Motivational Interviewing in Health Care- Helping Patients Change Behavior

Self-Study Examination

Instructions: After studying the text answer the following true/false or multiple choice questions.  Remember, there's only one answer to each question.

1. There are signs today that young adults may be the first generation in modern history to be less healthier than their parents.

a) True
b) False

2. Motivational interviewing works by:
  1. giving rewards for appropriate behavior
  2. activating patient’s own motivation for change
  3. securing support systems
  4. adherence to treatment

a) all the above
b) 1 and 2
c) 3 and 4
d) 1 and 3

3. “There is something in human nature that resists being coerced and told what to do” — is a description of which “spirit:”

a) collaborative
b) evocative
c) honoring patient autonomy

4. “When consultation time is limited, it would be better to ask patients why they want to make a change and how they might do it, rather than telling them they should” — is a description of:

a) resist the righting teflex
b) understanding your patient’s motivation
c) listen to your patient
d) empower your patient

5. Which style fits communicates, “I can help you to solve this for yourself.”

a) following
b) directing
c) guiding

6. All of the following are guiding styles of MI except:

a) is goal directed
b) uses hypotheticals
c) seeks to evoke patient’s arguments for change
d) involves competence in skills and strategies to evoke patient behavior change

7. In many ways, _________ is the core skill when using the guiding style.

a) asking
b) listening
c) informing
d) directing

8. The most common tools that practitioners use is:

a) ask, then inform
b) ask, listen, then inform
c) listen, inform, and direct
d) ask, listen, inform, and guide

9. The statement, “I need to lose some weight, but I hate exercising,” is an example of:

a) procrastination
b) ambivalence
c) inability
d) status quo

10. The statement “I could probably take a walk before supper,” is an example of which change talk:

a) desire
b) ability
c) reasons
d) planing

11. The statement “I have to get some sleep,” is an example of which change talk:

a) need
b) commitment
c) taking steps

12. The precommitment forms of change talk are:

a) ability, reasons, commitment
b) reasons, need, ability, taking steps
c) desire, ability, reasons, need
d) need, ability, commitment, desire

13. An example of an open question would be:

a) “What is your address?”
b) “Have you been taking your medicine?”
c) “Does it seem worse in the morning or the evening?”
d) “How are you feeling today?”

14. Which of the following open questions would serve multiple purposes?

a) “How can I help you?”
b) “Tell me more about ……..”
c) “How many drinks do you normally have?”
d) “How have you been doing?”

15. One of the main principles of the Routine Assessment Using a “Typical Day” is:

a) focus on behavior and feelings
b) ask permission
c) go through a “typical day”
d) allow the patient to add anything

16. The first function of a good guide is:

a) setting a goal
b) implementing a plan
c) reviewing possible risks
d) finding out where the person wants to go

17. When setting the agenda, a finite set of topics can be chosen from:

a) a list
b) a bubble sheet
c) a form
d) an interactive video

18. Which of the following are purposes of a ruler:
  1. defines a patient’s motivation
  2. elicits change talk
  3. clarifies a statement
  4. announces an option

a) all the above
b) all but 3
c) 2 and 4
d) 1 and 2

19. The most productive questions regarding change are:
  1. “What is your first step?”
  2. “How anxious are you?
  3. “How important is this change?”
  4. “How confident are you in succeeding?”

a) all the above
b) 3 and 4
c) all but 1
d) all but 2

20. The essence of a key question is:

a) “What’s next?”
b) “How did I do?”
c) “What’s in it for me?”
d) “Are you ok?”

21. When you take time to listen, all of the following occur except:

a) patients feel like you have spent less time with them because you “aren’t doing anything.”
b) important information is gathered
c) change can occur
d) patients are more likely to adhere to advice

22. One of the most common patient criticism of consultations is:

a) having to wait
b) not being allowed to tell his or her story
c) not receiving applicable advice or treatment
d) lack of support

23. The two key signals that are extended to accompany listening are:

a) a smile and the spoken word
b) a handshake and eye contact
c) head movement and speaking
d) eye contact and lack of distraction

24. _____________ is often a good teacher.

a) Instructing
b) Reasoning
c) Silence
d) Interpreting

25. Which of the following are true about summaries:
  1. you listened and remembered what the patient said
  2. all pieces have been drawn together
  3. certain points can be emphasized
  4. gently allows you to move to the next task

a) all the above
b) all but 4
c) 1and 3
d) 2 only

26. All of the following are true about asking questions while listening except:

a) ask open rather than closed questions
b) do not ask two questions in a row
c) maintain eye contact
d) offer two reflections for every question you ask

27. One way to bring listening to an effective and gentle close is to be honest about your time limitations.

a) True
b) False

28. Methods to provide information and patient compliance are all of the following except:

a) do not overload patients
b) give simple information in chunks
c) check to make sure the patient understood
d) give handouts to read later

29. Which force is being described when the patient’s eyes glaze over, and they sit back in their chair and wait for you to get through the routine?

a) bewilderment
b) passivity
c) high emotion
d) mood and distraction

30. This method of obtaining permission to inform is analogous to knocking on the door before you enter:

a) the patient asks you for information or advice
b) you ask for permission to inform the patient
c) ask the patient what they want to hear first
d) acknowledge the patient’s autonomy by saying, “this may or may not concern you.”

31. When offering choices, offer one option at a time.

a) True
b) False

32. All of the following are good reasons to “check” when using the chunk, check, chunk method of informing except it:

a) allows the patient to remain neutral while learning
b) actively engages patients in their own care
c) communicates patience and respect
d) allows detection and correction of misunderstandings

33. The third part of EPE is to ask an open question such as:

a) “What do you already know?”
b) “May I tell you about this?”
c) “From my experience, would you like to know what is best?”
d) “What more would you like to know?”

34. Which question is appropriate when assessing commitment?

a) “What do you make of that?”
b) “How may I help you?”
c) “What are you going to do?”
d) “Does this make sense to you?”

35. An example of an initial question from the DARN acronym would be:

a) “What do you need to do?”
b) “What can I do to help you?”
c) “What do you want to do?”
d) “May I make a suggestion?”

36. When you are “in the moment” with the patient, you are:

a) deciding how to proceed
b) observing how the patient is reacting
d) staying in the present

37. As your skills of guiding improve, you will do all of the following except:

a) move on and summarize
b) tell them what to do or leave them to work it out themselves
c) shift direction and change topics
d) adopt a directing style

38. One of the origins of MI came from the realization that when things are difficult in the conversation, there is a tendency to blame the patient.

a) True
b) False

39. The patient states, “I can’t see why I need to change” and is in complete denial according to the health care team. A style that would freeze progress would be:

a) guiding style
b) directing style

40. All of the following are true about aspirations for patient behavior change except:

a) they are your thoughts and feelings about what would be good for the patient
b) are common and normal
c) when stressed, I accept it
d) if allowed to dominate, it can make it difficult to honor patient autonomy

41. A position of equipoise is best defined as the practitioner:

a) wanting the patient to change his or her behavior
b) addressing a behavior-change consultation
c) evaluating readiness to change on a continuum
d) not caring whether the person changes his or her behavior

42. When wanting a patient to change behavior, you plead, visit them at home, and offer money. This is an example of:

a) overloading the patient with information
b) persuading too hard
c) rescuing the patient
d) pursuing problems and weaknesses

43. A routine strategy for developing a compromise between your aspirations and those of the patient is agenda setting.

a) True
b) False

44. One way to get better at guiding is to:

a) attend seminars and workshops
b) listen to recordings (with patient permission)
c) have a mentor
d) follow guidelines of successful practitioners

45. In order to develop a Patient-Centered Model of Care, a set of ____ C’s was developed.

a) four
b) five
c) six
d) seven

46. In order to enhance patient health behavior change, attention is focused on the:

a) obstacles and results
b) rewards and outcomes
c) time and energy
d) why and how

47. All of the following are traps to avoid when guiding groups except:

a) encourage what has worked in the past
b) don’t conduct multiple consultations in a group setting
c) avoid question and answer sessions conducted by you
d) avoid allowing the group to be unfocused or too serious