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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.
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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 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 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 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 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.