Chapt. 12: Cognitive Interventions in Psychiatric Nursing
1.A nurse is assessing a patient with a psychiatric illness. The nurse interprets which patient statement as reflecting the concept of cognitive triad? A) I always mess things up. No matter what I do, my whole world is a mess, and my future will be a big mess, too. B) My sister is always the pretty one, her world is free of problems, and she'll have a perfect future. C) My bosses think they know it all, that they can control the world's future, and that the entire planet is dependent on them. D) My mother used to always tell me bad things happen in threeslike when someone you know dies, you just know two other people you know will die.
A
11. A nursing instructor is preparing a class presentation for a group of nursing students about cognitive behavioral therapy. Which of the following would the instructor be least likely to include? A) An event is the underlying issue causing the disturbance. B) An individual has a belief regardless of how it developed. C) Practice can help to alter the belief causing the problem. D) Negative inaccurate thoughts can be replaced.
A
16. A group of nursing students is preparing a class presentation comparing the different types of cognitive therapies. When describing solution-focused brief therapy, which of the following would the students identify as being different from the other therapies? A) Focus on functional aspects of the patient B) Challenge about the existence of problems C) Assumption that change is not constant D) View of the past rather than the present
A
18. A nurse is reading a journal article about cognitive behavior therapy techniques used in various settings. In which setting would the nurse expect to find solution-focused therapy being used? A) Acute inpatient setting B) Community setting C) Clinic setting D) Home care setting
A
5. A person was supposed to meet a friend at a local theatre to see a movie. The friend never showed up. The person's initial thought was, My friend didn't come because she doesn't like me. This automatic thought was most likely inferred from which irrational belief? A) I'm worthless, so no one could really want to be my friend. B) Movies are a waste of time and money anyway. C) I'm sure she just got confused and thought we were going to a different movie. D) I'm so forgetful and confused sometimes, I probably wrote down the wrong time.
A
10. During a solution-focused behavior therapy session, the therapist asks a patient to use his imagination based on a scenario in which a patient awakens and all his problems have disappeared. The therapist then asks the patient, How would your life be different? Which type of question is the therapist using? A) Exception question B) Miracle question C) Relationship question D) Scaling question
B
15. When engaged in rational emotive behavior therapy, which of the following would be addressed during the activating event sequence? A) Teaching the connection between beliefs and consequences B) Assessing the consequences of the problem C) Facilitating the working-through process D) Preparing patient to deepen conviction in rational beliefs
B
8. A nurse who is working with a patient being treated for depression is using solution-focused brief therapy (SFBT) during the patient's brief psychiatric hospitalization. The nurse decides to use an exception question. Which question would the nurse most likely use? A) When did you first feel depressed? B) When do you not feel depressed? C) What feelings contribute to your depression? D) What has to happen for you to feel depressed?
B
12. A nurse is preparing to reinforce the use of cognitive behavior therapy with a patient. When interacting with the patient, which of the following would be appropriate? A) Having the nurse establish the agenda B) Focusing primarily on behavior C) Using a future-oriented goal focus D) Identifying the problem from the nurse's perspective
C
13. A patient is being treated in an interdisciplinary clinic. During interactions with a patient who is receiving cognitive behavior therapy, which of the following would the nurse concentrate on first? A) Identifying alternative explanations of an event B) Exploring evidence to support or refute the beliefs C) Identifying the underlying beliefs D) Examining the real implications if the beliefs are true
C
17. During a therapy session, a patient is asked to rate the intensity of his current issue from 1 to 10 with 1 being complete absence of the issue and 10 being the most intense. The patient is being asked which type of question? A) Relationship B) Miracle C) Scaling D) Exception
C
3. A nurse is working as part of an interdisciplinary treatment team caring for patients with psychiatric disorders. Based on the nurse's understanding of cognitive behavioral therapy (CBT) and its limitations cited by critics, the nurse would identify which patient as an inappropriate candidate for CBT? A) A client diagnosed with substance abuse B) A client diagnosed with depression C) A client diagnosed with schizophrenia D) A client diagnosed with an eating disorder
C
4. A student does poorly on the first class exam of the semester. Although there are three more tests plus a final exam that will be given during the rest of the semester, the student believes that he will fail the course because of doing so poorly on the one exam. The student's belief reflects which type of irrational belief? A) Low frustration tolerance B) Absolute thinking C) Catastrophizing D) A demand
C
9. A group of nursing students is reviewing the history of the development of cognitive therapies over the years. The students demonstrate understanding of the information when they identify which individual as being responsible for first developing cognitive therapy interventions? A) Aaron Beck B) Sigmund Freud C) Albert Ellis D) de Shazer and Berg
C
14. A group of nursing students is reviewing information about cognitive processes and the development of mental disorders. The students demonstrate a need for additional review when they identify which of the following as being involved? A) Cognitive triad B) Cognitive distortions C) Schema D) Compliments
D
2. A nursing instructor is preparing a class lecture about cognitive behavioral therapy (CBT). Which of the following would the instructor use to best describe this process? A) Solving patients' problems for them by determining how they need to change their thoughts and actions and developing a plan that will help them do so. B) Using techniques to modify a patient's behavior shaping it into behavior that is appropriate in order to help the patient experience a more positive future. C) Reinforcing distorted beliefs so they can play a major part in changing a patient's behavior for the better and improving his or her quality of life. D) Working in a trusting and collaborative relationship to help patients focus on solving their own problems by changing the way they think and behave.
D
6. During a staff meeting, a therapist mentions planning to use bibliotherapy with a patient. Later that morning, the patient approaches the nurse and says his therapist just talked to him but that he is having trouble understanding what his therapist wants him to do. When the nurse asks him to clarify his concern, he asks what bibliotherapy really means. Which response by the nurse would be most appropriate? A) It entails listing books about your diagnosis alphabetically in a reference list in case you ever want to read about your diagnosis. B) It is a new form of coping technique associated with shopping in a bookstore that works to help lift your depression. C) It is a form of therapy based on your therapist teaching you knowledge that is crucial to your recovery that he has collected from a variety of books. D) It is a form of therapy that entails you reading books about ways of perceiving and responding to life events in a different way.
D
7. A nurse is working with an adolescent girl who describes herself as a compulsive overeater and presents with a history of using food to cope with stress. The nurse decides to use journaling as an intervention for this patient based on the rationale that journaling will help the patient identify which of the following? A) How often she eats compulsively in response to stress she encounters on a daily basis B) Patterns in her daily schedule that may be contributing to her compulsive eating C) Behaviors in others that trigger her compulsion to eat in when she experiences stress D) Changes in her self-perception and responses to stress that she might otherwise not notice
D