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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.
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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.
Correct Answer: A
Rationale: CBT focuses on how thoughts and beliefs about events, not the events themselves, cause disturbances. Option A incorrectly suggests the event is the underlying issue, making it least likely to be included. Options B, C, and D align with CBT?s focus on beliefs, practice, and thought replacement.
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
Correct Answer: C
Rationale: In CBT, the first step is identifying the patient?s underlying beliefs that drive negative thoughts and behaviors. This precedes exploring evidence (B), alternative explanations (A), or implications (D), as understanding the core beliefs guides subsequent interventions.
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
Correct Answer: D
Rationale: Journaling helps patients reflect on thoughts, emotions, and patterns, promoting insight into self-perception and stress responses, as in option D. It?s less about quantifying eating frequency (A), scheduling patterns (B), or others? behaviors (C), but rather fostering deeper self-awareness.
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 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?
Correct Answer: B
Rationale: In SFBT, an exception question asks about times when the problem (depression) is absent or less severe, as in 'When do you not feel depressed?' This helps identify strengths and solutions. Other options focus on the problem?s onset or causes, which are less aligned with SFBT?s solution-oriented approach.