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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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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
Correct Answer: C
Rationale: Catastrophizing involves exaggerating the negative impact of an event, assuming the worst outcome (failing the course based on one exam). Low frustration tolerance reflects difficulty coping with discomfort, absolute thinking involves all-or-nothing beliefs, and a demand involves rigid expectations, none of which fit as well.
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.
Correct Answer: D
Rationale: CBT involves a collaborative, patient-centered approach where the therapist and patient work together to identify and modify negative thoughts and behaviors to solve problems. Option D captures this essence. Option A is directive, not collaborative; option B focuses only on behavior; and option C incorrectly suggests reinforcing distorted beliefs.
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.
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, '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
Correct Answer: B
Rationale: The miracle question in SFBT asks patients to imagine a scenario where their problems are gone, as in 'How would your life be different?' to envision solutions. Exception questions focus on times without the problem, relationship questions explore others? perspectives, and scaling questions rate issue intensity.