a. dread d. a and b only
b. paranoia e. a, b, and c
c. terror

 

 

ANS:  E                    PTS:   1

 

  1. Physiological signs and symptoms of fright or fear include the following:
a. always a rise in body temperature
b. sinking feeling in pit of stomach
c. very dry palms
d. decreased heartbeat

 

 

ANS:  B                    PTS:   1

 

  1. Symptoms of a panic attack include
a. dyspnea d. a and c
b. decreased respirations e. a, b, and c
c. palpitations

 

 

ANS:  D                    PTS:   1

 

  1. A chronic form of anger is called
a. annoyance c. resentment
b. animosity d. hatred

 

 

ANS:  D                    PTS:   1

 

  1. Setting limits is especially appropriate when clients experience
a. distrust c. aggression
b. assertiveness d. painful feelings

 

 

ANS:  C                    PTS:   1

 

  1. Abusers often
a. suffer low self-esteem c. blame others for their actions
b. feel powerless d. a, b, and c

 

 

ANS:  D                    PTS:   1

 

  1. Which of the following statements about child abuse is true?
a. Family members are more willing to confess to abuse than children.
b. Many children think the abuse is normal and the result of their wrongdoing.
c. People who abuse generally come from well-adjusted families.
d. Treatment for child abusers is usually very successful.

 

 

ANS:  B                    PTS:   1

 

  1. Which of the following statements is true about rape?
a. Certain behaviors and dress can encourage rape.
b. Rape of women and children is increasing more than rape of men and boys.
c. Health professionals generally identify rapists in one of three categories: angry, power, and sadistic.
d. Rape survivors usually experience six distinct crisis stages in their recovery.

 

 

ANS:  C                    PTS:   1

 

  1. In reporting and documenting abuse, health professionals need to
a. report the abuse to the proper authorities
b. report facts as well as your feelings
c. bag, label, safely preserve, and protect any evidence collected
d. a and c
e. a, b, and c

 

 

ANS:  C                    PTS:   1

 

MATCHING

 

Match each item with the correct statement below.

a. Aggression d. Panic
b. Abuse e. Fear
c. Anger f. Assertion

 

 

  1. Behavior is brought on by threats, obstacles, or offensive situations.

 

  1. Behavior occurs when control and self-esteem are lost.

 

  1. Behavior aroused by uncertainty or real/imagined threat.

 

  1. Behavior exhibits as a phobia.

 

  1. Behavior is violent and there is intent to do harm.

 

  1. ANS:  C                    PTS:   1

 

  1. ANS:  A                    PTS:   1

 

  1. ANS:  E                    PTS:   1

 

  1. ANS:  D                    PTS:   1

 

  1. ANS:  B                    PTS:   1

 

SHORT ANSWER

 

  1. Identify and define one type of phobia that occurs during a panic attack.

 

ANS:

Answers will vary and include one of the following:

 

Acrophobia is fear of high places.

 

Claustrophobia is fear of being confined in any small space.

 

Agoraphobia is fear of public places.

 

PTS:   1

 

  1. Specifically state three therapeutic approaches health professionals should take when caring for a client who is fearful, frightened, or experiencing panic attacks.

 

ANS:

Any combination of the following:

 

  1. Allow the client as much control over the situation as possible.
  2. Act for the client who is panic stricken.
  3. Stay with the client when panic occurs in the health care setting.
  4. Recognize and accept the client’s fears.
  5. Use the problem-solving approach.

 

PTS:   1

 

  1. If health professionals wanted to identify clients who are angry, what actions and behaviors would they observe in the client?

 

ANS:

Answers will vary and include the following:

 

Angry tone in voice and in facial expression

 

Apt to use profanity

 

Talk rapidly and rarely listen

 

Appear frustrated and annoyed

 

PTS:   1

 

  1. What are the therapeutic responses for health care professionals when dealing with angry clients?

 

ANS:

Answers will vary and include the following:

 

Give reassurance and offer explanations of services and procedures.

 

Accept clients as they are.

 

Use techniques to deescalate client anger.

 

Be patient and do not rush interactions.

 

Listen intently to verbal and nonverbal communication.

 

Document everything.

 

Examine your feelings and response to clients’ anger.

 

PTS:   1

 

  1. When health professionals are belittled by clients, state what actions are appropriate by professionals. What are the professionals’ rights?

 

ANS:

Show clients respect, listen empathically, communicate assertively, and do not take anything personally.

 

Professionals do not have the right to belittle clients back or to disrespect them.

 

Professionals do have the right not to lose their self-respect.

 

PTS:   1

 

  1. List and define the phases of violence most often used to describe abuse.

 

ANS:

1. Tension phase: A triggering event precipitates this phase; tension builds, communication breaks down; abuser loses control, humiliates the abused; physical abuse may begin.
2. Crisis phase: Anxiety reaches a climax; series of “minor” assaults occurs over period of time leading to serious injury or death of abused; abuser tries to isolate or lock up abused.
3. Calm phase: Abuser asks forgiveness and is loving; abuser and abused are relieved crisis is past and both may be emotionally and physically exhausted.

 

 

PTS:   1

 

  1. Describe the difference in the terms victim and survivor as they are used in the textbook.

 

ANS:

Victim is usually used by the legal system, whereas survivor is usually used by health professionals. Victim is a stronger term in the legal system and implies that the person is truly a victim rather than a survivor. Victim may imply there is no hope of survival or treatment.

 

Survivor is used in the health care system because health professionals provide care to facilitate healing with the hope that the client can/will survive the abuse.

 

PTS:   1

 

  1. How does elder abuse differ from child abuse?

 

ANS:

Identifying elder abuse is difficult unless there is outright battering. It is rarely reported by the elderly because they fear loss of living arrangements, retaliation. They are ashamed that the very children they raised and nurtured would do such a thing.

 

Child abuse seems easier to observe, although the abuser may be able to rationalize “what really happened.” Young children aren’t necessarily aware that their abuser would retaliate or make them leave their home.

 

PTS:   1

 

  1. Elder abuse most likely occurs in two specific locations. Name and define both locations.

 

ANS:

  1. Domestic elder abuse occurs in the home or primary living residence.

 

  1. Institutional elder abuse occurs in a nursing home or some type of long-term care facility.

 

PTS:   1

 

  1. Explain the importance of the health professional understanding self when dealing with clients who are angry, aggressive, or fearful or have been either the abused or the abuser.

 

ANS:

Health professionals need to avoid stereotyping and feelings of distrust, anger, and avoidance of clients such as described above. This is especially important when health professionals themselves have been in these situations. Professionals’ feelings need to be addressed so that they can therapeutically communicate with clients.

 

PTS:   1

 

  1. In the treatment of abused clients, what therapeutic actions can health professionals take?

 

ANS:

Give prompt treatment for their injuries.

 

In cases of rape, use a rape kit.

 

Help to provide an environment where the abused feels safe.

 

Provide a list of safe places for the abused to go.

 

Focus on the survivor, not on the violent event.

 

Help and/or refer survivors to address their crisis situation.

 

PTS:   1

 

Chapter 7: The Therapeutic Response to Depressed and/or Suicidal Clients

 

MODIFIED TRUE/FALSE

 

  1. Minor depression is known as dysthymia. _________________________

 

ANS:  T                                                     PTS:   1

 

  1. There are three major tests used to diagnosis depression. _________________________

 

ANS:  F, no tests

 

PTS:   1

 

  1. Men are nearly twice as likely to experience depression as women. _________________________

 

ANS:  F, Women, men

 

PTS:   1

 

  1. Depression is among the leading cause of disability worldwide. _________________________

 

ANS:  T                                                     PTS:   1

 

  1. The elderly are more successful in suicide attempts than are younger people. _________________________

 

ANS:  T                                                     PTS:   1

 

  1. Preschoolers are the fastest growing market for antidepressants. _________________________

 

ANS:  T                                                     PTS:   1

 

  1. About half of the adults who are depressed believe their depression is a personal weakness and they are too embarrassed to seek help. _________________________

 

ANS:  T                                                     PTS:   1

 

  1. Most suicides occur without warning. _________________________

 

ANS:  F, with

 

PTS:   1

 

MULTIPLE CHOICE

 

  1. Major depression
a. indicates persons have just enough energy to do activities of daily living
b. is disabling
c. often means persons’ thoughts are centered around/related to self-esteem
d. often occurs for no apparent reason

 

 

ANS:  B                    PTS:   1

 

  1. What do researchers believe about depression?
a. After treatment of depression, the brain chemistry returns to normal.
b. Treatment of depression rarely requires psychotherapy.
c. All depression involves some changes in brain chemistry.
d. a and c only
e. a, b, and c

 

 

ANS:  D                    PTS:   1

 

  1. According to one of the diagnostic manuals that sets the diagnosis and classes of depression, major depression must have an episode(s) that
a. causes some impairment in a person’s social or occupational functioning
b. represents a change from previous functioning
c. lasts at least two weeks
d. a, b, and c

 

 

ANS:  D                    PTS:   1

 

  1. Subtypes of major depression include the following type(s).
a. endogenous d. a and b only
b. postpartum e. a, b, and c
c. suicidal

 

 

ANS:  D                    PTS:   1

 

  1. What type of depression leads to anger with temper outbursts, excessive crying, decreased sexual desire, and chronic fatigue?
a. dysthymic disorder c. seasonal affective disorder
b. involutional depression d. postpartum depression

 

 

ANS:  A                    PTS:   1

 

  1. Which of the following statements is true about seasonal affective disorder?
a. SAD occurs more often in men than women.
b. The treatment of choice is light therapy or phototherapy.
c. SAD is rarely if ever found in children.
d. A symptom of SAD is undereating, especially protein.

 

 

ANS:  B                    PTS:   1

 

  1. Which of the following statements is true about postpartum depression (PPD)?
a. PPD lasts about two years.
b. PPD is usually the first time individuals experience depression.
c. Stress seems to be one of the contributing factors of PPD.
d. Drug therapy is the preferred method of treating PPD.

 

 

ANS:  C                    PTS:   1

 

  1. Suicide statistics include
a. It is the eighth leading cause of death in the United States.
b. Of the percentage that attempt suicide, one third will succeed.
c. One half of all male suicides involve firearms.
d. Over one half of suicide victims communicate their plan to someone before they follow through with it.
e. a, c, and d only

 

 

ANS:  E                    PTS:   1

 

MATCHING

 

Match each item with the correct statement below.

a. Involutional depression e. Dysthymic disorder
b. Endogenous depression f. Unipolar
c. Clinical depression g. Bipolar depression
d. Major depression h. Seasonal affective disorder

 

 

  1. Also known as manic-depression, manic-depressive illness.

 

  1. Depression is severe enough to require treatment.

 

  1. Also known as melancholia.

 

  1. A person has had episodes of depression only.

 

  1. Depression caused by decreased sunlight.

 

  1. Comes from within and has no discernable cause.

 

  1. Chronic, low-level depression that may continue for years.

 

  1. ANS:  G                    PTS:   1

 

  1. ANS:  C                    PTS:   1

 

  1. ANS:  A                    PTS:   1

 

  1. ANS:  F                    PTS:   1

 

  1. ANS:  H                    PTS:   1

 

  1. ANS:  B                    PTS:   1

 

  1. ANS:  E                    PTS:   1

 

Match each item with the correct statement below.

a. Stage #1 of suicide d. Stage #4 of suicide
b. Stage #2 of suicide e. Stage #5 of suicide
c. Stage #3 of suicide

 

 

  1. Individuals begin a plan to carry out the suicide

 

  1. Individuals experience frustration, anger that turns inward, hostility

 

  1. Individuals communicate their helplessness to someone else

 

  1. Individuals’ stress levels become unbearable and they panic

 

  1. ANS:  D                    PTS:   1

 

  1. ANS:  A                    PTS:   1

 

  1. ANS:  C                    PTS:   1

 

  1. ANS:  B                    PTS:   1

 

SHORT ANSWER

 

  1. Describe the feelings a person with depression might experience.

 

ANS:

Answers may vary and include:

 

feelings of despair, gloom, or emptiness

 

a sense of foreboding

 

numbness

 

hopelessness

 

agony

 

negative sense of self-worth

 

PTS:   1

 

  1. Name the two books, internationally recognized sets of diagnostic criteria for depression, that have led to a greater uniformity in diagnosis and classification of depressive illnesses.

 

ANS:

  1. Diagnostic and Statistical Manual (DSM) and

 

  1. International Classification of Disease (ICD)

 

PTS:   1

 

  1. List symptoms that occur in the syndrome of major depression.

 

ANS:

Answers may vary and include the following:

 

Cry for no apparent reason

 

Are quiet with very little to say

 

Experience disrupted eating and sleeping patterns that cause additional fatigue and restlessness

 

PTS:   1

 

  1. What is bipolar depression?

 

ANS:

Answers may vary but should include:

 

Alternates between extreme highs of mania and severe lows of depression.

 

May include the following:

 

Each individual with BPD has a unique pattern of mood cycles that are predictable once the pattern is identified.

 

Strong genetic influence.

 

Typically begins in adolescence or early adulthood and continues through life.

 

PTS:   1

 

  1. Describe substance-induced mood disorder.

 

ANS:

A mood disorder caused by:

 

Individuals taking prescription drugs that have the side affect of causing depression. Such drugs include cardiac drugs, hypertensives, sedatives, steroids, stimulants, antibiotics, and analgesics.

 

People often self-medicate their depression with alcohol and drugs or a combination of the two, which will induce depression—the very thing they are trying to treat.

 

PTS:   1

 

  1. Explain why adolescents are at great risk for depressive disorders.

 

ANS:

Because of the many physical and emotional changes they are going through.

 

Their family structure and peer pressure may add to the stress.

 

PTS:   1

 

  1. Describe the therapeutic role of health professionals in working with clients who have depression.

 

ANS:

Answers may vary and include the following:

 

Provide nonthreatening and secure environment. Assist clients to manipulate their environment so they can effect positive change.

 

Reinforce clients’ ability to make personal decisions and problem-solve.

 

Work with clients to develop experiences that will give them positive feedback.

 

Encourage clients to seek professional help and provide community resources.

 

PTS:   1

 

  1. Describe risk factors for individuals who attempt suicide.

 

ANS:

Previous attempts of suicide

 

They already have some form of depression

 

Death of a loved one, recent loss of employment, and/or divorce

 

Exposure to suicide or suicidal behavior by others

 

Ready accessibility of firearm

 

PTS:   1

 

  1. Specifically relate how health professionals therapeutically communicate with suicidal clients.

 

ANS:

Pull up chair, sit close, and listen.

 

Let the persons know you really care about them and will not desert them.

 

Sometimes just sit in silence.

 

Communicate through a person’s strong learning channel.

 

Avoid arguments and power struggles.

 

Let yourself feel some of the person’s sufferings. Cry with them, if appropriate.

 

PTS:   1