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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.
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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
Correct Answer: A
Rationale: Aaron Beck is credited with developing cognitive therapy, focusing on altering distorted thoughts to improve mental health. Freud developed psychoanalysis, Ellis pioneered rational emotive behavior therapy, and de Shazer and Berg created solution-focused brief therapy, not cognitive therapy.
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.
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.
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.