The PMHNP is seeing a 34-year-old male client who recently decided to stop smoking marijuana after smoking it for 15 years. He is having trouble abstaining from marijuana, even though his wife has threatened to divorce him if he continues to smoke. Using the principles of motivational interviewing, which of the following would be the most appropriate response from the PMHNP to enhance his motivation to change?
I hear you saying you want to save your marriage, and I also hear you saying you want to keep smoking marijuana.
I thought you said you don't want to get divorced.
Think about what you were willing to do for your addiction. Think about all the time, effort, and money you put into getting high. You’d do anything to get your drugs. Why are you not willing to do anything for your recovery?
I really think you need to tell your family that you used again. You won’t be able to stay clean and sober if you are not honest with the people closest to you in your life.
The Correct Answer is A
Choice A reason: This response reflects a core principle of motivational interviewing—expressing empathy and highlighting ambivalence. It validates the client’s conflicting feelings and opens the door for deeper exploration of values and goals, which can enhance motivation for change.
Choice B reason: This response is confrontational and may provoke defensiveness. Motivational interviewing avoids judgment and instead fosters collaboration and self-reflection.
Choice C reason: This statement is shaming and accusatory. It undermines the supportive tone of motivational interviewing and may damage rapport, reducing the likelihood of behavior change.
Choice D reason: While honesty is important, this directive approach lacks the client-centered spirit of motivational interviewing. It imposes a solution rather than guiding the client to discover their own motivation.
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Related Questions
Correct Answer is C
Explanation
Choice A reason: "Legislate, execute, and judge" refers to the three branches of government and their functions, not the phases of health policy development. This framework is constitutional, not specific to health policy.
Choice B reason: "Plan, Do, Study, Act" is a quality improvement cycle used in healthcare settings to test and implement changes in clinical practice. It is not a framework for health policy development.
Choice C reason: The health policy process typically follows three core phases: formulation (developing policy proposals), implementation (putting policies into action), and evaluation (assessing the effectiveness and impact of the policy). This model is widely accepted in public health and policy literature.
Choice D reason: "Understand, design, and structure change" is a vague and non-standard framework. It does not reflect the established phases used in health policy analysis and development.
Correct Answer is D
Explanation
Choice A reason: The Department of Health and Human Services oversees public health programs and agencies but does not directly provide financial incentives for rare disease drug development.
Choice B reason: The National Organization for Rare Disorders advocates for patients and supports research, but it is not a legislative body and does not enact financial incentive programs.
Choice C reason: The Food and Drug Administration regulates drug approval and safety. While it administers the Orphan Drug Act, it is not the source of the legislation itself.
Choice D reason: The Orphan Drug Act, passed in 1983, provides financial incentives such as tax credits, grant funding, and market exclusivity to encourage pharmaceutical companies to develop treatments for rare diseases affecting fewer than 200,000 people in the U.S.
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