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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 threes?like when someone you know dies, you just know two other people you know will die.
Correct Answer: A
Rationale: The cognitive triad, a concept in Beck?s cognitive theory, involves negative views of oneself, the world, and the future. The statement in option A reflects this triad: self ('I always mess things up'), world ('my whole world is a mess'), and future ('my future will be a big mess, too'). Options B and C focus on others, and option D reflects a superstitious belief, not the cognitive triad.
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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.
Correct Answer: D
Rationale: Bibliotherapy involves reading materials to gain insight, cope with challenges, or change perspectives on life events, as in option D. Option A misrepresents it as a reference task, option B is incorrect and trivializes it, and option C focuses on the therapist?s role, not the patient?s engagement.
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
Correct Answer: B
Rationale: Solution-focused brief therapy (SFBT) is commonly used in community settings due to its brief, goal-oriented nature, which suits outpatient and community-based care. While possible in clinics or home care, it?s less typical in acute inpatient settings, where crisis stabilization is prioritized.
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
Correct Answer: C
Rationale: CBT is effective for depression, eating disorders, and substance abuse, as it targets cognitive distortions and behaviors. Schizophrenia, with prominent psychotic symptoms like delusions and hallucinations, is less responsive to CBT alone due to impaired reality testing, making it an inappropriate primary candidate, though CBT can be adjunctive.
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
Correct Answer: A
Rationale: Solution-focused brief therapy (SFBT) differs from other cognitive therapies by focusing on the patient?s strengths and functional aspects to build solutions, rather than analyzing problems or past events. Other therapies may challenge beliefs or focus on the past, and SFBT assumes change is possible, not static.
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
Correct Answer: C
Rationale: CBT emphasizes a collaborative, future-oriented approach to set goals for changing thoughts and behaviors, as in option C. The nurse does not unilaterally set the agenda (A), focus only on behavior (B), or define the problem from their perspective (D), as these are non-collaborative.