Question 1

A client is experiencing auditory hallucinations. Using a cognitive strategy, which should the nurse encourage the client to do?

Accepted Answer

A) "Try singing Happy Birthday until the voices are gone." 
B) "Document what the voices are saying to note cause and effect." 
C) "Try listening to music using headphones for distraction." 
D) "Remind yourself that the voices are symptoms of your disease." 
A) "Try singing Happy Birthday until the voices are gone." 
B) "Document what the voices are saying to note cause and effect." 
C) "Try listening to music using headphones for distraction." 
D) "Remind yourself that the voices are symptoms of your disease." D

Question 2

An advanced practice nurse recommends that a client participate in cognitive therapy. The client asks, "What's cognitive therapy and how can it help me?" Which is the nurse's most appropriate reply?

Accepted Answer

A) "It is a system of techniques in which you use positive thinking to improve your mood." 
B) "It is a long-term interpersonal approach that emphasizes the role of early childhood experiences." 
C) "It is a interpersonal treatment approach that specifically targets magical thinking." 
D) "It is a type of psychotherapy that focuses treatment on the modification of distorted thinking and maladaptive behaviors." 
A) "It is a system of techniques in which you use positive thinking to improve your mood." 
B) "It is a long-term interpersonal approach that emphasizes the role of early childhood experiences." 
C) "It is a interpersonal treatment approach that specifically targets magical thinking." 
D) "It is a type of psychotherapy that focuses treatment on the modification of distorted thinking and maladaptive behaviors." D

Question 3

A successful business executive continually thinks that job accomplishments are not adequate. A nurse recognizes that the client's thinking is reflective of which cognitive error?

Accepted Answer

A) Minimization 
B) Dichotomous thinking 
C) Arbitrary inference 
D) Personalization 
A) Minimization 
B) Dichotomous thinking 
C) Arbitrary inference 
D) Personalization A

Question 4

Which of the following client statements would indicate that teaching about benzodiazepines has been successful? (Select all that apply.)

Accepted Answer

A) "I can't drink alcohol when taking lorazepam (Ativan)." 
B) "If I abruptly stop taking buspirone (BuSpar), I may have a seizure." 
C) "Valium can make me drowsy, so I shouldn't drive for awhile." 
D) "My new diet cannot include aged cheese or pickled herring." 
E) "When the fluoxetine (Prozac) begins working, I can stop the alprazolam (Xanax)." 
A) "I can't drink alcohol when taking lorazepam (Ativan)." 
B) "If I abruptly stop taking buspirone (BuSpar), I may have a seizure." 
C) "Valium can make me drowsy, so I shouldn't drive for awhile." 
D) "My new diet cannot include aged cheese or pickled herring." 
E) "When the fluoxetine (Prozac) begins working, I can stop the alprazolam (Xanax)."

Question 5

A high school basketball player sustains a serious knee injury and states to the school nurse, "I will never get to college if I don't receive a basketball scholarship." Which nursing reply would assist the student to see a broader range of possibilities?

Accepted Answer

A) "Let's look at the alternatives for funding your college education." 
B) "I know you are feeling helpless now, but you are looking at this from only one perspective." 
C) "Can your family afford knee surgery?" 
D) "You now need to prioritize your academics and not focus on basketball." 
A) "Let's look at the alternatives for funding your college education." 
B) "I know you are feeling helpless now, but you are looking at this from only one perspective." 
C) "Can your family afford knee surgery?" 
D) "You now need to prioritize your academics and not focus on basketball."

Question 6

A nursing instructor is teaching about dichotomous thinking. Which student statement indicates that learning has occurred?

Accepted Answer

A) "Dichotomous thinking is when an individual views situations as being 'good or bad' or 'black or white.'" 
B) "Dichotomous thinking is when an individual takes complete responsibility for situations without considering other circumstances." 
C) "Dichotomous thinking is when an individual exaggerates the negative significance of an event." 
D) "Dichotomous thinking is when an individual undervalues the positive significance of an event." 
A) "Dichotomous thinking is when an individual views situations as being 'good or bad' or 'black or white.'" 
B) "Dichotomous thinking is when an individual takes complete responsibility for situations without considering other circumstances." 
C) "Dichotomous thinking is when an individual exaggerates the negative significance of an event." 
D) "Dichotomous thinking is when an individual undervalues the positive significance of an event."

Question 7

A welder has been selected as employee of the year. The welder wants to ask for a promotion but is hampered by poor self-esteem. The employee health nurse provides assistance. Which technique should the nurse use to help the employee request the promotion?

Accepted Answer

A) Socratic questioning 
B) Activity scheduling 
C) Distraction 
D) Cognitive rehearsal 
A) Socratic questioning 
B) Activity scheduling 
C) Distraction 
D) Cognitive rehearsal

Question 8

A psychiatric nurse is counseling a client who has thought patterns consisting of rapid responses to a situation without rational analysis. What assessment data will the nurse document on this client?

Accepted Answer

A) "Thought patterns are triggered by specific stressful stimuli." 
B) "Thought patterns contain the client's fundamental beliefs and assumptions." 
C) "Thought patterns are flexible and based on personal experience." 
D) "Thought patterns include a predominance of automatic thoughts." 
A) "Thought patterns are triggered by specific stressful stimuli." 
B) "Thought patterns contain the client's fundamental beliefs and assumptions." 
C) "Thought patterns are flexible and based on personal experience." 
D) "Thought patterns include a predominance of automatic thoughts."

Question 9

Which client statement would exemplify the cognitive changes that you would expect to see in mild anxiety?

Accepted Answer

A) "Right now I feel as sharp as a tack." 
B) "I'm having a tough time focusing." 
C) "Sometimes I feel like I'm having an out-of-body experience." 
D) "All I seem to focus on is my anger." 
A) "Right now I feel as sharp as a tack." 
B) "I'm having a tough time focusing." 
C) "Sometimes I feel like I'm having an out-of-body experience." 
D) "All I seem to focus on is my anger."

Question 10

A nursing student evaluates her group project partner as irresponsible because of minimal participation in planning. When told of this situation, the nursing instructor plans to use the cognitive technique of "examining the evidence." Which response exemplifies this technique?

Accepted Answer

A) "Let's look at the potential reasons why your partner has not participated." 
B) "How would you define irresponsibility?" 
C) "Has it occurred to you that your partner may be working on the project at home?" 
D) "Are you telling me that you feel totally responsible for this project?" 
A) "Let's look at the potential reasons why your partner has not participated." 
B) "How would you define irresponsibility?" 
C) "Has it occurred to you that your partner may be working on the project at home?" 
D) "Are you telling me that you feel totally responsible for this project?"

Question 11

A client admitted to a Veterans Administration (VA) hospital with a diagnosis of major depressive disorder tells the nurse, "I failed my battalion by giving the wrong order. Fortunately, no one was injured." Which nursing diagnosis should the nurse assign to this client?

Accepted Answer

A) Chronic low self-esteem 
B) Risk for self-directed violence 
C) Powerlessness 
D) Situational low self-esteem 
A) Chronic low self-esteem 
B) Risk for self-directed violence 
C) Powerlessness 
D) Situational low self-esteem

Question 12

Using a cognitive approach, which is an effective nursing intervention for assisting clients to manage their anger without the use of violence?

Accepted Answer

A) Assist the client to identify thoughts that trigger anger and substitute reality-based thinking. 
B) Provide consequences, such as removal from group therapy, in response to angry outbursts. 
C) Administer antipsychotic medications and use limit-setting such as a room restriction. 
D) Administer anti-anxiety medication and encourage participation in a group on medication actions. 
A) Assist the client to identify thoughts that trigger anger and substitute reality-based thinking. 
B) Provide consequences, such as removal from group therapy, in response to angry outbursts. 
C) Administer antipsychotic medications and use limit-setting such as a room restriction. 
D) Administer anti-anxiety medication and encourage participation in a group on medication actions.

Question 13

An advanced practice nurse is counseling a client diagnosed with generalized anxiety disorder. The nurse plans to use activity scheduling to address this client's concerns. What is the purpose of this nursing intervention?

Accepted Answer

A) To identify important areas needing concentration during therapy 
B) To increase self-esteem and decrease feelings of helplessness 
C) To modify maladaptive behaviors by the use of role-play 
D) To divert away from intrusive thoughts and depressive ruminations 
A) To identify important areas needing concentration during therapy 
B) To increase self-esteem and decrease feelings of helplessness 
C) To modify maladaptive behaviors by the use of role-play 
D) To divert away from intrusive thoughts and depressive ruminations

Question 14

A client diagnosed with borderline personality disorder states, "Get out of here. No one cares about me or my situation!" Which nursing reply is an example of a cognitive intervention?

Accepted Answer

A) "You have an anti-anxiety medication ordered.It may make you feel better." 
B) "It sounds like you are feeling really frustrated." 
C) "Can you explain further your thinking about your situation?" 
D) "No one cares about you?" 
A) "You have an anti-anxiety medication ordered.It may make you feel better." 
B) "It sounds like you are feeling really frustrated." 
C) "Can you explain further your thinking about your situation?" 
D) "No one cares about you?"

Question 15

A nursing student states, "The instructor gave me a failing grade on my research paper. I know it's because the instructor doesn't like me." Which cognitive error does a nurse recognize in this student's statement?

Accepted Answer

A) Dichotomous thinking 
B) Catastrophic thinking 
C) Magnification 
D) Overgeneralization 
A) Dichotomous thinking 
B) Catastrophic thinking 
C) Magnification 
D) Overgeneralization

Question 16

A labor and delivery nurse listens to a new mother relate thoughts regarding her healthy, 8-pound baby girl. Which statement by the mother indicates to the nurse the use of the cognitive error, selective abstraction?

Accepted Answer

A) "My baby is refusing to nurse, and I know it's because she hates me." 
B) "My baby needs to be under the 'bilirubin lights,' but I resent her time away from me." 
C) "My baby is wonderful, but I'm upset and depressed because I wanted twins." 
D) "My baby has an elevated bilirubin, and I know it will get worse and she will die." 
A) "My baby is refusing to nurse, and I know it's because she hates me." 
B) "My baby needs to be under the 'bilirubin lights,' but I resent her time away from me." 
C) "My baby is wonderful, but I'm upset and depressed because I wanted twins." 
D) "My baby has an elevated bilirubin, and I know it will get worse and she will die."

Question 17

A nursing instructor is teaching about the didactic aspects of cognitive therapy. Which student statement indicates a deficit in meeting the learning objectives of this content?

Accepted Answer

A) "The therapist provides information about the process of cognitive therapy." 
B) "The therapist uses guided imagery in an effort to elicit automatic thoughts." 
C) "The therapist provides information about how cognitive therapy works." 
D) "The therapist uses reading assignments to reinforce learning." 
A) "The therapist provides information about the process of cognitive therapy." 
B) "The therapist uses guided imagery in an effort to elicit automatic thoughts." 
C) "The therapist provides information about how cognitive therapy works." 
D) "The therapist uses reading assignments to reinforce learning."

Question 18

The director of nursing (DON) sets up a meeting with the newly appointed nurse manager who, to this point, has done an excellent job. The nurse manager anticipates job termination. What is the best description of the cognitive error being employed by the nurse manager?

Accepted Answer

A) Thinking from an "all-or-nothing" perspective 
B) Always thinking the worst will occur without considering positive outcomes 
C) Viewing only selected negative evidence while editing out positive aspects 
D) Undervaluing the positive significance of an event 
A) Thinking from an "all-or-nothing" perspective 
B) Always thinking the worst will occur without considering positive outcomes 
C) Viewing only selected negative evidence while editing out positive aspects 
D) Undervaluing the positive significance of an event

Question 19

When using a cognitive approach, which point would a nurse include when teaching a client about panic disorder?

Accepted Answer

A) "You might want to stay in the house when you notice the symptoms beginning." 
B) "Medications such as lorazepan (Ativan) should be taken when symptoms start." 
C) "Remind yourself that symptoms of a panic attack are time limited and will end." 
D) "Keep a journal in order to note feelings surrounding the panic attacks." 
A) "You might want to stay in the house when you notice the symptoms beginning." 
B) "Medications such as lorazepan (Ativan) should be taken when symptoms start." 
C) "Remind yourself that symptoms of a panic attack are time limited and will end." 
D) "Keep a journal in order to note feelings surrounding the panic attacks."

Question 20

A client recovering from alcohol toxicity is using minimization. Which statement reflects this cognitive distortion?

Accepted Answer

A) "I can't give up alcohol right now because I just gave up smoking." 
B) "I just read that red wine has health benefits." 
C) "I may have a minor problem, but I can handle it." 
D) "I don't drink as much as my wife and nobody thinks she has a problem." 
A) "I can't give up alcohol right now because I just gave up smoking." 
B) "I just read that red wine has health benefits." 
C) "I may have a minor problem, but I can handle it." 
D) "I don't drink as much as my wife and nobody thinks she has a problem."

Exam 20: Cognitive Therapy

A client is experiencing auditory hallucinations. Using a cognitive strategy, which should the nurse encourage the client to do?

An advanced practice nurse recommends that a client participate in cognitive therapy. The client asks, "What's cognitive therapy and how can it help me?" Which is the nurse's most appropriate reply?

A successful business executive continually thinks that job accomplishments are not adequate. A nurse recognizes that the client's thinking is reflective of which cognitive error?

Which of the following client statements would indicate that teaching about benzodiazepines has been successful? (Select all that apply.)

A high school basketball player sustains a serious knee injury and states to the school nurse, "I will never get to college if I don't receive a basketball scholarship." Which nursing reply would assist the student to see a broader range of possibilities?

A nursing instructor is teaching about dichotomous thinking. Which student statement indicates that learning has occurred?

A welder has been selected as employee of the year. The welder wants to ask for a promotion but is hampered by poor self-esteem. The employee health nurse provides assistance. Which technique should the nurse use to help the employee request the promotion?

A psychiatric nurse is counseling a client who has thought patterns consisting of rapid responses to a situation without rational analysis. What assessment data will the nurse document on this client?

Which client statement would exemplify the cognitive changes that you would expect to see in mild anxiety?

A nursing student evaluates her group project partner as irresponsible because of minimal participation in planning. When told of this situation, the nursing instructor plans to use the cognitive technique of "examining the evidence." Which response exemplifies this technique?

A client admitted to a Veterans Administration (VA) hospital with a diagnosis of major depressive disorder tells the nurse, "I failed my battalion by giving the wrong order. Fortunately, no one was injured." Which nursing diagnosis should the nurse assign to this client?

Using a cognitive approach, which is an effective nursing intervention for assisting clients to manage their anger without the use of violence?

An advanced practice nurse is counseling a client diagnosed with generalized anxiety disorder. The nurse plans to use activity scheduling to address this client's concerns. What is the purpose of this nursing intervention?

A client diagnosed with borderline personality disorder states, "Get out of here. No one cares about me or my situation!" Which nursing reply is an example of a cognitive intervention?

A nursing student states, "The instructor gave me a failing grade on my research paper. I know it's because the instructor doesn't like me." Which cognitive error does a nurse recognize in this student's statement?

A labor and delivery nurse listens to a new mother relate thoughts regarding her healthy, 8-pound baby girl. Which statement by the mother indicates to the nurse the use of the cognitive error, selective abstraction?

A nursing instructor is teaching about the didactic aspects of cognitive therapy. Which student statement indicates a deficit in meeting the learning objectives of this content?

The director of nursing (DON) sets up a meeting with the newly appointed nurse manager who, to this point, has done an excellent job. The nurse manager anticipates job termination. What is the best description of the cognitive error being employed by the nurse manager?

When using a cognitive approach, which point would a nurse include when teaching a client about panic disorder?

A client recovering from alcohol toxicity is using minimization. Which statement reflects this cognitive distortion?

The Concept of Stress Adaptation

Mental Healthmental Illness: Historical and Theoretical Concepts

Theoretical Models of Personality Development

Concepts of Psychobiology

Ethical and Legal Issues in Psychiatricmental Health Nursing

Cultural and Spiritual Concepts Relevant to Psychiatricmental Health Nursing

Relationship Development

Therapeutic Communication

The Nursing Process in Psychiatricmental Health Nursing

Therapeutic Groups

Intervention With Families

Milieu Therapy - the Therapeutic Community

Crisis Intervention

Relaxation Therapy

Assertiveness Training

Promoting Self Esteem

Angeraggression Management

Intervention With a Suicidal Client

Behavior Therapy

Electroconvolusive Therapy

Complementary Therapies

Disorders Usually First Diagnosed in Infancy, Childhood, or Adolescence

Delirium, Dementia, and Amnestic Disorders

Substance-Related Disorders

Schizophrenia and Other Psychotic Disorders

Mood Diorders: Depression

Mood Disorders: Bipolar Disorder

Anxiety Disorders

Somatoform and Disassociative Disorders

Issues Related to Human Sexuality and Gender Identity

Eating Disorders

Adjustment and Impulse Control Disorders

Personality Disorders

The Aging Individual

Victims of Abuse or Neglect

Community Mental Health Nursing

Forensic Nursing

The Bereaved Individual

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