Chapter 13: Cognitive Interventions in Psychiatric Nursing

Format: Multiple Choice

Client Needs: Psychosocial Integrity

Cognitive Level: Analyze

Integrated Process: Nursing Process

Objective: 2

Page and Header: 204–205, Cognitive Processes

1. A nurse is assessing a client diagnosed with a psychiatric illness. The nurse interprets which client statement as reflecting the concept of “cognitive triad?”

A) “I always mess things up. No matter what I do, my whole world is a mess, and my future will be a big mess, too.”

B) “My sister is always the pretty one, her world is free of problems, and she’ll have a perfect future.”

C) “My bosses think they know it all, that they can control the world’s future, and that the entire planet is dependent on them.”

D) “My mother used to always tell me bad things happen in threes—like when someone you know dies, you just know that two other people you know will die.”

Page and Header: 204, Development of Cognitive Therapies

2. A nursing instructor is preparing a class lecture about cognitive behavioral therapy. Which would the instructor use to best describe this process?

A) Solving clients’ 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 client’s behavior, shaping it into behavior that is appropriate in order to help the client experience a more positive future

C) Reinforcing distorted beliefs so they can play a major part in changing a client’s behavior for the better, and improving the client’s quality of life

D) Working in a trusting and collaborative relationship to help clients focus on solving their own problems by changing the way they think and behave

Page and Header: 206, Strengths and Limitations of Cognitive Behavioral Therapy

3. A nurse is working as part of an interdisciplinary treatment team caring for clients diagnosed with psychiatric disorders. Based on the nurse’s understanding of cognitive behavioral therapy and its limitations cited by critics, the nurse identifies that it would be inappropriate to engage in cognitive behavioral therapy with a client diagnosed with which disorder?

A) Substance abuse

B) Depression

C) Schizophrenia

D) An eating disorder

Page and Header: 204–205, Cognitive Processes

4. A college 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 states, “I will fail the course because of doing so poorly on the first exam”. The student’s belief reflects which type of irrational belief?

A) Low frustration tolerance

B) Absolute thinking

C) Catastrophizing

D) Demand

Page and Header: 204–205, Cognitive Processes

5. A client was supposed to meet a friend at a local theater to see a movie. The friend never showed up. The client’s initial thought was, “My friend didn’t come because my friend doesn’t like me.” This automatic thought was most likely inferred from which irrational belief?

A) “I’m worthless, so no one could really want to be my friend.”

B) “Movies are a waste of time and money anyway.”

C) “I’m sure my friend just got confused and thought we were going to a different movie.”

D) “I’m so forgetful and confused sometimes; I probably wrote down the wrong time.”

Page and Header: 206, Intervention Framework

6. A client approaches a nurse, relates that the therapist just suggested a new therapy, and asks what “bibliotherapy” is. 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, knowledge that the therapist 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.”

Page and Header: 206, Intervention Framework

7. A nurse is working with an adolescent client who self-describes as being a “compulsive overeater” who uses food to cope with stress. The client is receiving cognitive behavioral therapy and journaling is being used as an intervention. What should the nurse instruct the client to convey during journaling?

A) How often the client eats compulsively in response to stress the client encounters on a daily basis

B) Patterns in the client’s daily schedule that may be contributing to the client’s compulsive eating

C) Behaviors in others that trigger the client’s compulsion to eat when experiencing stress

D) Changes in the client’s self-perception and responses to stress that the client might otherwise not notice

Page and Header: 208, Solution-Focused Behavior Therapy Interventions

8. A nurse working with a client being treated for depression is using solution-focused brief therapy during the client’s brief psychiatric hospitalization. Which “exception 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?”

Page and Header: 204, Development of Cognitive Therapies

9. A nurse is reviewing a journal article about the history of the development of cognitive therapies. The nurse demonstrates understanding of the information by identifying which person as responsible for first developing cognitive therapy interventions?

A) Aaron Beck

B) Sigmund Freud

C) Albert Ellis

D) de Shazer and Berg

Page and Header: 208, Solution-Focused Behavior Therapy Interventions

10. During a solution-focused behavior therapy session, the nurse asks the client, “How would your life be different if you woke up tomorrow and all your problems had disappeared?” Which type of question is the therapist using?

A) Exception question

B) Miracle question

C) Relationship question

D) Scaling question

Page and Header: 203–204, Introduction

11. A psychiatric–mental health nurse practitioner is conducting an in-service presentation for a group of psychiatric–mental health nurses about cognitive behavioral therapy. The nurse practitioner determines that additional discussion is needed when the group identifies which information as being associated with this type of therapy?

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.

Page and Header: 205, Implementing Cognitive Behavioral Therapy

12. A nurse is preparing to reinforce the use of cognitive behavior therapy with a client. When interacting with the client, which action would be most appropriate?

A) Have the nurse establish the agenda.

B) Focus primarily on behavior.

C) Use a future-oriented goal focus.

D) Identify the problem from the nurse’s perspective.

Page and Header: 206, Intervention Framework

13. A client is being treated in an interdisciplinary clinic. During interactions with a client who is receiving cognitive behavior therapy, what 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

Page and Header: 204–205, Cognitive Processes

14. A group of nursing students is reviewing information about cognitive processes and the development of mental disorders. The students demonstrate a need for additional review when they identify what as being involved?

A) Cognitive triad

B) Cognitive distortions

C) Schema

D) Compliments

Page and Header: 206–207, Rational Emotive Behavior Therapy Framework

15. When a client is engaged in rational emotive behavior therapy, which would the nurse address during the activating event sequence?

A) Teaching the connection between beliefs and consequences

B) Assessing the consequences of the problem

C) Facilitating the working-through process

D) Preparing the client to deepen conviction in rational beliefs

Page and Header: 207–208, Solution-Focused Brief Therapy

16. A group of nursing students is preparing a class presentation comparing the different types of cognitive therapies. When describing solution-focused brief therapy, which characteristic would the students identify as being different from the other therapies?

A) Focus on functional aspects of the client

B) Challenge about the existence of problems

C) Assumption that change is not constant

D) View of the past rather than the present

Page and Header: 208–209, Solution-Focused Behavior Therapy Interventions

17. During a therapy session, a client is asked to rate the intensity of the current issue from 1 to 10, with 1 being complete absence of the issue and 10 being the most intense. The client is being asked which type of question?

A) Relationship

B) Miracle

C) Scaling

D) Exception

Page and Header: 210, Inpatient Settings

18. 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

Page and Header: 204–205, Cognitive Processes

19. The client diagnosed with depression tells the nurse, “I’m such a screw-up. I can never do anything right.” The nurse interprets this statement as which type of cognitive distortion?

A) Overgeneralization

B) Personalizing

C) Catastrophizing

D) Selective abstraction

Page and Header: 208, Solution-Focused Behavior Therapy Interventions

20. A client receiving solution-focused behavioral therapy for anger management is asked to rate the level of anger experienced today in comparison to last week. The client is to use the numbers from 1 to 10, with 1 being the most intense anger and 10 being completely free of anger. The therapist is using which type of question?

A) Miracle

B) Exception

C) Scaling

D) Relationship