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.
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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 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.
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.
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.
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