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Which approach to therapy is most effective when planning for a client with negative thinking?
- A. Behavior modification
- B. Client-centered therapy
- C. Cognitive therapy
- D. Reality therapy
Correct Answer: C
Rationale: Cognitive therapy directly addresses negative thinking by altering thought patterns, which subsequently influences feelings and behaviors.
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A college student decides to go to a party the night before a major exam instead of studying. After receiving a low score on the exam, the student tells a fellow student, 'I have to work too much and don't have time to study. It wouldn't matter anyway because the teacher is so unreasonable.' The defense mechanisms the student is using are
- A. Denial and displacement
- B. Rationalization and projection
- C. Reaction formation and resistance
- D. Regression and compensation
Correct Answer: B
Rationale: The student uses rationalization by excusing poor performance with external factors (work) and projection by blaming the teacher's unreasonableness for the outcome.
A patient is blaming his impending divorce on the fact that his wife goes out frequently with her girlfriends. If using reality therapy, the nurse would help the patient with which of the following responses?
- A. If you really love her, she should love you as well.
- B. What does being divorced mean for you?
- C. How do you feel about your marriage ending?
- D. What role do you think you have played in the end of your marriage?
Correct Answer: D
Rationale: Reality therapy encourages clients to examine their own behaviors and their impact on life goals, such as taking responsibility for their role in the divorce.
A patient has just been told she has cervical cancer. When asked about how this is impacting her, she states 'It's just an infection, it will clear up.' The statement indicates
- A. Needs education on cervical cancer
- B. Is unable to express true feelings
- C. Should be immediately referred
- D. Is using denial to protect herself from an emotionally painful thought
Correct Answer: D
Rationale: The patient's statement reflects denial, an ego defense mechanism used unconsciously to protect against the emotional pain of a serious diagnosis like cervical cancer. Education or referrals are premature until the denial is addressed, and the statement does not indicate an inability to express feelings.
Which of the following is most essential when planning care for a client who is experiencing a crisis?
- A. Explore previous coping strategies
- B. Explore underlying personality dynamics
- C. Focus on emotional deficits
- D. Offer a referral to a self-help group
Correct Answer: A
Rationale: Crisis intervention leverages the client's existing coping strategies and strengths to address the current situation, making this the most essential focus.
A client begins to take stock of his life and look into the future. The nurse assesses that this client is in which of Erikson's developmental stages?
- A. Identity versus role confusion
- B. Industry versus inferiority
- C. Integrity versus despair
- D. Generativity versus stagnation
Correct Answer: C
Rationale: Erikson's integrity vs. despair stage, occurring in later adulthood, involves reflecting on one's life and future, as described in the client's behavior.