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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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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 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 therapy session, a patient is asked to rate the intensity of his current issue from 1 to 10 with 1 being complete absence of the issue and 10 being the most intense. The patient is being asked which type of question?
- A. Relationship
- B. Miracle
- C. Scaling
- D. Exception
Correct Answer: C
Rationale: A scaling question in SFBT asks patients to rate the intensity of an issue on a numerical scale, as described, to assess progress and guide interventions. Relationship questions explore others? perspectives, miracle questions envision problem-free scenarios, and exception questions identify problem-free times.
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.