PrepU- Chapter 12

Which question asked of a client being treated with solution-focused behavioral therapy is an example of a miracle question? A. "How would your life be different if you woke up tomorrow without any anxiety?" B. "How does your anxiety affect your children's lives?" C. "What do you think is different about the times when you aren't feeling anxious?" "Are you still rating your anxiety as a 3 today?"

A. "How would your life be different if you woke up tomorrow without any anxiety?"

The education provided to a client receiving cognitive behavioral therapy provides the client with information on the nature and course of the disorder and ... A. empowers clients to engage in a collaborative approach to their care. B. promotes the relationship with therapist for indefinite period of time. C. examines the pros and cons of receiving cognitive behavior therapy. D. identifies client weaknesses.

A. empowers clients to engage in a collaborative approach to their care.

An individual's life rules that act as a filter for cognitive distortions are known as what? A. Schema B. Demand C. Engagement D. Activating event

A. Schema Rationale: Schema is an individual's life rules that act as a sieve or filter. They allow only information compatible with the internal picture of the self and the world to be brought to the person's awareness. The activating event may be either external or internal; it is not necessarily an actual event but may be an emotion, thought, or expectation. Engagement is the first step in CBT. A demand is something that must happen.

When considering cognitive behavioral therapy, which client has the best chance of altering their schema about their personal abilities? A. The 30 year old whose marriage ended in divorce. B. The 5 year old who is having difficulty riding a two wheel bike. C. The 50 year old who has recently lost their job for the third time. D. The 16 year old who has failing their driving test twice.

B. The 5 year old who is having difficulty riding a two wheel bike.

Considering that cognitive behavioral therapy (CBT) requires a clear understanding of one's own belief system, which client is not a candidate for effective CBT? A. The client grieving the death of an infant child. B. The client diagnosed with schizophrenia 2 years ago. C. The client expressing an intense fear of closed-in spaces. D. The client diagnosed with post-traumatic stress disorder after being sexually assaulted.

B. The client diagnosed with schizophrenia 2 years ago. Rationale: Chief among the limitations identified associated with CBT is the concern that success is dependent on the client developing a clear understanding of their belief system and the origin of that system; thus, CBT is not effective with persons who have thought disorders and other issues that interfere with the ability to do so. Schizophrenia is a thought disorder while the other options are all mood disorders, such as depression and anxiety.

A psychiataric-mental health nurse is reinforcing the interventions used with a patient receiving solution-focused behavior therapy. Which question would be most appropriate to use as a relationship-focused question? A. "How long have you and your life partner been together?" B. "How would you rate the support you get from your family?" C. "How are your children affected by your anger issues?" D. "Do you think your siblings understand what you are going through?"

C. "How are your children affected by your anger issues?"

Which of the following components is part of the cognitive triad? Select all that apply. A. Tolerance B. World C. Oneself D. Future E. Demand

B. World C. Oneself D. Future

Which of the following reinforce the client's successes and strengths? A. Compliments B. Scaling questions C. Miracle questions D. Relationship questions

A. Compliments Rationale: Compliments are affirmations of the client. They reinforce the client's successes and the strengths needed to achieve those successes. Scaling questions are useful in making the client's problem or issue more specific, in quantifying exceptions noted in intensity, and in tracking change over time. In miracle questions, the therapist structures a scenario that the patient is asked to think about carefully and to use his or her imagination in crafting the response, again to very specific questions. Relationship questions are used to amplify and reinforce positive responses to the other questions.

Rational beliefs accept that human beings are fallible and reject absolutes such as what? Select all that apply. A. "Once in a while" B. "Always" C. "Sometimes" D. "Never" E. "Maybe"

B. "Always" D. "Never"

Which statement made by the client identifies a misconception of the goal of cognitive behavioral therapy (CBT) that the nurse should address initially? A. "I want to change the way I perceive my experiences as usually being negative and hopeless." B. "Concentrating on past mistakes will help me make better decisions in the future." C. "My future isn't dictated by my past." D. "I've got to stop thinking of myself as a loser."

B. "Concentrating on past mistakes will help me make better decisions in the future."

Cognitive techniques focus on the client's patterns of which type of thinking? A. Magical B. Automatic C. Delayed D. Delusional

B. Automatic

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? A. Cognitive triad B. Cognitive distortion C. Schema D. All of the above

B. Cognitive distortion

An important aspect of cognitive behavior therapy is to weigh both the evidence for and evidence against an automatic thought to promote a new and balanced way of thinking. This refers to ... A. Mental filter B. Modifying thoughts C. Replacing negative thoughts D. Emotional reasoning

B. Modifying thoughts

A nurse working in a psychiatric facility identifies the goal of cognitive therapy (CT) to be what? A. Help the person maintain all thoughts and behaviors. B. Restructure how a person perceives events. C. Redirect all events in a person's life. D. Change events in a person's life.

B. Restructure how a person perceives events.

Dysfunctional consequences follow which type of belief? A. Fair B. Rigid C. Rational D. Flexible

B. Rigid

A therapist who applies a positive approach and views the client as an individual with a collection of strengths and successes as opposed to a diagnosis and collection of symptoms is using which approach? A. Cognitive-behavioral theory B. Solution focused theory C. Rational emotive behavior theory D. Psychoanalytic theory

B. Solution focused theory

Which statement made by a client engaged in solution-focused behavior therapy (SFBT) demonstrates an understanding of a fundamental assumption of this form of therapy? A. "I know everyone has a temper but mine is just out of control." B. "I have to identify what triggers my explosive anger so I can control those feelings." C. "I'm trying to find ways to change how I function when I'm faced with a frustrating situation." D. "I know we can discover what it is that makes me so easily angered."

C. "I'm trying to find ways to change how I function when I'm faced with a frustrating situation."

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? A. "Solution-focused approaches have been effective with hospitalized people experiencing delusions." B. "Lengths of stay for clients in inpatient settings are becoming shorter each year." C. "Lengths of stay for clients in inpatient settings are becoming longer each year." D. "The context of practice has changed considerably over the years for psychiatric nurses."

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

A psychiatric-mental health nurse is working as part of the interdisciplinary team to develop the plan of care for a client who is to receive solution-focused behavior therapy. Which question would the nurse identify as being most appropriate to ask during the client's initial session? A. "What are your major symptoms?" B. "What is your diagnosis?" C. "What brought you here today?" D. "What kind of problem are you having?"

C. "What brought you here today?"

The tendency to see things in black and white categories with no shades of grey describes ... A. Overgeneralization B. Labeling C. All-or-nothing thinking D. Mental filter

C. All-or-nothing thinking

Which is an assumption of solution-focused behavior therapy? A. There is only a right way to see things. B. It is necessary to know a lot about the report and its origins or functions in order to resolve it. C. Change is most likely to occur when the focus is on what is changeable. D. Usually, long-standing issues cannot be resolved in short periods of time.

C. Change is most likely to occur when the focus is on what is changeable. Rationale: According to solution-focused behavior therapy, change is most likely to occur when the focus is on what is changeable. It isn't necessary to know a lot about the report and its origin or functions in order to resolve it. Even long-standing issues can be resolved in a relatively short period of time. There is not a right or wrong way to see things.

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? A. The client will continue to have sessions with the therapist once a week for life. B. The client will relinquish all control. C. The client will engage in self-care independent of professional assistance. D. The client will no longer have to take medication.

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

A psychiatric- mental health advanced practice nurse is conducting rational emotive behavior therapy (REBT) with a client. When explaining the concept of consequences, which information would the nurse most likely include about dysfunctional consequences? A. They are the end result of any action B. They are the reasons people engage in certain behaviors C. They are the result of irrational beliefs D. They give meaning to one's actions

C. They are the result of irrational beliefs

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: A. is self-defeating. B. reflects infallibility. C. reflects flexibility. D. is absolute.

C. reflects flexibility. Rationale: Rational beliefs are flexible and lead to reasonable evaluations of negative activating events. Rational beliefs accept that human beings are fallible and reject absolutes such as always and never.

Which statement demonstrates a client's cognitive distortion about success in a course the client is enrolled in? A. "Tests just aren't the best way to evaluate my knowledge of the subject." B. "Everyone says the course is hard but I really like the subject so I'll do well." C. "I wish the test wasn't on Tuesday; I do better on tests scheduled on Mondays." D. "I didn't make an A on that test; I'm never going to pass this course."

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

An "all or nothing at all" thought process is an example of which theme associated with irrational beliefs? A. Low frustration tolerance B. Catastrophizing C. A demand D. Absolute thinking

D. Absolute thinking

Which type of cognitive intervention identifies the possible solutions before addressing the problem? A. Rational emotive behavior therapy B. Psychotherapy C. Cognitive behavioral therapy D. Solution-focused behavior therapy

D. Solution-focused behavior therapy

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? A. Minimizing the event B. View of "can" instead of "must" C. High frustration tolerance D. Absolute thinking

D. Absolute thinking Rationale: There are five themes common in irrational beliefs: a demand, such that "This must happen"; absolute thinking, for example, "All or nothing at all"; catastrophizing, that is, exaggerating negative consequences of an event; low frustration tolerance (i.e., everything should be easy); and global evaluations of human worth, such that "People can be rated and some are better than others."

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? A. Psychoanalytic therapy B. Humanistic therapy C. Group therapy D. Cognitive therapy

D. Cognitive therapy

From the standpoint of cognitive therapy, the term cognition refers to what? A.Dysfunctional ways of responding to situations B. Faulty thought patterns that result in abnormal behavior C. An idea D. How clients think about themselves and their world

D. How clients think about themselves and their world

All except which are cognitive therapy techniques? A. Reviewing homework assignments B. Listing an agenda for each session C. Reviewing the session prior to ending D. Listing primary defenses used in life

D. Listing primary defenses used in life

Beck's cognitive triad refers to the client's views about what three areas? A. Self, the past, and the future B. Self, the world, and the present C. Self, the past, and the present D. Self, the world, and the future

D. Self, the world, and the future

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? A. Threats from the world B. Threats from her past C. Threats to her self D. Threats about her future

D. Threats about her future

A client reports anxiety over "sounding stupid" when talking to strangers. As a part of cognitive behavioral therapy, the client is expected to speak to a stranger on the bus ride home and to journal about the experience. What information will be evaluated to determine the effect the activity has on the client's irrational belief about "sounding stupid"? A. What self-talk the client employed to prepare for the conversation. B. What the stranger said during the conversation C. What physical manifestations the client felt during the conversation D. What actually happened compared to what the client feared would happen

D. What actually happened compared to what the client feared would happen Rationale: The information concerning what really happened during the conversation compared to what the client feared would happen will be evaluated to determine the refuting of the irrational belief at the root of the client's fears. None of the other options are focused on the belief but rather the client's response to, preparation for, and memory of the conversation.