Chapter 13: Cognitive Interventions in Psychiatric Nursing

A client with extreme anxiety associated with flying is involved in cognitive behavior therapy to help manage those fears. Which statement demonstrates the client's attempt to refute the belief that supports the fear of flying?

"I've read that flying is safer than traveling in a car."

A therapist is using solution-focused behavior therapy (SFBT). A nursing student is observing the session and asks afterward why the therapist did not mention the client's problems. What is the best response by the therapist?

"In SFBT, it is best to focus on strengths and successes as opposed to a diagnosis."

An instructor is teaching a class about the use of cognitive therapies in psychiatric nursing. Which statement made by a student identifies a need for further instruction?

"Lengths of stay for clients in inpatient settings are becoming longer each year."

A psychiatric-mental health nurse is working with a client who is receiving rational emotive behavior therapy. While reviewing the client's history, the nurse identifies statements that reflect common themes associated with irrational beliefs. Which theme would the nurse most identify in these beliefs?

Absolute thinking

An "all or nothing at all" thought process is an example of which theme associated with irrational beliefs?

Absolute thinking

Which is an assumption of solution-focused behavior therapy?

Change is most likely to occur when the focus is on what is changeable.

From the standpoint of cognitive therapy, the term cognition refers to what?

How clients think about themselves and their world

In which of the following environments did cognitive interventions have their beginning?

Long-term inpatient settings

Beck's cognitive triad refers to the client's views about what three areas?

Self, the world, and the future

A client who is to receive cogntive behavior therapy asks the nurse, "What will we be focusing on with this type of therapy?" Which information would the nurse intergrate into the response?

Dysfunctional thinking through the examination of the cognitive triad

Which response by a client involved in solution focused brief therapy demonstrates an understanding of the fundamental principles of this form of therapy?

"Finding ways to manage my anger will allow my relationships to be so much more fulfilling."

Which statement demonstrates a client's cognitive distortion about success in a course the client is enrolled in?

"I didn't make an A on that test; I'm never going to pass this course."

A psychiatric-mental health nurse is interviewing a client who has come to the community mental health center for an evaluation of anger issues. Which client statement would the nurse interpret as an irrational belief?

"Nobody understands the enormous stress I'm under, so what's the use."

A psychiatric-mental health nurse is working with a client. Which statement made by the client involved in solution-focused behavior therapy demonstrates effective use of a scaling question?

"Now that I understand what triggers my fear of flying, it feels more like a 7 than a 5."

Cognitive interventions are based on the concept of cognition. Who developed cognitive behavioral therapy?

Aaron Beck

Rational beliefs accept that human beings are fallible and reject absolutes such as what? Select all that apply.

Always, Never

Cognitive techniques focus on the client's patterns of which type of thinking?

Automatic

Changing negative thought patterns as means to improve mood and behavior is the basis of ...

Cognitive behavior therapy

A 47-year-old client who is in marital counseling states that the client works obsessively because otherwise the client will lose the client's job and the couple will go bankrupt. What is this an example of?

Cognitive distortion

A nursing student has heard that material on the next test is difficult to master and many students have failed this particular test over the last few years. The student chooses to go skiing for the weekend instead of studying for the test and ultimately fails. The student then blames the test, not the lack of attention to study. This is an example of which cognitive process?

Cognitive distortion

A nurse working on a psychiatric unit is helping clients to understand how individual perceptions determine a person's response or behavior in stressful situations. Which therapeutic approach is the nurse employing?

Cognitive therapy

A nurse working in a psychiatric facility identifies the goal of cognitive therapy (CT) to be what?

Restructure how a person perceives events.

A nursing student who fails an examination believes that because the student earned a low grade, the student now must develop a better understanding of the material. This student is exhibiting a belief system that is what?

Rational

A psychiatric-mental health nurse is assisting a client who is receiving solution-focused behavior therapy. The nurse is working to reinforce the client's positive responses to other questions. Which type of question would be most appropriate to use?

Relationship

A client is using cognitive therapy as an adjunct treatment for bipolar disorder. Which would be an overall goal for this client related to the use of cognitive therapy for this condition?

The client will engage in self-care independent of professional assistance.

Cognitive behavioral therapy is not effective with which client population?

Thought disorders

A client states that she is anxious about separating from her emotionally abusive husband because she hasn't worked in many years. Using Beck's cognitive triad, the nurse understands that the client is concerned primarily about what?

Threats about her future

A psychiatric-mental health nurse is assessing a client and evaluating a client's beliefs. The nurse determines that the client's beliefs are rational because the belief:

reflects flexibility.

When clients are asked to consider the points of view of significant others in their lives, the nurse is asking which type of question?

relationship

Dysfunctional consequences follow which type of belief?

rigid

The nurse provides care for a client who is hospitalized in an acute inpatient psychiatric setting. The client experiences hallucinations. Which is the best approach to include in this client's plan of care?

the use of solution-focused therapy