Chapter 12: Cognitive Interventions in Psychiatric Nursing - ML4 - PrepU

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Who developed cognitive therapy for persons with depression? 1- Aaron Beck 2- Albert Ellis 3- Sigmund Freud 4- Jean Piaget

1

Beck's cognitive triad refers to the client's views about what three areas? 1- Self, the world, and the future 2- Self, the past, and the future 3- Self, the past, and the present 4- Self, the world, and the present

1

Cognitive interventions are based on the concept of cognition. Who developed cognitive behavioral therapy? 1- Aaron Beck 2- Albert Ellis 3- Steven DeShazer 4- Insoo Kim Berg

1

exception questions

Solution-focused therapists inquire about those times in clients' lives when the problems they identify have not been problematic. Exploring these exceptions reminds clients that problems are not all-powerful and have not existed forever.

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? 1- They are the end result of any action 2- They are the result of irrational beliefs 3- They are the reasons people engage in certain behaviors 4- They give meaning to one's actions

2

Which of the following reinforce the client's successes and strengths? 1- Scaling questions 2- Compliments 3- Miracle questions 4- Relationship questions

2

Cognitive techniques focus on the client's patterns of which type of thinking? 1- Delayed 2- Delusional 3- Automatic 4- Magical

3

The education provided to a client receiving cognitive behavioral therapy provides the client with information on the nature and course of the disorder and ... 1- identifies client weaknesses. 2- promotes the relationship with therapist for indefinite period of time. 3- examines the pros and cons of receiving cognitive behavior therapy. 4- empowers clients to engage in a collaborative approach to their care.

4

Scaling Questions

A solution-focused technique that asks clients to observe changes in feelings, moods, thoughts, and behaviors. On a scale of zero to 10, clients are asked to rate some change in their experiences.

dyScaling Questions

A solution-focused technique that asks clients to observe changes in feelings, moods, thoughts, and behaviors. On a scale of zero to 10, clients are asked to rate some change in their experiences.

Miracle Question

A solution-focused technique that asks clients to imagine how their life would be different if they woke up tomorrow and they no longer had their problem.

cognition

all the mental activities associated with thinking, knowing, remembering, and communicating

dysfunctional consequences

follow from absolute, rigid, and irrational beliefs whereas functional consequences follow from flexible and rational beliefs

Beck's cognitive triad

negative views about the self, the world and the future

When clients are asked to consider the points of view of significant others in their lives, the nurse is asking which type of question? 1- relationship 2- scaling 3- exception 4- compliments

1

An individual's life rules that act as a filter for cognitive distortions are known as what? 1- Activating event 2- Engagement 3- Schema 4- Demand

3

A client is involved with cognitive behavioral therapy. While working with the client, the therapist explains that the client's problems are manageable. The therapist is engaged in which step? 1- engagement 2- intervention 3- evaluation 4- termination

1

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: 1- reflects flexibility. 2- is absolute. 3- is self-defeating. 4- reflects infallibility.

1

A psychiatric-mental health nurse is reviewing the interdisciplinary treatment plan for a client who is receiving cognitive behavioral therapy. Which goal would the nurse most likely identify as the ultimate goal? 1- independent self-care 2- enhanced personal strengths 3- control of the future 4- improved problem-solving

1

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? 1- "What brought you here today?" 2- "What are your major symptoms?" 3- "What is your diagnosis?" 4- "What kind of problem are you having?"

1

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? 1- Absolute thinking 2- Minimizing the event 3- High frustration tolerance 4- View of "can" instead of "must"

1

Which is an assumption of solution-focused behavior therapy? 1- Change is most likely to occur when the focus is on what is changeable. 2- It is necessary to know a lot about the report and its origins or functions in order to resolve it. 3- Usually, long-standing issues cannot be resolved in short periods of time. 4- There is only a right way to see things.

1

Which response by a client involved in solution focused brief therapy demonstrates an understanding of the fundamental principles of this form of therapy? 1- "Finding ways to manage my anger will allow my relationships to be so much more fulfilling." 2- "I have both strengths and weaknesses that are important to my health and happiness." 3- "The basis for my beliefs were for formed during my middle childhood years." 4- "My anger results in consequences that have a negative impact on my life."

1

Which statement demonstrates a client's cognitive distortion about success in a course the client is enrolled in? 1- "I didn't make an A on that test; I'm never going to pass this course." 2- "I wish the test wasn't on Tuesday; I do better on tests scheduled on Mondays." 3- "Tests just aren't the best way to evaluate my knowledge of the subject." 4- "Everyone says the course is hard but I really like the subject so I'll do well."

1

While interviewing a client, the client says, "I never will get promoted, no matter how hard I work or what great ideas I have. I'm just not as talented as my colleagues are." Which is the correct interpretation by the nurse about the client's statement? 1- cognitive distortion 2- cognitive triad 3- schema 4- compliment

1

A psychiatric-mental health nurse is describing solution-focused behavior therapy. Which statement reflects an assumption upon which solution-focused behavior therapy is based? Select all that apply. 1- "You have strengths and abilities that will help you manage this problem." 2- "Successful change is dependent upon knowing the origins of the problem." 3- "There is no right or wrong way to view your situation." 4- "Change is most likely to occur when the focus is on that which can be changed." 5- "Long-standing problems take a long time to resolve."

1, 3, 4

Which of the following components is part of the cognitive triad? Select all that apply. 1- Oneself 2- Demand 3- World 4- Tolerance 5- Future

1,3,5

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? 1- The client will no longer have to take medication. 2- The client will engage in self-care independent of professional assistance. 3- The client will relinquish all control. 4- The client will continue to have sessions with the therapist once a week for life.

2

A nurse working in a psychiatric facility identifies the goal of cognitive therapy (CT) to be what? 1- Change events in a person's life. 2- Restructure how a person perceives events. 3- Help the person maintain all thoughts and behaviors. 4- Redirect all events in a person's life.

2

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? 1- Cognitive triad 2- Cognitive distortion 3- Schema 4- All of the above

2

A psychiatric-mental health nurse is working with several clients who are hospitalized for mential illness. The nurse would anticipate the use of solution-focused approaches with clients experiencing which issue? 1- Mania 2- Schizophrenia 3- Depression 4- Eating disorder

2

A therapist using cognitive-behavioral therapy (CBT) with a client has introduced a tool to help change self-perception. This tool uses books that offer alternative thoughts and responses. Additionally, the therapist encourages the client to keep a diary focused on emotional responses. These approaches are known as which of the following? 1- Emotive behavior therapy 2- Bibliotherapy 3- Psychoanalytical therapy 4- Distraction therapy

2

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? 1- "Solution-focused approaches have been effective with hospitalized people experiencing delusions." 2- "Lengths of stay for clients in inpatient settings are becoming longer each year." 3- "The context of practice has changed considerably over the years for psychiatric nurses." 4- "Lengths of stay for clients in inpatient settings are becoming shorter each year."

2

From the standpoint of cognitive therapy, the term cognition refers to what? 1- Faulty thought patterns that result in abnormal behavior 2- How clients think about themselves and their world 3- An idea 4- Dysfunctional ways of responding to situations

2

Which question asked by the nurse demonstrates an attempt to implement cognitive behavioral therapy (CBT) with a client who has stated, "I'm worthless"? 1- "When did you first begin feeling worthless?" 2- "Can you identify one quality you admire in yourself?" 3- "Do you think others see you as worthless?" 4- "Do you believe me when I say you have many good qualities?"

2

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? 1- "I know we can discover what it is that makes me so easily angered." 2- "I'm trying to find ways to change how I function when I'm faced with a frustrating situation." 3- "I have to identify what triggers my explosive anger so I can control those feelings." 4- "I know everyone has a temper but mine is just out of control."

2

Rational beliefs accept that human beings are fallible and reject absolutes such as what? Select all that apply. 1- "Sometimes" 2- "Always" 3- "Maybe" 4- "Never" 5- "Once in a while"

2,4

A client is receiving solution-focused behavior therapy. Which type of question would most likely be used to amplify and reinforce positive responses to other questions? 1- Scaling questions 2- Exception questions 3- Relationship questions 4- Miracle questions

3

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? 1- Threats from the world 2- Threats to her self 3- Threats about her future 4- Threats from her past

3

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? 1- "No one else seems to be so afraid of flying." 2- "I'm an adult; I can overcome this fear." 3- "I've read that flying is safer than traveling in a car." 4- "I've never actually been in a airplane accident."

3

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? 1- Psychoanalytic therapy 2- Group therapy 3- Cognitive therapy 4- Humanistic therapy

3

A therapist meeting with a client for the first time plans to use a type of therapy that focuses more on solutions than problems and that asks the client to explore his or her life. This type of therapy is referred to as ... 1- Emotive behavior therapy 2- Cognitive-behavioral therapy 3- Solution-focused brief therapy 4- Psychoanalytic therapy

3

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? 1- The client diagnosed with post-traumatic stress disorder after being sexually assaulted. 2- The client grieving the death of an infant child. 3- The client diagnosed with schizophrenia 2 years ago. 4- The client expressing an intense fear of closed-in spaces.

3

Which form of questioning typically used as part of solution-focused behavioral therapy should be avoided for clients diagnosed with thought disorders? 1- Scaling 2- Relationship 3- Miracle 4- Exception

3

Which statement made by the client identifies a misconception of the goal of cognitive behavioral therapy (CBT) that the nurse should address initially? 1- "My future isn't dictated by my past." 2- "I've got to stop thinking of myself as a loser." 3- "Concentrating on past mistakes will help me make better decisions in the future." 4- "I want to change the way I perceive my experiences as usually being negative and hopeless."

3

Which type of question is useful in making the client's problem or issue more specific? 1- Relationship questions 2- Miracle questions 3- Scaling questions 4- Exception questions

3

Relationship Questions

Questions used to amplify and reinforce positive responses to the other questions.

schema

a conceptual framework a person uses to make sense of the world

rational emotive behavior therapy

a confrontational cognitive therapy, developed by Albert Ellis, that vigorously challenges people's illogical, self-defeating attitudes and assumptions

cognitive therapy

therapy that teaches people new, more adaptive ways of thinking and acting; based on the assumption that thoughts intervene between events and our emotional reactions


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