Question 1

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

When the nurse helps the student to see a broader range of possibilities,the nurse is using the cognitive technique of generating alternatives.

Question 2

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

Accepted Answer

The statement "I may have a minor problem,but I can handle it" is an example of the use of the cognitive distortion of minimization.Minimization is the undervaluing of the positive significance of an event.

Question 3

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

Cognitive rehearsal allows the employee to uncover potential automatic thoughts in advance of his or her meeting to request a promotion.This allows the employee to develop strategies to modify any dysfunctional thinking.

Question 4

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

Accepted Answer

When a nurse reminds a client that symptoms of a panic attack are time limited and will end,the nurse is using the cognitive approach of presenting rational thinking.

Question 5

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

Emotional responses are largely dependent on cognitive appraisals of the significance of environmental cues.The nursing diagnosis of situational low self-esteem is used for individuals who have a negative perception of self-worth in response to a current situation.This client's cognitive appraisal of the situation has led to the diagnosis of major depressive disorder and low self-esteem.

Question 6

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

Catastrophic thinking involves always thinking that the worst will occur without considering the possibility of more likely positive outcomes.The nurse manager has quickly jumped to the conclusion that the meeting will result in job termination.

Question 7

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

In activity scheduling,the client is asked to keep a daily log of activities and rate them for mastery and pleasure in order to identify recurring daily patterns that may need to be addressed in therapy.

Question 8

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

When using the technique of examining the evidence,the student and nurse review automatic thoughts and study the evidence to support or counter the belief.

Question 9

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

Cognitive therapy is meant to be a time-limited intervention in which the therapist works in collaboration with the client to modify thinking to eliminate cognitive errors that reinforce emotional disturbances.

Question 10

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

According to Beck,automatic thoughts consist of rapid responses to a situation without rational analysis.These thoughts are often negative and based on erroneous logic.

Question 11

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

Accepted Answer

An individual who is using dichotomous thinking views situations in terms of "all or nothing," "good or bad," or "black or white."

Question 12

A nursing assistant has failed a prerequisite course toward admission to nursing school and states,"I will always be only a nursing assistant and never an RN." Her nursing advisor understands this is an example of which automatic thought?

Accepted Answer

Overgeneralization occurs when sweeping conclusions are made on the basis of one incident.Because the student failed a prerequisite nursing course,the student overgeneralizes that the goal of being an RN will never be attained.

Question 13

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

In magnification,negative events are exaggerated.It is irrational to assume that there is a relationship between failing a paper and being personally disliked by the instructor.

Question 14

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

Minimization is the cognitive error that undervalues positive events and experiences.The client cannot give credit for personal strengths.

Question 15

Using a cognitive approach,a nurse would choose which intervention for assisting clients to manage their anger without the use of violence?

Accepted Answer

By assisting the client to identify thoughts that trigger anger and encourage the substitution of more reality-based thinking,the nurse can help the client to alter dysfunctional beliefs that predispose the client to distort experiences.

Question 16

When a client's husband comes home late from work,the wife immediately fears infidelity.The advanced practice nurse therapist encourages the wife to consider other explanations for her husband's tardiness.What technique is the nurse using?

Accepted Answer

Using the technique of generating alternatives will assist the client to recognize a wider range of possible explanations for her husband's behavior.

Question 17

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

In selective abstraction the individual focuses attention on evidence that is viewed as a failure (not having twins)rather than any successes (a healthy baby)that have occurred.

Question 18

A client states,"I keep having horrible nightmares about the car accident that killed my daughter.I shouldn't have taken her with me to the store." Using a cognitive approach,which nursing reply would be most therapeutic?

Accepted Answer

When the nurse attempts to encourage the client to reframe thoughts,the nurse is using a cognitive approach.

Question 19

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

Accepted Answer

Cognitive ability will be enhanced with mild anxiety.Mild anxiety prepares the individual for heightened responses to environmental stimuli.

Question 20

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

Cognitive therapy prepares the client to become his or her own cognitive therapist.The didactic portion of the therapy provides educational material to reinforce learning about the therapy and how it affects psychiatric disorders.

Quiz 19: Cognitive Therapy