MCQ Quiz: Communication Principles – Motivational Interviewing

Motivational Interviewing (MI) is a collaborative, goal-oriented communication technique that strengthens a patient’s own motivation for change. Rooted in empathy and patient autonomy, MI is especially effective in promoting medication adherence, lifestyle changes, and chronic disease management. This MCQ quiz helps Pharm.D. students understand and apply the foundational principles, processes, and strategies of MI in clinical pharmacy settings.

1. What is the primary goal of Motivational Interviewing (MI)?

• A. To prescribe new medications
• B. To persuade the patient to agree
• C. To strengthen a patient’s motivation and commitment to change
• D. To control patient decisions
  Correct answer: C. To strengthen a patient’s motivation and commitment to change

2. MI is best described as:

• A. Confrontational
• B. Directive and authoritarian
• C. Collaborative and patient-centered
• D. Judgmental and persuasive
  Correct answer: C. Collaborative and patient-centered

3. Which of the following is NOT a core principle of MI?

• A. Expressing empathy
• B. Rolling with resistance
• C. Arguing for change
• D. Supporting self-efficacy
  Correct answer: C. Arguing for change

4. “OARS” is a key set of MI techniques. What does the “R” stand for?

• A. Review
• B. Reflection
• C. Reasoning
• D. Reporting
  Correct answer: B. Reflection

5. Reflective listening in MI helps the patient to:

• A. Avoid responsibility
• B. Feel heard and understood
• C. Justify inaction
• D. Memorize facts
  Correct answer: B. Feel heard and understood

6. The “spirit” of Motivational Interviewing includes all EXCEPT:

• A. Partnership
• B. Acceptance
• C. Compassion
• D. Authority
  Correct answer: D. Authority

7. Which response best demonstrates reflective listening?

• A. “You’re wrong about that.”
• B. “I think you should exercise more.”
• C. “It sounds like you’re feeling unsure about starting the medication.”
• D. “Let’s move on.”
  Correct answer: C. “It sounds like you’re feeling unsure about starting the medication.”

8. Rolling with resistance involves:

• A. Ignoring the patient’s concerns
• B. Pushing back firmly
• C. Accepting ambivalence and avoiding confrontation
• D. Changing the topic
  Correct answer: C. Accepting ambivalence and avoiding confrontation

9. Which of the following is an example of an open-ended question?

• A. “Are you taking your meds?”
• B. “Do you feel better?”
• C. “What concerns do you have about your medication?”
• D. “Did you refill your prescription?”
  Correct answer: C. “What concerns do you have about your medication?”

10. Affirmations in MI are used to:

• A. Convince the patient to act
• B. Reinforce a patient’s strengths and efforts
• C. Judge patient behavior
• D. Summarize medical data
  Correct answer: B. Reinforce a patient’s strengths and efforts

11. Which is a core MI process?

• A. Prescribing
• B. Planning
• C. Diagnosing
• D. Documenting
  Correct answer: B. Planning

12. In the context of MI, “developing discrepancy” refers to:

• A. Highlighting inconsistencies between current behavior and goals
• B. Arguing with the patient
• C. Providing multiple treatment options
• D. Comparing brand-name vs. generic drugs
  Correct answer: A. Highlighting inconsistencies between current behavior and goals

13. Which MI strategy helps the patient explore change?

• A. Providing a list of benefits
• B. Asking, “Why haven’t you changed yet?”
• C. Asking, “What would be different if you made this change?”
• D. Suggesting a treatment protocol
  Correct answer: C. Asking, “What would be different if you made this change?”

14. The acronym “DARN” refers to:

• A. Denial, Acceptance, Rebuttal, Negotiation
• B. Desire, Ability, Reason, Need (for change talk)
• C. Disposition, Affection, Regulation, Neglect
• D. Drugs, Adherence, Reaction, Need
  Correct answer: B. Desire, Ability, Reason, Need (for change talk)

15. Change talk is:

• A. The patient’s arguments against treatment
• B. Passive agreement
• C. Patient statements indicating interest in or commitment to change
• D. A list of side effects
  Correct answer: C. Patient statements indicating interest in or commitment to change

16. Which of the following represents “change talk”?

• A. “This won’t work.”
• B. “I might try walking more this week.”
• C. “My friend takes that too.”
• D. “I forgot your name.”
  Correct answer: B. “I might try walking more this week.”

17. Which is a key element of the MI process “engaging”?

• A. Setting goals
• B. Exploring medication side effects
• C. Establishing a trusting relationship
• D. Writing prescriptions
  Correct answer: C. Establishing a trusting relationship

18. Planning in MI occurs when:

• A. The patient expresses readiness to change
• B. The pharmacist decides on a treatment
• C. The physician approves a new dose
• D. The pharmacist ends the visit
  Correct answer: A. The patient expresses readiness to change

19. The “evoking” process in MI aims to:

• A. Discuss lab results
• B. Draw out the patient’s own motivations for change
• C. Persuade with facts
• D. Write instructions
  Correct answer: B. Draw out the patient’s own motivations for change

20. Which of the following would be inappropriate in MI?

• A. “Tell me what you like about smoking.”
• B. “I’m not here to tell you what to do.”
• C. “Let’s explore your reasons for continuing.”
• D. “You really should quit now or else.”
  Correct answer: D. “You really should quit now or else.”

21. The correct order of the four MI processes is:

• A. Planning, Engaging, Focusing, Evoking
• B. Engaging, Focusing, Evoking, Planning
• C. Evoking, Engaging, Planning, Focusing
• D. Focusing, Planning, Engaging, Evoking
  Correct answer: B. Engaging, Focusing, Evoking, Planning

22. What is a sign that a patient is in the “precontemplation” stage of change?

• A. “I already started exercising.”
• B. “I’m not thinking about changing right now.”
• C. “I’ve scheduled my quit date.”
• D. “I’ll talk to my doctor today.”
  Correct answer: B. “I’m not thinking about changing right now.”

23. MI supports autonomy by:

• A. Telling patients what to do
• B. Giving them control over their choices
• C. Repeating instructions
• D. Limiting options
  Correct answer: B. Giving them control over their choices

24. Which is an example of a summary statement in MI?

• A. “You’re wrong about this.”
• B. “You’ve told me that you’re concerned about your blood pressure and want to find a way to improve it.”
• C. “Take this medication.”
• D. “Let’s move on.”
  Correct answer: B. “You’ve told me that you’re concerned about your blood pressure and want to find a way to improve it.”

25. A good evoking question in MI is:

• A. “Do you understand?”
• B. “What would it take for you to make this change?”
• C. “What’s wrong with you?”
• D. “Are you sure about that?”
  Correct answer: B. “What would it take for you to make this change?”

26. A common trap to avoid in MI is the:

• A. Affirmation trap
• B. Information overload trap
• C. Fix-it trap
• D. Active listening trap
  Correct answer: C. Fix-it trap

27. What’s the role of empathy in MI?

• A. To agree with everything
• B. To express understanding and non-judgment
• C. To impress the patient
• D. To diagnose mental health
  Correct answer: B. To express understanding and non-judgment

28. What’s the difference between MI and traditional advice-giving?

• A. MI is quicker
• B. MI is more directive
• C. MI emphasizes collaboration and evocation
• D. MI avoids patient input
  Correct answer: C. MI emphasizes collaboration and evocation

29. In MI, focusing means:

• A. Narrowing the conversation to a specific goal
• B. Analyzing lab results
• C. Repeating therapy steps
• D. Avoiding difficult topics
  Correct answer: A. Narrowing the conversation to a specific goal

30. What does “supporting self-efficacy” mean in MI?

• A. Telling patients to try harder
• B. Empowering patients to believe they can change
• C. Repeating benefits of change
• D. Explaining insurance plans
  Correct answer: B. Empowering patients to believe they can change

31. MI is most effective for which types of behaviors?

• A. Medication refills only
• B. Complex, behavior-dependent conditions like smoking, adherence, and diet
• C. Insurance selection
• D. Acute infection treatment
  Correct answer: B. Complex, behavior-dependent conditions like smoking, adherence, and diet

32. Affirmations should focus on:

• A. Judging behavior
• B. Patient strengths and efforts
• C. Health plan limits
• D. Minimizing risk
  Correct answer: B. Patient strengths and efforts

33. An MI-consistent approach to resistance is to:

• A. Push harder
• B. Ignore it
• C. Reflect and explore it
• D. Dismiss it
  Correct answer: C. Reflect and explore it

34. MI enhances intrinsic motivation by:

• A. Giving step-by-step orders
• B. Telling the patient they are wrong
• C. Exploring their own reasons for change
• D. Delegating decisions
  Correct answer: C. Exploring their own reasons for change

35. A helpful affirmation might be:

• A. “You always mess this up.”
• B. “You’re clearly trying very hard.”
• C. “That wasn’t smart.”
• D. “You’re doing it wrong.”
  Correct answer: B. “You’re clearly trying very hard.”

36. Which of the following statements reflects the MI spirit of compassion?

• A. “That’s your responsibility.”
• B. “Let’s see how I can support you best.”
• C. “It’s time to get serious.”
• D. “Stop making excuses.”
  Correct answer: B. “Let’s see how I can support you best.”

37. The “righting reflex” in MI refers to the:

• A. Pharmacist’s desire to fix problems prematurely
• B. Patient’s need for medication
• C. Clinician’s interest in lab values
• D. Insurance company’s recommendations
  Correct answer: A. Pharmacist’s desire to fix problems prematurely

38. One technique to evoke change talk is:

• A. Asking yes/no questions
• B. Exploring values and goals
• C. Repeating instructions
• D. Describing side effects
  Correct answer: B. Exploring values and goals

39. MI helps reduce:

• A. Adherence
• B. Ambivalence about change
• C. Costs
• D. Drug errors
  Correct answer: B. Ambivalence about change

40. “I’ve quit before, so I know I can do it again” is an example of:

• A. Sustain talk
• B. Change talk and self-efficacy
• C. Resistance
• D. Patient doubt
  Correct answer: B. Change talk and self-efficacy

41. A key outcome of effective MI is:

• A. Higher prescription rates
• B. Improved patient engagement and long-term behavior change
• C. Faster consultations
• D. More referrals
  Correct answer: B. Improved patient engagement and long-term behavior change

42. When a patient voices “I guess I should stop drinking soda,” the pharmacist should:

• A. Ignore it
• B. Ask, “What makes you feel that way?”
• C. Lecture on sugar
• D. Change topics
  Correct answer: B. Ask, “What makes you feel that way?”

43. MI is especially helpful when patients are:

• A. Highly motivated already
• B. Fully compliant
• C. Ambivalent about change
• D. Not taking any medications
  Correct answer: C. Ambivalent about change

44. The outcome of sustained MI use in practice includes:

• A. Reduced trust
• B. Improved therapeutic relationships
• C. Increased workload
• D. Lower communication standards
  Correct answer: B. Improved therapeutic relationships

45. What does the “planning” stage involve in MI?

• A. Telling the patient what to do
• B. Scheduling lab appointments
• C. Developing actionable steps with the patient
• D. Avoiding specifics
  Correct answer: C. Developing actionable steps with the patient

46. MI differs from standard counseling because it:

• A. Is faster
• B. Builds decisions from patient motivation
• C. Focuses only on clinical measures
• D. Avoids difficult topics
  Correct answer: B. Builds decisions from patient motivation

47. MI communication is considered:

• A. Coercive
• B. Directive
• C. Patient-empowering
• D. Protocol-driven
  Correct answer: C. Patient-empowering

48. A statement like “You’re already thinking about it—that’s a great first step” is:

• A. Dismissive
• B. Directive
• C. Affirming
• D. Diagnostic
  Correct answer: C. Affirming

49. MI success depends most on:

• A. Patient’s insurance
• B. Provider’s communication style and attitude
• C. Number of medications
• D. Use of statistics
  Correct answer: B. Provider’s communication style and attitude

50. Which is the best example of engaging in MI?

• A. “I have limited time today.”
• B. “Let’s work together on this.”
• C. “You’re not following the plan.”
• D. “Here’s what you should do.”
  Correct answer: B. “Let’s work together on this.”