When should healthcare professionals be most alert to the possibility of communication errors resulting in harm to the patient?

Correct Answer: A

Rationale: Healthcare professionals should be most alert to the possibility of communication errors resulting in harm to the patient during change of shift reports. This is a critical time when information is transferred between healthcare providers, and any errors in communication during this handover can lead to adverse outcomes for the patient.

Correct Answer: A

Rationale: Carolina's best response is **A: *"That sounds exciting, would you be willing to visit and show me the app?"*** because it demonstrates openness, curiosity, and a patient-centered approach. By validating the patient’s interest in the app, Carolina fosters trust and keeps communication lines open. This response allows her to assess the app’s credibility, discuss its integration with their ongoing therapy, and ensure the patient isn’t abandoning evidence-based care prematurely. It also avoids defensiveness, which could alienate the patient. A collaborative approach encourages the patient to remain engaged while allowing Carolina to provide professional guidance on whether the app complements or conflicts with their treatment plan. **B: *"At this time, there is no real evidence that the app can replace our therapy."*** is problematic because it dismisses the patient’s autonomy and enthusiasm without exploration. While it may be true that many apps lack rigorous evidence, outright rejection can make the patient defensive. A better approach would involve discussing research together, evaluating the app's merits, and addressing gaps in its effectiveness rather than issuing a blanket dismissal. This response risks shutting down dialogue and may push the patient further away from professional support. **C: *"I am not sure that is a good idea right now, we are so close to progress."*** assumes that the therapist's perspective on progress outweighs the patient’s agency. While the concern is valid—abruptly stopping therapy can disrupt gains—this phrasing centers Carolina’s agenda rather than the patient’s needs. It could come across as manipulative ("we’re *so close*") rather than collaborative. A more effective approach would be acknowledging the patient’s autonomy while discussing potential risks of discontinuing sessions. **D: *"Why would you think that is a better option than meeting with me?"*** is the least constructive, as it frames the question confrontationally. This puts the patient in a position to justify their choice defensively, which could damage rapport. It implies that Carolina’s ego is more important than understanding the patient’s perspective. Even if the app is inadequate, this response fails to guide the patient toward an informed decision, instead breeding resentment or withdrawal. In summary, **A** succeeds because it balances professional guidance with respect for the patient’s choices, fostering a partnership rather than authority-based compliance. The incorrect options either dismiss, manipulate, or challenge the patient in ways that undermine therapeutic trust. Effective responses in such scenarios prioritize curiosity, collaboration, and patient empowerment while ensuring clinical oversight.

Correct Answer: A

Rationale: Choice A, 'Hitting me when you are angry is unacceptable,' demonstrates a well-structured attempt at limit setting because it clearly defines the unacceptable behavior without ambiguity. This statement sets a clear boundary and clearly communicates the consequence for the behavior. In contrast, choices B, C, and D are less effective in setting limits as they are either vague expectations or commands without specific consequences for crossing the limit.

Correct Answer: D

Rationale: Children with ADHD often struggle with sustained attention, impulsivity, and hyperactivity, making it essential to select activities that align with their neurological needs while minimizing frustration. Tennis (D) is the most appropriate choice because it combines physical exertion, structured rules, and intermittent bursts of focused activity, which are well-suited for ADHD. Physical exercise, such as tennis, has been shown to improve executive function, attention, and impulse control by increasing dopamine and norepinephrine levels—neurotransmitters often dysregulated in ADHD. The game’s fast-paced nature provides immediate feedback and rewards, keeping the child engaged without requiring prolonged static focus. Additionally, the social and competitive aspects can reinforce positive behavior and teamwork. Reading an adventure novel (A) is less ideal because it demands sustained silent focus, a challenge for children with ADHD who may struggle with attention spans and sitting still. While some children with ADHD might enjoy stories, the lack of physical engagement and delayed gratification (e.g., waiting for plot developments) can lead to frustration or disengagement. Monopoly (B) is problematic due to its lengthy playtime, complex rules, and turn-based structure, which may exacerbate impulsivity (e.g., acting out of turn) or boredom during waiting periods. The game’s reliance on strategic planning and delayed rewards can also be overwhelming for a child with executive function difficulties. Checkers (C), while simpler than Monopoly, still requires sustained attention and strategic thinking, which can be taxing. The sedentary nature of the game may not accommodate the child’s need for movement, potentially leading to restlessness or impulsivity, such as making hasty moves without planning. Tennis stands out as the best option because it channels the child’s energy productively, provides sensory and motor stimulation, and aligns with evidence-based interventions for ADHD, such as incorporating physical activity into daily routines. The other choices, while potentially enjoyable for some, fail to address the core challenges of ADHD as effectively.

Correct Answer: B

Rationale: In cognitive-behavioral therapy, recognizing and challenging negative thoughts is crucial for progress. Choice B demonstrates the patient's ability to identify and correct distorted thoughts, indicating positive advancement in therapy. This cognitive restructuring is a key component of cognitive-behavioral therapy, helping individuals develop healthier thinking patterns and coping strategies.