MCQ Quiz: Communication with Patients Who Have Mental Health Problems

Effective communication is a cornerstone of patient-centered care and a critical skill for every pharmacist. When caring for patients with mental health problems, the ability to communicate with empathy, establish a therapeutic relationship, and navigate difficult conversations is paramount to ensuring safety and treatment success. The pharmacy curriculum emphasizes the development of these skills, from demonstrating empathy and cultural competency when communicating with a patient and their family to collaborating as a member of an interprofessional team. This quiz will test your knowledge on the principles and techniques for communicating with patients experiencing behavioral challenges and mental health crises, as taught in your patient care and skills lab courses.

1. When beginning an interview with a new patient with a known mental health condition, which communication technique is best for building rapport?

• A. Immediately asking about their medication adherence.
• B. Using complex medical terminology to establish authority.
• C. Introducing yourself and explaining the purpose of the counseling session in a non-judgmental tone.
• D. Asking “why” they are taking their specific medication.

Answer: C. Introducing yourself and explaining the purpose of the counseling session in a non-judgmental tone.

2. A patient appears agitated and is speaking loudly. What is the best initial communication strategy for the pharmacist?

• A. Speak louder than the patient to gain control of the conversation.
• B. Use a calm, steady tone of voice and maintain a safe physical distance.
• C. Tell the patient to calm down immediately.
• D. Avoid eye contact and ignore the patient’s behavior.

Answer: B. Use a calm, steady tone of voice and maintain a safe physical distance.

3. The skill of demonstrating “empathic attributes” is a course-level objective in the Professional Practice Skills Lab. Which of the following is the best example of an empathetic response?

• A. “You shouldn’t feel that way.”
• B. “I understand exactly how you feel.”
• C. “It sounds like this has been a very difficult and frustrating experience for you.”
• D. “Let’s just focus on the facts.”

Answer: C. “It sounds like this has been a very difficult and frustrating experience for you.”

4. The

PHA5789C syllabus includes a lecture on “Working with Patients in Crisis.” If a patient expresses vague suicidal thoughts, what is the most appropriate next step?

• A. Ignore the comment to avoid making the patient uncomfortable.
• B. Change the subject to their medication side effects.
• C. Ask a direct question, such as “Are you thinking about killing yourself?” to assess the seriousness of the risk.
• D. Tell them everything will be okay.

Answer: C. Ask a direct question, such as “Are you thinking about killing yourself?” to assess the seriousness of the risk.

5. Active listening is a key communication skill. It involves:

• A. Thinking about what you are going to say next while the patient is talking.
• B. Interrupting the patient frequently to correct them.
• C. Giving your full attention to the speaker, reflecting on their statements, and asking clarifying questions.
• D. Focusing only on the patient’s non-verbal cues.

Answer: C. Giving your full attention to the speaker, reflecting on their statements, and asking clarifying questions.

6. A patient with schizophrenia expresses a firm belief that their medication is poison. This is likely a delusion. What is the most therapeutic way to communicate?

• A. Argue with the patient and present facts to prove their belief is wrong.
• B. Acknowledge the patient’s fear without validating the delusion (e.g., “It must be frightening to feel that way”) and gently redirect the conversation to the medication’s purpose.
• C. Pretend to agree with the patient’s belief.
• D. Refuse to speak with the patient until they change their mind.

Answer: B. Acknowledge the patient’s fear without validating the delusion (e.g., “It must be frightening to feel that way”) and gently redirect the conversation to the medication’s purpose.

7. Motivational Interviewing is a technique taught in skills lab to help patients with behavioral change. A core principle of MI is to:

• A. Confront the patient about their poor choices.
• B. Persuade the patient by highlighting all the negative consequences of their behavior.
• C. Support the patient’s autonomy and help them explore their own reasons for change.
• D. Provide a strict set of rules for the patient to follow.

Answer: C. Support the patient’s autonomy and help them explore their own reasons for change.

8. When communicating with a patient who has low health literacy, which strategy is most effective?

• A. Using complex medical jargon to ensure accuracy.
• B. Speaking very slowly and loudly.
• C. Using plain language, focusing on 2-3 key points, and using the teach-back method.
• D. Providing lengthy, text-heavy brochures.

Answer: C. Using plain language, focusing on 2-3 key points, and using the teach-back method.

9. A patient is angry about an insurance rejection. Which communication technique can help de-escalate the situation?

• A. Telling the patient it’s not your problem.
• B. Blaming the insurance company without offering help.
• C. Validating their frustration (e.g., “I can see why you are upset, this is a frustrating situation”) before offering to help investigate the issue.
• D. Ignoring their anger and asking for their date of birth.

Answer: C. Validating their frustration (e.g., “I can see why you are upset, this is a frustrating situation”) before offering to help investigate the issue.

10. What is the purpose of using open-ended questions (e.g., “Can you tell me more about what you’re experiencing?”) when communicating with a patient?

• A. To get simple “yes” or “no” answers.
• B. To limit the amount of information the patient provides.
• C. To encourage the patient to share more detailed information and their perspective.
• D. To make the interview process take longer.

Answer: C. To encourage the patient to share more detailed information and their perspective.

11. The syllabus for

PHA5023C mentions the “HBR 20-minute Manager Series” on “Difficult Conversations.” This highlights the importance of being prepared to discuss sensitive topics, such as:

• A. The weather.
• B. Medication side effects like sexual dysfunction.
• C. Sports scores.
• D. The pharmacy’s hours of operation.

Answer: B. Medication side effects like sexual dysfunction.

12. A patient’s caregiver calls and is very distressed about the patient’s behavior. The pharmacist should:

• A. Refuse to speak with the caregiver due to HIPAA.
• B. Listen patiently to the caregiver’s concerns while respecting patient confidentiality, and offer general guidance or suggest they have the patient contact the prescriber.
• C. Provide specific details about the patient’s diagnosis and treatment plan to the caregiver without patient consent.
• D. Tell the caregiver to handle the problem on their own.

Answer: B. Listen patiently to the caregiver’s concerns while respecting patient confidentiality, and offer general guidance or suggest they have the patient contact the prescriber.

13. Non-verbal communication is critical. What might crossing your arms and avoiding eye contact convey to a patient?

• A. Openness and interest.
• B. Empathy and warmth.
• C. Disinterest, defensiveness, or discomfort.
• D. Confidence and professionalism.

Answer: C. Disinterest, defensiveness, or discomfort.

14. The “SBAR” (Situation, Background, Assessment, Recommendation) technique is taught in skills lab for what purpose?

• A. A method for counseling patients on new prescriptions.
• B. A structured way to communicate with other healthcare professionals, such as a prescriber.
• C. A tool for calculating medication dosages.
• D. A technique for managing pharmacy inventory.

Answer: B. A structured way to communicate with other healthcare professionals, such as a prescriber.

15. When a patient with depression says, “I’m just so tired of it all,” a reflective listening response would be:

• A. “You should try to get more sleep.”
• B. “So you’re feeling exhausted by everything that’s been going on.”
• C. “Why are you so tired?”
• D. “Everyone gets tired sometimes.”

Answer: B. “So you’re feeling exhausted by everything that’s been going on.”

16. The concept of “cultural competency” in communication means:

• A. Treating every patient exactly the same, regardless of their background.
• B. Being aware of and respectfully responding to a patient’s cultural beliefs and values as they relate to their health.
• C. Assuming a patient’s culture dictates all of their decisions.
• D. Only communicating with patients from your own cultural background.

Answer: B. Being aware of and respectfully responding to a patient’s cultural beliefs and values as they relate to their health.

17. If a patient asks a pharmacist for advice about a mental health issue that is outside the pharmacist’s scope of practice, the most professional response is to:

• A. Offer an opinion based on personal experience.
• B. Provide the requested advice to the best of their ability.
• C. Acknowledge the concern and refer the patient to the appropriate healthcare provider, such as their primary doctor or a mental health specialist.
• D. Tell the patient not to worry about it.

Answer: C. Acknowledge the concern and refer the patient to the appropriate healthcare provider, such as their primary doctor or a mental health specialist.

18. Why is it important to ask a patient’s permission before discussing sensitive topics (e.g., “Would it be alright if I ask you a few questions about your mood?”)?

• A. It is not important; the pharmacist should always assume permission.
• B. It empowers the patient and respects their autonomy.
• C. It is a legal requirement in all 50 states.
• D. It makes the pharmacist seem less confident.

Answer: B. It empowers the patient and respects their autonomy.

19. When a patient is non-adherent to their medication due to side effects, the best communication strategy is to:

• A. Criticize the patient for not taking their medication as prescribed.
• B. Explore the specific side effects they are experiencing and collaboratively problem-solve, which may involve contacting the prescriber.
• C. Tell them the side effects are not real.
• D. Refuse to fill their prescriptions in the future.

Answer: B. Explore the specific side effects they are experiencing and collaboratively problem-solve, which may involve contacting the prescriber.

20. A patient in a manic state may exhibit pressured speech and flight of ideas. An effective communication tactic for the pharmacist is to:

• A. Try to match their speaking pace to build rapport.
• B. Use short, simple sentences and gently redirect the conversation back to the essential topic.
• C. Ask complex, multi-part questions.
• D. Let the patient talk without interruption for as long as they want.

Answer: B. Use short, simple sentences and gently redirect the conversation back to the essential topic.

21. The “teach-back” method is a communication tool to assess:

• A. The patient’s satisfaction with the pharmacy.
• B. The patient’s understanding of the information provided.
• C. The patient’s willingness to pay for the medication.
• D. The patient’s socioeconomic status.

Answer: B. The patient’s understanding of the information provided.

22. “Means restriction” is a key part of suicide prevention counseling. It involves:

• A. Restricting the patient’s diet.
• B. Discussing with the patient and their family how to limit access to lethal means (e.g., firearms, stockpiled medications).
• C. Limiting the patient to only one therapy session per month.
• D. Restricting the patient’s ability to communicate with their family.

Answer: B. Discussing with the patient and their family how to limit access to lethal means (e.g., firearms, stockpiled medications).

23. When communicating about a medication error, the most appropriate approach is to be:

• A. Evasive and defensive.
• B. Honest, transparent, and empathetic, while following facility protocols.
• C. Silent and hope the patient does not notice.
• D. Blame another member of the healthcare team.

Answer: B. Honest, transparent, and empathetic, while following facility protocols.

24. The Personal and Professional Development (PPD) courses emphasize self-awareness as a key attribute. How does self-awareness improve communication with psychiatric patients?

• A. It allows the pharmacist to focus only on their own feelings.
• B. It helps the pharmacist recognize and manage their own biases or emotional reactions, allowing for more professional and objective communication.
• C. It is not relevant to patient communication.
• D. It encourages the pharmacist to over-share personal information.

Answer: B. It helps the pharmacist recognize and manage their own biases or emotional reactions, allowing for more professional and objective communication.

25. A patient with social anxiety disorder may have difficulty communicating verbally. An effective strategy could be:

• A. Forcing them to speak in front of a crowd.
• B. Allowing them time to process questions and perhaps using written communication as an adjunct.
• C. Asking them personal questions in a loud voice.
• D. Limiting the interaction to less than 30 seconds.

Answer: B. Allowing them time to process questions and perhaps using written communication as an adjunct.

26. What does the “A” in the SCHOLAR-MAC questioning technique for self-care consultations stand for?

• A. Age
• B. Actions taken
• C. Allergies
• D. Assessment

Answer: C. Allergies

27. Building a “therapeutic alliance” is a key goal of patient communication. This alliance is best described as:

• A. A personal friendship with the patient.
• B. A trusting, collaborative partnership between the clinician and patient.
• C. A legal contract.
• D. An agreement that the pharmacist is always right.

Answer: B. A trusting, collaborative partnership between the clinician and patient.

28. If a patient’s communication is disorganized due to psychosis, the pharmacist should:

• A. Try to interpret the symbolic meaning of their speech.
• B. Focus on concrete realities, ask clear and simple questions, and assess for basic needs and safety.
• C. Correct their grammar and sentence structure.
• D. Ask a family member to speak for them without involving the patient.

Answer: B. Focus on concrete realities, ask clear and simple questions, and assess for basic needs and safety.

29. A patient is ambivalent about starting an antidepressant. An appropriate response using motivational interviewing principles would be:

• A. “You have to take this or you will not get better.”
• B. “What are some of the reasons you might consider taking it? And what are some of the reasons that make you hesitant?”
• C. “If you don’t take this, I can’t be your pharmacist anymore.”
• D. “Let me tell you about all the terrible things that will happen if you don’t start this medicine.”

Answer: B. “What are some of the reasons you might consider taking it? And what are some of the reasons that make you hesitant?”

30. Communicating with an interprofessional team about a psychiatric patient requires the pharmacist to be:

• A. Vague and non-committal.
• B. Focused only on medication cost.
• C. Concise, objective, and collaborative, often using a structured format like SBAR.
• D. Critical of the other team members’ decisions.

Answer: C. Concise, objective, and collaborative, often using a structured format like SBAR.

31. The “GATOR Way Patient Counseling Rubric” includes assessing patient understanding via the teach-back method. Which of the following is a good teach-back prompt?

• A. “Do you have any questions?”
• B. “Did you understand all of that?”
• C. “To make sure I was clear, can you tell me in your own words how you are going to take this medication?”
• D. “Just read the label on the bottle.”

Answer: C. “To make sure I was clear, can you tell me in your own words how you are going to take this medication?”

32. A patient with severe depression speaks in a very quiet, monotone voice. The pharmacist should:

• A. Speak very loudly to compensate.
• B. Lean in, listen carefully, and speak in a clear, moderate voice.
• C. Tell the patient to speak up.
• D. Assume the patient does not want to communicate and end the conversation.

Answer: B. Lean in, listen carefully, and speak in a clear, moderate voice.

33. When counseling on a medication with a “black box warning” for suicidality, it is essential for the pharmacist to:

• A. Avoid mentioning the warning to prevent scaring the patient.
• B. Communicate the risk clearly but without causing undue alarm, and counsel on warning signs and when to seek help.
• C. Tell the patient they will definitely become suicidal.
• D. Only discuss the warning with a family member.

Answer: B. Communicate the risk clearly but without causing undue alarm, and counsel on warning signs and when to seek help.

34. A patient is tearful during a consultation. The most appropriate initial response is to:

• A. Ignore the tears and continue with the consultation.
• B. Acknowledge their distress with a supportive statement and offer a tissue or a moment of quiet.
• C. Immediately end the conversation.
• D. Ask them why they are crying.

Answer: B. Acknowledge their distress with a supportive statement and offer a tissue or a moment of quiet.

35. A core objective in the skills lab curriculum is to “Demonstrate attributes that promote a professional therapeutic relationship.” This includes all of the following EXCEPT:

• A. Empathy
• B. Respect
• C. Judgmental criticism
• D. Trustworthiness

Answer: C. Judgmental criticism

36. A patient asks, “Will this medication make me feel ‘numb’ and not like myself?” A good therapeutic response would be:

• A. “No, of course not.”
• B. “Yes, it will definitely make you feel numb.”
• C. “That’s a very common concern. The goal is for you to feel like yourself again, without the weight of depression. We should monitor how you feel, and you can tell me or your doctor if you feel ‘flat’ or ‘numb’.”
• D. “You shouldn’t worry about that.”

Answer: C. “That’s a very common concern. The goal is for you to feel like yourself again, without the weight of depression. We should monitor how you feel, and you can tell me or your doctor if you feel ‘flat’ or ‘numb’.”

37. When communicating with an adolescent patient with a mental health condition, it is important to:

• A. Speak only to their parents.
• B. Address the adolescent directly and build rapport with them, while also including the parents in the conversation as appropriate.
• C. Use slang to seem relatable.
• D. Assume they are not an active participant in their own care.

Answer: B. Address the adolescent directly and build rapport with them, while also including the parents in the conversation as appropriate.

38. Why is maintaining confidentiality a critical component of communication with all patients, especially those with mental health conditions?

• A. It is not important.
• B. It is essential for building trust and is a legal and ethical requirement under HIPAA.
• C. It only applies to patients without mental health conditions.
• D. It prevents the pharmacist from talking to the patient’s doctor.

Answer: B. It is essential for building trust and is a legal and ethical requirement under HIPAA.

39. A patient is having paranoid thoughts about the pharmacy staff. The best approach is to:

• A. Become defensive and argue with the patient.
• B. Be consistent, predictable, and transparent in your actions and communication to build trust over time.
• C. Have a different pharmacist speak with them every time.
• D. Secretly record the conversation.

Answer: B. Be consistent, predictable, and transparent in your actions and communication to build trust over time.

40. The use of “person-first” language (e.g., “a person with schizophrenia” instead of “a schizophrenic”) is a communication strategy that:

• A. Is overly complicated and unnecessary.
• B. Emphasizes the person’s identity before their diagnosis, promoting respect and dignity.
• C. Is only used by therapists.
• D. Makes the medical record less accurate.

Answer: B. Emphasizes the person’s identity before their diagnosis, promoting respect and dignity.

41. If a patient’s caregiver is experiencing significant burnout, a pharmacist can communicate support by:

• A. Telling them they are not doing enough for the patient.
• B. Acknowledging the difficulty of their role and providing them with information about caregiver support resources.
• C. Ignoring the caregiver and focusing only on the patient.
• D. Suggesting they stop caring for the patient.

Answer: B. Acknowledging the difficulty of their role and providing them with information about caregiver support resources.

42. Which communication style is most effective for shared decision-making with a patient?

• A. Paternalistic (telling the patient what to do).
• B. Passive (letting the patient make all decisions without guidance).
• C. Collaborative (presenting options and helping the patient make an informed choice that aligns with their values).
• D. Aggressive (insisting on one course of action).

Answer: C. Collaborative (presenting options and helping the patient make an informed choice that aligns with their values).

43. A patient is communicating in a way that suggests they are experiencing command hallucinations. The first priority is to:

• A. Ask what the voices are saying to assess for safety risks to self or others.
• B. Explore the symbolic meaning of the hallucinations.
• C. Tell the patient the voices are not real.
• D. Document the event for a future appointment.

Answer: A. Ask what the voices are saying to assess for safety risks to self or others.

44. What is a key challenge in communicating with a patient in a severe depressive episode?

• A. They may speak too quickly and have flight of ideas.
• B. They may exhibit psychomotor slowing, have difficulty concentrating, and express feelings of hopelessness.
• C. They are typically overly talkative and cheerful.
• D. They are never willing to communicate.

Answer: B. They may exhibit psychomotor slowing, have difficulty concentrating, and express feelings of hopelessness.

45. Ending a consultation with a psychiatric patient should include:

• A. A quick departure without a summary.
• B. A summary of key points, an opportunity for final questions, and a clear plan for follow-up.
• C. A promise that the medication will cure them in a week.
• D. A list of all the things the patient is doing wrong.

Answer: B. A summary of key points, an opportunity for final questions, and a clear plan for follow-up.

46. When a patient with a mental health condition asks for a recommendation, what is a key part of the “Collect” step of the PPCP?

• A. Immediately recommending a product.
• B. Gathering subjective and objective information to fully understand the situation.
• C. Telling the patient you cannot help them.
• D. Guessing what the patient needs.

Answer: B. Gathering subjective and objective information to fully understand the situation.

47. Body language is a powerful communication tool. A pharmacist demonstrating active listening would likely:

• A. Turn their body away from the patient.
• B. Face the patient, maintain an open posture, and nod to show understanding.
• C. Look at their phone while the patient is talking.
• D. Stand with their arms crossed.

Answer: B. Face the patient, maintain an open posture, and nod to show understanding.

48. Communicating a treatment plan to a patient with a mental health disorder should always involve:

• A. A discussion of the rationale for the selected therapy.
• B. A clear explanation of what to expect, including the therapeutic timeline and potential side effects.
• C. A chance for the patient to ask questions and express concerns.
• D. All of the above.

Answer: D. All of the above.

49. If a communication attempt with a patient is failing and the situation is escalating, a professional pharmacist should:

• A. Continue the interaction no matter what.
• B. Recognize the need to pause the interaction and perhaps seek assistance from a colleague or another team member.
• C. Raise their voice to be heard.
• D. End the conversation by walking away without a word.

Answer: B. Recognize the need to pause the interaction and perhaps seek assistance from a colleague or another team member.

50. The ultimate goal of effective communication with patients who have mental health problems is to:

• A. Ensure the pharmacist is in control.
• B. Foster a trusting relationship that promotes medication adherence, patient safety, and positive health outcomes.
• C. Make the prescription filling process faster.
• D. Avoid all liability.

Answer: B. Foster a trusting relationship that promotes medication adherence, patient safety, and positive health outcomes.