Chapter 30 My Nursing Test Banks

 

Kneisl, Contemporary Psychiatric-Mental Health Nursing, 3/e Test Bank
Chapter 30

Question 1

Type: MCSA

The nurse knows that attributions are perceived causes that:

1. Isolate family members from one another.

2. Promote rigidity and chaos.

3. May or may not be objectively accurate.

4. Support a loss of autonomy.

Correct Answer: 3

Rationale 1: As humans, we constantly ascribe causes to the events in our lives. By labeling or assigning meaning to a circumstance or set of circumstances, we make attributions. Attributions are perceived causes that may or may not be objectively accurate. Depressed people often attribute failure to themselves and success to others. We attribute associated features or characteristics to a circumstance, expect a certain outcome from those circumstances, and behave consistently with that expectation. Finally, we have feelings that match, or are congruent with the experience. The basic idea is that thoughts and behaviors lead to feelings.

Rationale 2: As humans, we constantly ascribe causes to the events in our lives. By labeling or assigning meaning to a circumstance or set of circumstances, we make attributions. Attributions are perceived causes that may or may not be objectively accurate. Depressed people often attribute failure to themselves and success to others. We attribute associated features or characteristics to a circumstance, expect a certain outcome from those circumstances, and behave consistently with that expectation. Finally, we have feelings that match, or are congruent with the experience. The basic idea is that thoughts and behaviors lead to feelings.

Rationale 3: As humans, we constantly ascribe causes to the events in our lives. By labeling or assigning meaning to a circumstance or set of circumstances, we make attributions. Attributions are perceived causes that may or may not be objectively accurate. Depressed people often attribute failure to themselves and success to others. We attribute associated features or characteristics to a circumstance, expect a certain outcome from those circumstances, and behave consistently with that expectation. Finally, we have feelings that match, or are congruent with the experience. The basic idea is that thoughts and behaviors lead to feelings.

Rationale 4: As humans, we constantly ascribe causes to the events in our lives. By labeling or assigning meaning to a circumstance or set of circumstances, we make attributions. Attributions are perceived causes that may or may not be objectively accurate. Depressed people often attribute failure to themselves and success to others. We attribute associated features or characteristics to a circumstance, expect a certain outcome from those circumstances, and behave consistently with that expectation. Finally, we have feelings that match, or are congruent with the experience. The basic idea is that thoughts and behaviors lead to feelings.

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Explain the central features of cognitive behavioral interventions.

Question 2

Type: MCSA

During a group session, the nursing student notes one of the clients imitating another clients manner of speaking and communicating. The client being imitated has actively participated in all groups and is going home tomorrow. The nursing student suspects the client doing the imitating is:

1. Modeling behavior.

2. Being a comedian.

3. Expecting an award.

4. Jealous of the other client.

Correct Answer: 1

Rationale 1: Modeling involves imitating others in the expectation that one will receive rewards such as those other people seem to be getting.

Rationale 2: Modeling involves imitating others in the expectation that one will receive rewards such as those other people seem to be getting.

Rationale 3: Modeling involves imitating others in the expectation that one will receive rewards such as those other people seem to be getting.

Rationale 4: Modeling involves imitating others in the expectation that one will receive rewards such as those other people seem to be getting.

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: Explain the central features of cognitive behavioral interventions.

Question 3

Type: MCSA

Nurses are instrumental in helping clients during cognitive therapy. The nurse helps clients:

1. Correct the id and the superego in relation to self-awareness.

2. Examine connections of the mind, body, and spirit.

3. Determine the best course of treatment.

4. Identify unrealistic and negative thoughts.

Correct Answer: 4

Rationale 1: The purpose of cognitive therapy is first to identify thoughts that are unrealistic, negative, or otherwise problematic. Once these thoughts are identified, they are examined for their impact on the individual. Nurses are instrumental in helping a client see how a particular set of thoughts can create a problem. When this connection is made, substituting neutral or positive thoughts for the problematic thinking schema takes place over time. Correcting automatic problematic thinking is a retraining experience. The individual must unlearn the maladaptive cognitive style, and then learn adaptive cognitions. The other choices are not relevant for cognitive therapy.

Rationale 2: The purpose of cognitive therapy is first to identify thoughts that are unrealistic, negative, or otherwise problematic. Once these thoughts are identified, they are examined for their impact on the individual. Nurses are instrumental in helping a client see how a particular set of thoughts can create a problem. When this connection is made, substituting neutral or positive thoughts for the problematic thinking schema takes place over time. Correcting automatic problematic thinking is a retraining experience. The individual must unlearn the maladaptive cognitive style, and then learn adaptive cognitions. The other choices are not relevant for cognitive therapy.

Rationale 3: The purpose of cognitive therapy is first to identify thoughts that are unrealistic, negative, or otherwise problematic. Once these thoughts are identified, they are examined for their impact on the individual. Nurses are instrumental in helping a client see how a particular set of thoughts can create a problem. When this connection is made, substituting neutral or positive thoughts for the problematic thinking schema takes place over time. Correcting automatic problematic thinking is a retraining experience. The individual must unlearn the maladaptive cognitive style, and then learn adaptive cognitions. The other choices are not relevant for cognitive therapy.

Rationale 4: The purpose of cognitive therapy is first to identify thoughts that are unrealistic, negative, or otherwise problematic. Once these thoughts are identified, they are examined for their impact on the individual. Nurses are instrumental in helping a client see how a particular set of thoughts can create a problem. When this connection is made, substituting neutral or positive thoughts for the problematic thinking schema takes place over time. Correcting automatic problematic thinking is a retraining experience. The individual must unlearn the maladaptive cognitive style, and then learn adaptive cognitions. The other choices are not relevant for cognitive therapy.

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Explain the central features of cognitive behavioral interventions.

Question 4

Type: MCSA

The nurse is assessing a client with nicotine addiction. The nurse knows the client plans to compete in a marathon several months away and asks the client to imagine snapping a cigarette in half and winning the marathon whenever the urge to smoke occurs. The nurse knows that shaping ones thoughts so that they have control over a particular situation, thereby creating a successful behavior change, is called:

1. Communication.

2. Mastery imagery.

3. Image restructuring.

4. Positive imagery.

Correct Answer: 2

Rationale 1: Mastery imagery shapes the individuals thoughts about being in control or having mastery over a particular situation. The point of this technique is to practice imagining successful behavior change.

Rationale 2: Mastery imagery shapes the individuals thoughts about being in control or having mastery over a particular situation. The point of this technique is to practice imagining successful behavior change.

Rationale 3: Mastery imagery shapes the individuals thoughts about being in control or having mastery over a particular situation. The point of this technique is to practice imagining successful behavior change.

Rationale 4: Mastery imagery shapes the individuals thoughts about being in control or having mastery over a particular situation. The point of this technique is to practice imagining successful behavior change.

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Explain the central features of cognitive behavioral interventions.

Question 5

Type: MCSA

A client complains of feeling angry whenever he sees families relating well with one another. During a family group session, the nursing student observes a family member belittling every statement made by the client. The nursing student knows that the clients thinking is often:

1. What leads the client to negative behaviors.

2. Erratic and problematic.

3. Conscious and deliberate.

4. Automatic, without active or conscious effort.

Correct Answer: 4

Rationale 1: The heart of cognitive therapy lies in recognizing how we think and behave and in identifying problematic learning. People develop patterns of thinking over time, often automatically, without active or conscious effort. Automatic thoughts can develop into specific (and frequently solidly crystallized) sets of problematic thinking. Clients automatic thinking may comprise a part of negative behaviors. The clients thinking does not appear to be conscious, deliberate, or erratic.

Rationale 2: The heart of cognitive therapy lies in recognizing how we think and behave and in identifying problematic learning. People develop patterns of thinking over time, often automatically, without active or conscious effort. Automatic thoughts can develop into specific (and frequently solidly crystallized) sets of problematic thinking. Clients automatic thinking may comprise a part of negative behaviors. The clients thinking does not appear to be conscious, deliberate, or erratic.

Rationale 3: The heart of cognitive therapy lies in recognizing how we think and behave and in identifying problematic learning. People develop patterns of thinking over time, often automatically, without active or conscious effort. Automatic thoughts can develop into specific (and frequently solidly crystallized) sets of problematic thinking. Clients automatic thinking may comprise a part of negative behaviors. The clients thinking does not appear to be conscious, deliberate, or erratic.

Rationale 4: The heart of cognitive therapy lies in recognizing how we think and behave and in identifying problematic learning. People develop patterns of thinking over time, often automatically, without active or conscious effort. Automatic thoughts can develop into specific (and frequently solidly crystallized) sets of problematic thinking. Clients automatic thinking may comprise a part of negative behaviors. The clients thinking does not appear to be conscious, deliberate, or erratic.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Discuss how humans express themselves in cognitive and behavioral ways.

Question 6

Type: MCSA

A client diagnosed with depression states, Even in high school I was a failure. Its a wonder I was associated with successful friends. The nurse knows this client is making:

1. A hard situation worse.

2. Attributions about his life.

3. Excuses about his present behavior.

4. Assumptions about his friends.

Correct Answer: 4

Rationale 1: As humans, we constantly ascribe causes to the events in our lives. By labeling or assigning meaning to a circumstance, or a set of circumstances, we make attributions (I only got a grade of C. Im no good at anything. Sarah and Francisco got As. They can do anything.). Think of attributions as perceived causes that may or may not be objectively accurate. Depressed people often attribute failure to themselves and success to others. Then, we attribute associated features or characteristics to that circumstance (such as being a good student or knowing the material). Next, we expect a certain outcome from that circumstance and we behave consistently with that expectation. Finally, we have feelings that match, or are congruent with, the experience. The basic idea is that thoughts and behaviors lead to feelings.

Rationale 2: As humans, we constantly ascribe causes to the events in our lives. By labeling or assigning meaning to a circumstance, or a set of circumstances, we make attributions (I only got a grade of C. Im no good at anything. Sarah and Francisco got As. They can do anything.). Think of attributions as perceived causes that may or may not be objectively accurate. Depressed people often attribute failure to themselves and success to others. Then, we attribute associated features or characteristics to that circumstance (such as being a good student or knowing the material). Next, we expect a certain outcome from that circumstance and we behave consistently with that expectation. Finally, we have feelings that match, or are congruent with, the experience. The basic idea is that thoughts and behaviors lead to feelings.

Rationale 3: As humans, we constantly ascribe causes to the events in our lives. By labeling or assigning meaning to a circumstance, or a set of circumstances, we make attributions (I only got a grade of C. Im no good at anything. Sarah and Francisco got As. They can do anything.). Think of attributions as perceived causes that may or may not be objectively accurate. Depressed people often attribute failure to themselves and success to others. Then, we attribute associated features or characteristics to that circumstance (such as being a good student or knowing the material). Next, we expect a certain outcome from that circumstance and we behave consistently with that expectation. Finally, we have feelings that match, or are congruent with, the experience. The basic idea is that thoughts and behaviors lead to feelings.

Rationale 4: As humans, we constantly ascribe causes to the events in our lives. By labeling or assigning meaning to a circumstance, or a set of circumstances, we make attributions (I only got a grade of C. Im no good at anything. Sarah and Francisco got As. They can do anything.). Think of attributions as perceived causes that may or may not be objectively accurate. Depressed people often attribute failure to themselves and success to others. Then, we attribute associated features or characteristics to that circumstance (such as being a good student or knowing the material). Next, we expect a certain outcome from that circumstance and we behave consistently with that expectation. Finally, we have feelings that match, or are congruent with, the experience. The basic idea is that thoughts and behaviors lead to feelings.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Discuss how humans express themselves in cognitive and behavioral ways.

Question 7

Type: MCSA

A nursing student receiving Ds on quizzes decides to begin studying with a group of students known to make As. The nursing instructor knows that the student is exhibiting what type of behavior?

1. Modeling

2. Attributing

3. Self-efficacy

4. Assuming

Correct Answer: 1

Rationale 1: Modeling involves imitating others in the expectation that one will receive rewards such as those other people seem to be getting.

Rationale 2: Modeling involves imitating others in the expectation that one will receive rewards such as those other people seem to be getting.

Rationale 3: Modeling involves imitating others in the expectation that one will receive rewards such as those other people seem to be getting.

Rationale 4: Modeling involves imitating others in the expectation that one will receive rewards such as those other people seem to be getting.

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Discuss how humans express themselves in cognitive and behavioral ways.

Question 8

Type: MCSA

The nurse knows that when the mental health client has learned how to successfully adapt in new or different circumstances, the client has developed a sense of:

1. Pride.

2. Self-efficacy.

3. Self.

4. Self-esteem.

Correct Answer: 2

Rationale 1: Human learning can occur through self-efficacy, which involves feeling effective through ones own actions. People learn and adapt when they find themselves in circumstances demanding new or different skills. People who tend to believe that they can cope successfully with problems in living through acquiring skills, practicing them, and observing successful outcomes will gain confidence and a sense of self-efficacy.

Rationale 2: Human learning can occur through self-efficacy, which involves feeling effective through ones own actions. People learn and adapt when they find themselves in circumstances demanding new or different skills. People who tend to believe that they can cope successfully with problems in living through acquiring skills, practicing them, and observing successful outcomes will gain confidence and a sense of self-efficacy.

Rationale 3: Human learning can occur through self-efficacy, which involves feeling effective through ones own actions. People learn and adapt when they find themselves in circumstances demanding new or different skills. People who tend to believe that they can cope successfully with problems in living through acquiring skills, practicing them, and observing successful outcomes will gain confidence and a sense of self-efficacy.

Rationale 4: Human learning can occur through self-efficacy, which involves feeling effective through ones own actions. People learn and adapt when they find themselves in circumstances demanding new or different skills. People who tend to believe that they can cope successfully with problems in living through acquiring skills, practicing them, and observing successful outcomes will gain confidence and a sense of self-efficacy.

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Discuss how humans express themselves in cognitive and behavioral ways.

Question 9

Type: MCSA

The nurse knows that obtaining a smoking cessation contract from a client will:

1. Help clients adapt through change.

2. Increase positive reinforcement through adaptation.

3. Facilitate change through contracts.

4. Formulate well-thought-out plans.

Correct Answer: 2

Rationale 1: The therapists goal in operant conditioning is to help the individual increase positive reinforcement through more adaptive and effective behaviors. The effort to change health-related behaviors can be facilitated with a behavioral contract. An effective behavioral contract must be tailored for the individual, and a comprehensive behavioral assessment is necessary to formulate such a contract, as is the formulation of practical, measurable, and feasible objectives and goals.

Rationale 2: The therapists goal in operant conditioning is to help the individual increase positive reinforcement through more adaptive and effective behaviors. The effort to change health-related behaviors can be facilitated with a behavioral contract. An effective behavioral contract must be tailored for the individual, and a comprehensive behavioral assessment is necessary to formulate such a contract, as is the formulation of practical, measurable, and feasible objectives and goals.

Rationale 3: The therapists goal in operant conditioning is to help the individual increase positive reinforcement through more adaptive and effective behaviors. The effort to change health-related behaviors can be facilitated with a behavioral contract. An effective behavioral contract must be tailored for the individual, and a comprehensive behavioral assessment is necessary to formulate such a contract, as is the formulation of practical, measurable, and feasible objectives and goals.

Rationale 4: The therapists goal in operant conditioning is to help the individual increase positive reinforcement through more adaptive and effective behaviors. The effort to change health-related behaviors can be facilitated with a behavioral contract. An effective behavioral contract must be tailored for the individual, and a comprehensive behavioral assessment is necessary to formulate such a contract, as is the formulation of practical, measurable, and feasible objectives and goals.

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Relate conditioning and association to the process of human learning.

Question 10

Type: MCSA

The nurse therapist skilled in rational emotive therapy (RET) helps clients identify:

1. Cognitive causes for rational beliefs.

2. Health-damaging beliefs and practices.

3. Rational thoughts and healthy emotions.

4. Irrational thoughts and develop more rational life philosophies.

Correct Answer: 4

Rationale 1: Rational emotive therapy (RET) was originated by Albert Ellis (1975) and emphasizes cognitive causes of emotional problems along with the importance of taking personal responsibility for maintaining health-damaging thought habits and irrational beliefs. An irrational belief is a belief that lacks reason and sound judgment. The clinician who is skilled in RET helps identify irrational thought structures with the client and then helps develop a plan to substitute more rational personal life philosophies and attitudes based on accurately perceived realities (Ellis, 1997). Healthy emotional consequences occur when rational thinking drives adequate functional behaviors. Identifying health-damaging beliefs and cognitive causes for rational beliefs are not the goals of RET.

Rationale 2: Rational emotive therapy (RET) was originated by Albert Ellis (1975) and emphasizes cognitive causes of emotional problems along with the importance of taking personal responsibility for maintaining health-damaging thought habits and irrational beliefs. An irrational belief is a belief that lacks reason and sound judgment. The clinician who is skilled in RET helps identify irrational thought structures with the client and then helps develop a plan to substitute more rational personal life philosophies and attitudes based on accurately perceived realities (Ellis, 1997). Healthy emotional consequences occur when rational thinking drives adequate functional behaviors. Identifying health-damaging beliefs and cognitive causes for rational beliefs are not the goals of RET.

Rationale 3: Rational emotive therapy (RET) was originated by Albert Ellis (1975) and emphasizes cognitive causes of emotional problems along with the importance of taking personal responsibility for maintaining health-damaging thought habits and irrational beliefs. An irrational belief is a belief that lacks reason and sound judgment. The clinician who is skilled in RET helps identify irrational thought structures with the client and then helps develop a plan to substitute more rational personal life philosophies and attitudes based on accurately perceived realities (Ellis, 1997). Healthy emotional consequences occur when rational thinking drives adequate functional behaviors. Identifying health-damaging beliefs and cognitive causes for rational beliefs are not the goals of RET.

Rationale 4: Rational emotive therapy (RET) was originated by Albert Ellis (1975) and emphasizes cognitive causes of emotional problems along with the importance of taking personal responsibility for maintaining health-damaging thought habits and irrational beliefs. An irrational belief is a belief that lacks reason and sound judgment. The clinician who is skilled in RET helps identify irrational thought structures with the client and then helps develop a plan to substitute more rational personal life philosophies and attitudes based on accurately perceived realities (Ellis, 1997). Healthy emotional consequences occur when rational thinking drives adequate functional behaviors. Identifying health-damaging beliefs and cognitive causes for rational beliefs are not the goals of RET.

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Relate conditioning and association to the process of human learning.

Question 11

Type: MCSA

The nursing student knows that the therapists goal in behavior therapy is to:

1. Decrease classical conditioning.

2. Increase self-confidence.

3. Deny religiosity in mental health clients.

4. Increase social reasoning.

Correct Answer: 1

Rationale 1: In classical conditioning, people learn to associate a particular feeling state with a particular circumstance that then becomes a conditioned stimulus for the feeling. Over time, the association between the circumstance and the feeling is strengthened through repetition and rehearsal. The therapists goal in behavior therapy is to decrease or eliminate the association of a particular circumstance (the conditioned stimulus) with a particular feeling. Denying religiosity, increasing self-confidence, and increasing social reasoning are not goals of behavior therapy.

Rationale 2: In classical conditioning, people learn to associate a particular feeling state with a particular circumstance that then becomes a conditioned stimulus for the feeling. Over time, the association between the circumstance and the feeling is strengthened through repetition and rehearsal. The therapists goal in behavior therapy is to decrease or eliminate the association of a particular circumstance (the conditioned stimulus) with a particular feeling. Denying religiosity, increasing self-confidence, and increasing social reasoning are not goals of behavior therapy.

Rationale 3: In classical conditioning, people learn to associate a particular feeling state with a particular circumstance that then becomes a conditioned stimulus for the feeling. Over time, the association between the circumstance and the feeling is strengthened through repetition and rehearsal. The therapists goal in behavior therapy is to decrease or eliminate the association of a particular circumstance (the conditioned stimulus) with a particular feeling. Denying religiosity, increasing self-confidence, and increasing social reasoning are not goals of behavior therapy.

Rationale 4: In classical conditioning, people learn to associate a particular feeling state with a particular circumstance that then becomes a conditioned stimulus for the feeling. Over time, the association between the circumstance and the feeling is strengthened through repetition and rehearsal. The therapists goal in behavior therapy is to decrease or eliminate the association of a particular circumstance (the conditioned stimulus) with a particular feeling. Denying religiosity, increasing self-confidence, and increasing social reasoning are not goals of behavior therapy.

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Relate conditioning and association to the process of human learning.

Question 12

Type: MCSA

Clients with mental disorders who form inferences from rational beliefs are:

1. Better supported by family members.

2. Significantly more functional than clients who hold irrational beliefs.

3. Able to control impulses.

4. On their way to feeling normal.

Correct Answer: 2

Rationale 1: Rational emotive behavior therapy (REBT) identifies and corrects irrational beliefs. Rational and irrational beliefs, defined by REBT, form the basis of inferences (conclusions based on reasoning) derived to explain life experiences. Those inferences can be more or less functional, depending on the beliefs behind them. People who hold rational beliefs form inferences that are significantly more functional than those formed by people who hold irrational beliefs. The capacity to form inferences from rational beliefs has not been shown to influence family support, impulse control, or clients feelings of normalcy.

Rationale 2: Rational emotive behavior therapy (REBT) identifies and corrects irrational beliefs. Rational and irrational beliefs, defined by REBT, form the basis of inferences (conclusions based on reasoning) derived to explain life experiences. Those inferences can be more or less functional, depending on the beliefs behind them. People who hold rational beliefs form inferences that are significantly more functional than those formed by people who hold irrational beliefs. The capacity to form inferences from rational beliefs has not been shown to influence family support, impulse control, or clients feelings of normalcy.

Rationale 3: Rational emotive behavior therapy (REBT) identifies and corrects irrational beliefs. Rational and irrational beliefs, defined by REBT, form the basis of inferences (conclusions based on reasoning) derived to explain life experiences. Those inferences can be more or less functional, depending on the beliefs behind them. People who hold rational beliefs form inferences that are significantly more functional than those formed by people who hold irrational beliefs. The capacity to form inferences from rational beliefs has not been shown to influence family support, impulse control, or clients feelings of normalcy.

Rationale 4: Rational emotive behavior therapy (REBT) identifies and corrects irrational beliefs. Rational and irrational beliefs, defined by REBT, form the basis of inferences (conclusions based on reasoning) derived to explain life experiences. Those inferences can be more or less functional, depending on the beliefs behind them. People who hold rational beliefs form inferences that are significantly more functional than those formed by people who hold irrational beliefs. The capacity to form inferences from rational beliefs has not been shown to influence family support, impulse control, or clients feelings of normalcy.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Relate conditioning and association to the process of human learning.

Question 13

Type: MCSA

The nursing student working on a group project brings healthy snacks to the meeting so he and his fellow classmates will not gain unwanted pounds as they did on a previous massive assignment. The student has employed:

1. Unobserved behaviors tracked in subjective measurable terms.

2. Behavior modification.

3. Process illumination.

4. Interactional group therapy.

Correct Answer: 2

Rationale 1: Behavior modification frequently focuses on a target behavior that is problematic for the individual or for the community, in this case overeating. The behavior was observed in objective and measurable terms of weight gained, then addressed with a behavior modification plan. The student has not used interactional group therapy. Process illumination is considering the process involved.

Rationale 2: Behavior modification frequently focuses on a target behavior that is problematic for the individual or for the community, in this case overeating. The behavior was observed in objective and measurable terms of weight gained, then addressed with a behavior modification plan. The student has not used interactional group therapy. Process illumination is considering the process involved.

Rationale 3: Behavior modification frequently focuses on a target behavior that is problematic for the individual or for the community, in this case overeating. The behavior was observed in objective and measurable terms of weight gained, then addressed with a behavior modification plan. The student has not used interactional group therapy. Process illumination is considering the process involved.

Rationale 4: Behavior modification frequently focuses on a target behavior that is problematic for the individual or for the community, in this case overeating. The behavior was observed in objective and measurable terms of weight gained, then addressed with a behavior modification plan. The student has not used interactional group therapy. Process illumination is considering the process involved.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Design nursing care plans for people with varied diagnoses using cognitive behavioral therapies.

Question 14

Type: MCSA

A client admitted with borderline personality disorder complains during group therapy that she, always falls for the bad guy. She has been in and out of rehabilitation and abuse crisis centers. The nursing student knows this client would benefit from:

1. Intrapsychic cognitive therapy.

2. Family conflict therapy.

3. Dialectical behavioral therapy.

4. Self-reflective therapy.

Correct Answer: 3

Rationale 1: Linehan specifically developed dialectical behavioral therapy (DBT) for the outpatient treatment of chronically suicidal people with borderline personality disorder. DBT is a specialized subset of the cognitive behavioral treatment modalities. The client with borderline personality disorder tends to be crisis prone, with intense relational episodes. In other words, interactions with others have the potential to disrupt the client powerfully.

Rationale 2: Linehan specifically developed dialectical behavioral therapy (DBT) for the outpatient treatment of chronically suicidal people with borderline personality disorder. DBT is a specialized subset of the cognitive behavioral treatment modalities. The client with borderline personality disorder tends to be crisis prone, with intense relational episodes. In other words, interactions with others have the potential to disrupt the client powerfully.

Rationale 3: Linehan specifically developed dialectical behavioral therapy (DBT) for the outpatient treatment of chronically suicidal people with borderline personality disorder. DBT is a specialized subset of the cognitive behavioral treatment modalities. The client with borderline personality disorder tends to be crisis prone, with intense relational episodes. In other words, interactions with others have the potential to disrupt the client powerfully.

Rationale 4: Linehan specifically developed dialectical behavioral therapy (DBT) for the outpatient treatment of chronically suicidal people with borderline personality disorder. DBT is a specialized subset of the cognitive behavioral treatment modalities. The client with borderline personality disorder tends to be crisis prone, with intense relational episodes. In other words, interactions with others have the potential to disrupt the client powerfully.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Design nursing care plans for people with varied diagnoses using cognitive behavioral therapies.

Question 15

Type: MCSA

The nurse knows that being a competent provider of cognitive behavioral interventions involves understanding and being aware of cultural considerations. Characteristics that nurses must be aware of during assessment include:

1. Gender, sexual orientation, and age.

2. Illness prevention, disability, and gender.

3. Group expression, self-awareness, and religion.

4. Family matters, self-awareness, and age.

Correct Answer: 1

Rationale 1: Cultural considerations involve more than an individuals race or ethnicity. Culture is an envelope that includes, among other characteristics, religion, spirituality, gender, disability, sexual orientation and expression, social status, and age. To be a competent provider of cognitive behavioral interventions, the nurse must, at a minimum, understand these variables, be self-aware, and be comfortable working with those from a culture that differs from the nurses own. Self-awareness and illness prevention are not part of cultural considerations.

Rationale 2: Cultural considerations involve more than an individuals race or ethnicity. Culture is an envelope that includes, among other characteristics, religion, spirituality, gender, disability, sexual orientation and expression, social status, and age. To be a competent provider of cognitive behavioral interventions, the nurse must, at a minimum, understand these variables, be self-aware, and be comfortable working with those from a culture that differs from the nurses own. Self-awareness and illness prevention are not part of cultural considerations.

Rationale 3: Cultural considerations involve more than an individuals race or ethnicity. Culture is an envelope that includes, among other characteristics, religion, spirituality, gender, disability, sexual orientation and expression, social status, and age. To be a competent provider of cognitive behavioral interventions, the nurse must, at a minimum, understand these variables, be self-aware, and be comfortable working with those from a culture that differs from the nurses own. Self-awareness and illness prevention are not part of cultural considerations.

Rationale 4: Cultural considerations involve more than an individuals race or ethnicity. Culture is an envelope that includes, among other characteristics, religion, spirituality, gender, disability, sexual orientation and expression, social status, and age. To be a competent provider of cognitive behavioral interventions, the nurse must, at a minimum, understand these variables, be self-aware, and be comfortable working with those from a culture that differs from the nurses own. Self-awareness and illness prevention are not part of cultural considerations.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Design nursing care plans for people with varied diagnoses using cognitive behavioral therapies.

Question 16

Type: MCSA

The nurse knows that a client who has panic attacks when she sees waterfalls because she had been physically assaulted in a park with a waterfall, would benefit from the feature of cognitive and behavioral treatment of:

1. Suggesting alternative behavior.

2. Seeking social support.

3. Reframing.

4. Expressing affection.

Correct Answer: 3

Rationale 1: Cognitive and behavioral treatment consists of identifying and recognizing maladaptive thinking styles and working toward the acquisition of new skills for managing stressors. Features of treatment include teaching, interpreting, reframing, and learning and practicing new behaviors. Once thoughts and behaviors are realistically and rationally framed and implemented, emotional reactions will be consistent with them. Seeking social support and expressing affection are not part of cognitive and behavioral therapy. The clients need is to reframe, not just receive a suggested alternative behavior.

Rationale 2: Cognitive and behavioral treatment consists of identifying and recognizing maladaptive thinking styles and working toward the acquisition of new skills for managing stressors. Features of treatment include teaching, interpreting, reframing, and learning and practicing new behaviors. Once thoughts and behaviors are realistically and rationally framed and implemented, emotional reactions will be consistent with them. Seeking social support and expressing affection are not part of cognitive and behavioral therapy. The clients need is to reframe, not just receive a suggested alternative behavior.

Rationale 3: Cognitive and behavioral treatment consists of identifying and recognizing maladaptive thinking styles and working toward the acquisition of new skills for managing stressors. Features of treatment include teaching, interpreting, reframing, and learning and practicing new behaviors. Once thoughts and behaviors are realistically and rationally framed and implemented, emotional reactions will be consistent with them. Seeking social support and expressing affection are not part of cognitive and behavioral therapy. The clients need is to reframe, not just receive a suggested alternative behavior.

Rationale 4: Cognitive and behavioral treatment consists of identifying and recognizing maladaptive thinking styles and working toward the acquisition of new skills for managing stressors. Features of treatment include teaching, interpreting, reframing, and learning and practicing new behaviors. Once thoughts and behaviors are realistically and rationally framed and implemented, emotional reactions will be consistent with them. Seeking social support and expressing affection are not part of cognitive and behavioral therapy. The clients need is to reframe, not just receive a suggested alternative behavior.

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Design nursing care plans for people with varied diagnoses using cognitive behavioral therapies.

Question 17

Type: MCSA

A nursing student attempting to use a behavioral modification contract found in the textbook is having trouble getting the client to follow through with everything in the contract. The nursing instructor knows to tell the student that behavioral contracts must be:

1. Affected by the functionality of the client.

2. Reflective of the clients mental illness.

3. Tailored for the individual.

4. Reflective of the characteristics within the clients family.

Correct Answer: 3

Rationale 1: A behavioral contract is a behavior modification plan arranged as a specific agreement between the individual and the team of caregivers who identify the behavior and design the plan. To be effective, the behavioral contract is tailored for the individual client. A contract that is reflective of the clients illness, considers the clients functionality, and reflects characteristics within the family are all aspects of tailoring the contract for the individual.

Rationale 2: A behavioral contract is a behavior modification plan arranged as a specific agreement between the individual and the team of caregivers who identify the behavior and design the plan. To be effective, the behavioral contract is tailored for the individual client. A contract that is reflective of the clients illness, considers the clients functionality, and reflects characteristics within the family are all aspects of tailoring the contract for the individual.

Rationale 3: A behavioral contract is a behavior modification plan arranged as a specific agreement between the individual and the team of caregivers who identify the behavior and design the plan. To be effective, the behavioral contract is tailored for the individual client. A contract that is reflective of the clients illness, considers the clients functionality, and reflects characteristics within the family are all aspects of tailoring the contract for the individual.

Rationale 4: A behavioral contract is a behavior modification plan arranged as a specific agreement between the individual and the team of caregivers who identify the behavior and design the plan. To be effective, the behavioral contract is tailored for the individual client. A contract that is reflective of the clients illness, considers the clients functionality, and reflects characteristics within the family are all aspects of tailoring the contract for the individual.

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: Analyze the effectiveness of a behavioral contract to promote a change in health-related behaviors.

Question 18

Type: MCSA

A nursing student is praised for the comprehensive assessment of a client diagnosed with suicidal ideation. Based on the assessment interview, the student develops a plan to keep the client safe, and the client signs the resulting:

1. DNR contract.

2. Behavioral contract.

3. Patient bill of rights contract.

4. Acceptance letter.

Correct Answer: 2

Rationale 1: A comprehensive assessment interview is the first step in developing a contract with the goal of behavioral change. The purpose of the interview is to assemble a complete picture of the behavior and what maintains it or keeps it going, so that strategies for changing the behavior have the best chance of success. A do-not-resuscitate (DNR) contract, patient bill of rights, and acceptance letter do not apply to the client in the scenario.

Rationale 2: A comprehensive assessment interview is the first step in developing a contract with the goal of behavioral change. The purpose of the interview is to assemble a complete picture of the behavior and what maintains it or keeps it going, so that strategies for changing the behavior have the best chance of success. A do-not-resuscitate (DNR) contract, patient bill of rights, and acceptance letter do not apply to the client in the scenario.

Rationale 3: A comprehensive assessment interview is the first step in developing a contract with the goal of behavioral change. The purpose of the interview is to assemble a complete picture of the behavior and what maintains it or keeps it going, so that strategies for changing the behavior have the best chance of success. A do-not-resuscitate (DNR) contract, patient bill of rights, and acceptance letter do not apply to the client in the scenario.

Rationale 4: A comprehensive assessment interview is the first step in developing a contract with the goal of behavioral change. The purpose of the interview is to assemble a complete picture of the behavior and what maintains it or keeps it going, so that strategies for changing the behavior have the best chance of success. A do-not-resuscitate (DNR) contract, patient bill of rights, and acceptance letter do not apply to the client in the scenario.

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Analyze the effectiveness of a behavioral contract to promote a change in health-related behaviors.

Question 19

Type: MCSA

The nurse knows that nursing diagnoses for cognitive behavioral assessment include:

1. Pseudohostility and Ineffective Coping.

2. Knowledge Deficit and Effective Coping.

3. Interrupted Family Processes and Hopelessness.

4. Hopelessness and Functional Family Processes.

Correct Answer: 3

Rationale 1: Examples of nursing diagnoses that may derive from a cognitive behavioral assessment in preparation for the development of a behavioral contract include Interrupted Family Processes and Hopelessness, Knowledge Deficit, Ineffective Coping, and Dysfunctional Family Processes. Pseudohostility, Functional Family Processes, and Effective Coping are not diagnoses related to cognitive behavioral assessment.

Rationale 2: Examples of nursing diagnoses that may derive from a cognitive behavioral assessment in preparation for the development of a behavioral contract include Interrupted Family Processes and Hopelessness, Knowledge Deficit, Ineffective Coping, and Dysfunctional Family Processes. Pseudohostility, Functional Family Processes, and Effective Coping are not diagnoses related to cognitive behavioral assessment.

Rationale 3: Examples of nursing diagnoses that may derive from a cognitive behavioral assessment in preparation for the development of a behavioral contract include Interrupted Family Processes and Hopelessness, Knowledge Deficit, Ineffective Coping, and Dysfunctional Family Processes. Pseudohostility, Functional Family Processes, and Effective Coping are not diagnoses related to cognitive behavioral assessment.

Rationale 4: Examples of nursing diagnoses that may derive from a cognitive behavioral assessment in preparation for the development of a behavioral contract include Interrupted Family Processes and Hopelessness, Knowledge Deficit, Ineffective Coping, and Dysfunctional Family Processes. Pseudohostility, Functional Family Processes, and Effective Coping are not diagnoses related to cognitive behavioral assessment.

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: Analyze the effectiveness of a behavioral contract to promote a change in health-related behaviors.

Question 20

Type: MCSA

A client diagnosed with schizoaffective disorder has threatened suicide. While developing the care plan, the nurse puts in the nurses notes, The client, though disheveled, is articulate and has a clear plan for suicide, but has made no current attempts. The nursing note helps the nurse develop the behavioral contract by:

1. Orienting the client to the nursing process.

2. Considering interactions during the assessment process.

3. Observing essential information.

4. Cooperating with the family.

Correct Answer: 2

Rationale 1: The planning phase of the nursing process with behavioral contracting requires taking into consideration interactions with the nurse during the assessment interview including aspects of appearance, behavior, attitude, and responsiveness. Obtaining family cooperation and signing behavioral contracts occur during implementation. Orientation to the nursing process is not part of the planning phase. Observations that contribute essential information would be included in interactions during the assessment process.

Rationale 2: The planning phase of the nursing process with behavioral contracting requires taking into consideration interactions with the nurse during the assessment interview including aspects of appearance, behavior, attitude, and responsiveness. Obtaining family cooperation and signing behavioral contracts occur during implementation. Orientation to the nursing process is not part of the planning phase. Observations that contribute essential information would be included in interactions during the assessment process.

Rationale 3: The planning phase of the nursing process with behavioral contracting requires taking into consideration interactions with the nurse during the assessment interview including aspects of appearance, behavior, attitude, and responsiveness. Obtaining family cooperation and signing behavioral contracts occur during implementation. Orientation to the nursing process is not part of the planning phase. Observations that contribute essential information would be included in interactions during the assessment process.

Rationale 4: The planning phase of the nursing process with behavioral contracting requires taking into consideration interactions with the nurse during the assessment interview including aspects of appearance, behavior, attitude, and responsiveness. Obtaining family cooperation and signing behavioral contracts occur during implementation. Orientation to the nursing process is not part of the planning phase. Observations that contribute essential information would be included in interactions during the assessment process.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: Analyze the effectiveness of a behavioral contract to promote a change in health-related behaviors.

Question 21

Type: MCSA

Involving families with the clients treatment is an important aspect of family nursing. It is important to involve them as much as appropriate for the formulation and implementation of:

1. Family identity.

2. Hope, support, and happiness.

3. Behavioral contracts.

4. Positive client behavior.

Correct Answer: 3

Rationale 1: Family involvement is a powerful and useful catalyst for promoting and maintaining behavioral change. Significant others, particularly those with whom the client resides or will reside, are likely to provide important input regarding the level of contract adherence. It is, therefore, important to involve them as much as appropriate in the formulation and implementation of the behavioral contract. If the details of the contract do not work for the involved family, they will not work for the client.

Rationale 2: Family involvement is a powerful and useful catalyst for promoting and maintaining behavioral change. Significant others, particularly those with whom the client resides or will reside, are likely to provide important input regarding the level of contract adherence. It is, therefore, important to involve them as much as appropriate in the formulation and implementation of the behavioral contract. If the details of the contract do not work for the involved family, they will not work for the client.

Rationale 3: Family involvement is a powerful and useful catalyst for promoting and maintaining behavioral change. Significant others, particularly those with whom the client resides or will reside, are likely to provide important input regarding the level of contract adherence. It is, therefore, important to involve them as much as appropriate in the formulation and implementation of the behavioral contract. If the details of the contract do not work for the involved family, they will not work for the client.

Rationale 4: Family involvement is a powerful and useful catalyst for promoting and maintaining behavioral change. Significant others, particularly those with whom the client resides or will reside, are likely to provide important input regarding the level of contract adherence. It is, therefore, important to involve them as much as appropriate in the formulation and implementation of the behavioral contract. If the details of the contract do not work for the involved family, they will not work for the client.

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: Modify a nursing care plan to promote and enhance positive outcomes for cognitive behavioral therapies.

Question 22

Type: MCSA

The night nurse at the mental health clinic is designing a behavioral contract for a client diagnosed with panic attacks. During the assessment phase, the client is negative and exhibits low self-esteem. However, the nurse knows that in order to develop an effective contract, the focus must be on:

1. Specific social weaknesses.

2. The clients abilities and strengths.

3. The clients family.

4. The goals of discharge.

Correct Answer: 2

Rationale 1: Evaluating client abilities and strengths, particularly with regard to learning and making changes, will help in the design of the contract. Discover what other situations requiring behavioral change the client has mastered and what specific personal or social strengths the client employed in implementing the change. Evaluate the clients weaknesses with regard to learning and making changes as well. These interactions address specific problematic behaviors, rather than social weaknesses or family issues. Goals of discharge are developed later in the treatment process.

Rationale 2: Evaluating client abilities and strengths, particularly with regard to learning and making changes, will help in the design of the contract. Discover what other situations requiring behavioral change the client has mastered and what specific personal or social strengths the client employed in implementing the change. Evaluate the clients weaknesses with regard to learning and making changes as well. These interactions address specific problematic behaviors, rather than social weaknesses or family issues. Goals of discharge are developed later in the treatment process.

Rationale 3: Evaluating client abilities and strengths, particularly with regard to learning and making changes, will help in the design of the contract. Discover what other situations requiring behavioral change the client has mastered and what specific personal or social strengths the client employed in implementing the change. Evaluate the clients weaknesses with regard to learning and making changes as well. These interactions address specific problematic behaviors, rather than social weaknesses or family issues. Goals of discharge are developed later in the treatment process.

Rationale 4: Evaluating client abilities and strengths, particularly with regard to learning and making changes, will help in the design of the contract. Discover what other situations requiring behavioral change the client has mastered and what specific personal or social strengths the client employed in implementing the change. Evaluate the clients weaknesses with regard to learning and making changes as well. These interactions address specific problematic behaviors, rather than social weaknesses or family issues. Goals of discharge are developed later in the treatment process.

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: Modify a nursing care plan to promote and enhance positive outcomes for cognitive behavioral therapies.

Question 23

Type: MCSA

The nurse student taking care of a client with schizophrenia has difficulty keeping up with the clients music therapy and individual therapy times. The nurse knows, however, that the case manager is helpful in maintaining the routines and schedules of:

1. Self-study.

2. All clients on the unit.

3. Cognitive behavioral interventions..

4. Clients in music therapy.

Correct Answer: 3

Rationale 1: It is important to focus on maintaining the routines and schedules of cognitive behavioral interventions once a plan of care has been established. Homework assignments and practice using more competent responses will ensure that the client retains the skills obtained in therapy. The case manager can be helpful in sustaining that structure. The variety of interventions, such as group or individual therapy, behavior modification, and self-study can all be promoted and supported through case management.

Rationale 2: It is important to focus on maintaining the routines and schedules of cognitive behavioral interventions once a plan of care has been established. Homework assignments and practice using more competent responses will ensure that the client retains the skills obtained in therapy. The case manager can be helpful in sustaining that structure. The variety of interventions, such as group or individual therapy, behavior modification, and self-study can all be promoted and supported through case management.

Rationale 3: It is important to focus on maintaining the routines and schedules of cognitive behavioral interventions once a plan of care has been established. Homework assignments and practice using more competent responses will ensure that the client retains the skills obtained in therapy. The case manager can be helpful in sustaining that structure. The variety of interventions, such as group or individual therapy, behavior modification, and self-study can all be promoted and supported through case management.

Rationale 4: It is important to focus on maintaining the routines and schedules of cognitive behavioral interventions once a plan of care has been established. Homework assignments and practice using more competent responses will ensure that the client retains the skills obtained in therapy. The case manager can be helpful in sustaining that structure. The variety of interventions, such as group or individual therapy, behavior modification, and self-study can all be promoted and supported through case management.

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: Modify a nursing care plan to promote and enhance positive outcomes for cognitive behavioral therapies.

Question 24

Type: MCSA

A client being discharged from the mental health clinic is fearful about not being able to keep up with therapy and treatments after leaving the clinic. The nurse knows that to ensure client success after discharge, the clients behavioral contract should:

1. Support the clients family and friends.

2. Ensure client success.

3. Build and maintain treatments to help the community.

4. Address issues the client will face in community living.

Correct Answer: 4

Rationale 1: The behavioral contract can be designed to address inpatient issues and community living and to enhance the transition from inpatient treatment to an outpatient setting. Additional supports can be built into the contract to assure the clients success after the transition. These interventions in the community maximize both the quality of life and management of symptoms. No contract can ensure success.

Rationale 2: The behavioral contract can be designed to address inpatient issues and community living and to enhance the transition from inpatient treatment to an outpatient setting. Additional supports can be built into the contract to assure the clients success after the transition. These interventions in the community maximize both the quality of life and management of symptoms. No contract can ensure success.

Rationale 3: The behavioral contract can be designed to address inpatient issues and community living and to enhance the transition from inpatient treatment to an outpatient setting. Additional supports can be built into the contract to assure the clients success after the transition. These interventions in the community maximize both the quality of life and management of symptoms. No contract can ensure success.

Rationale 4: The behavioral contract can be designed to address inpatient issues and community living and to enhance the transition from inpatient treatment to an outpatient setting. Additional supports can be built into the contract to assure the clients success after the transition. These interventions in the community maximize both the quality of life and management of symptoms. No contract can ensure success.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: Modify a nursing care plan to promote and enhance positive outcomes for cognitive behavioral therapies.

Question 25

Type: MCMA

During the assessment, the family nurse therapist inquires about weaknesses regarding learning the client may have. The client becomes defensive and states, You sure are nosy! Smiling, the nurse states, I dont mean to seem nosy, but I must ask these questions to develop a plan that will work for you. The nurses therapeutic response is an attempt to ascertain:

Standard Text: Select all that apply.

1. How the client interacts with family members.

2. Anecdotes from family and friends.

3. The psychiatrists progress notes.

4. Specific factors that have interfered with the success of a goal.

Correct Answer: 4

Rationale 1: Evaluating the client weaknesses with regard to learning and making changes will help the nurse discover what other situations requiring behavioral change the client has mastered, and what specific personal or social strengths the client employed in implementing the change. It is helpful to know what the client attempted to change without success, and the specific factors that interfered with the success, of that goal. The questions may result in knowledge of the clients interaction with family members. The questions to the client would not elicit anecdotes from family or friends, or the psychiatrists progress notes.

Rationale 2: Evaluating the client weaknesses with regard to learning and making changes will help the nurse discover what other situations requiring behavioral change the client has mastered, and what specific personal or social strengths the client employed in implementing the change. It is helpful to know what the client attempted to change without success, and the specific factors that interfered with the success, of that goal. The questions may result in knowledge of the clients interaction with family members. The questions to the client would not elicit anecdotes from family or friends, or the psychiatrists progress notes.

Rationale 3: Evaluating the client weaknesses with regard to learning and making changes will help the nurse discover what other situations requiring behavioral change the client has mastered, and what specific personal or social strengths the client employed in implementing the change. It is helpful to know what the client attempted to change without success, and the specific factors that interfered with the success, of that goal. The questions may result in knowledge of the clients interaction with family members. The questions to the client would not elicit anecdotes from family or friends, or the psychiatrists progress notes.

Rationale 4: Evaluating the client weaknesses with regard to learning and making changes will help the nurse discover what other situations requiring behavioral change the client has mastered, and what specific personal or social strengths the client employed in implementing the change. It is helpful to know what the client attempted to change without success, and the specific factors that interfered with the success, of that goal. The questions may result in knowledge of the clients interaction with family members. The questions to the client would not elicit anecdotes from family or friends, or the psychiatrists progress notes.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: Describe how your personal characteristics might influence your effectiveness in using cognitive behavioral therapies.

Question 26

Type: MCSA

A nurse skillful in the writing process knows that this talent may benefit the client because a well-written behavioral contract:

1. Teaches the client about past mistakes to lead to a successful outcome.

2. Provides everything needed for a cure.

3. Teaches the client to embrace the future helps overcome past misdeeds.

4. Can promote successful outcomes.

Correct Answer: 4

Rationale 1: For a contract to lead to a successful outcome, it must be carefully crafted. A contract does not provide everything needed for a cure, or teach the client to embrace the future. The contract is framed in positive terms (e.g., will maintain abstinence) rather than past mistakes (e.g., will not relapse into use).

Rationale 2: For a contract to lead to a successful outcome, it must be carefully crafted. A contract does not provide everything needed for a cure, or teach the client to embrace the future. The contract is framed in positive terms (e.g., will maintain abstinence) rather than past mistakes (e.g., will not relapse into use).

Rationale 3: For a contract to lead to a successful outcome, it must be carefully crafted. A contract does not provide everything needed for a cure, or teach the client to embrace the future. The contract is framed in positive terms (e.g., will maintain abstinence) rather than past mistakes (e.g., will not relapse into use).

Rationale 4: For a contract to lead to a successful outcome, it must be carefully crafted. A contract does not provide everything needed for a cure, or teach the client to embrace the future. The contract is framed in positive terms (e.g., will maintain abstinence) rather than past mistakes (e.g., will not relapse into use).

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: Describe how your personal characteristics might influence your effectiveness in using cognitive behavioral therapies.

Question 27

Type: MCSA

When speaking with a client who has a mental illness, the nurse uses medical terminology and is condescending. This type of behavior negates the basic rules of negotiating a behavioral contract and:

1. Encourages the client to ask questions.

2. Causes the client to feel uncomfortable with the contract.

3. Appropriately introduces the client to important terminology.

4. Helps the client understand behavioral contracts on his/her terms.

Correct Answer: 2

Rationale 1: The basic rules for negotiating a behavioral contract include engaging the client as a colleague, avoiding complex terminology or coercive formats, and making sure the client completely understands, agrees to, and, to the extent possible, feels comfortable with the contract. The nurses condescending attitude will not encourage the client to ask questions. Complex or medical terminology will not help the client understand the contract.

Rationale 2: The basic rules for negotiating a behavioral contract include engaging the client as a colleague, avoiding complex terminology or coercive formats, and making sure the client completely understands, agrees to, and, to the extent possible, feels comfortable with the contract. The nurses condescending attitude will not encourage the client to ask questions. Complex or medical terminology will not help the client understand the contract.

Rationale 3: The basic rules for negotiating a behavioral contract include engaging the client as a colleague, avoiding complex terminology or coercive formats, and making sure the client completely understands, agrees to, and, to the extent possible, feels comfortable with the contract. The nurses condescending attitude will not encourage the client to ask questions. Complex or medical terminology will not help the client understand the contract.

Rationale 4: The basic rules for negotiating a behavioral contract include engaging the client as a colleague, avoiding complex terminology or coercive formats, and making sure the client completely understands, agrees to, and, to the extent possible, feels comfortable with the contract. The nurses condescending attitude will not encourage the client to ask questions. Complex or medical terminology will not help the client understand the contract.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: Describe how your personal characteristics might influence your effectiveness in using cognitive behavioral therapies.

Question 28

Type: MCSA

A client diagnosed with bipolar disorder is hyperverbal during the initial assessment. In an effort to help the client understand what is required in treatment, the nurse has a calm demeanor, decreases stimuli, and talks to the client one-on-one. The nurse is responding to the clients:

1. Cognitive style.

2. Negative behavior.

3. Positive behavior style.

4. Mania.

Correct Answer: 1

Rationale 1: How people think and react and remember is their cognitive style or overall pattern of thought. The nurses actions indicate an understanding of the way the client thinks. The clients behavior is neither positive nor negative. The client being hyperverbal may or may not indicate mania.

Rationale 2: How people think and react and remember is their cognitive style or overall pattern of thought. The nurses actions indicate an understanding of the way the client thinks. The clients behavior is neither positive nor negative. The client being hyperverbal may or may not indicate mania.

Rationale 3: How people think and react and remember is their cognitive style or overall pattern of thought. The nurses actions indicate an understanding of the way the client thinks. The clients behavior is neither positive nor negative. The client being hyperverbal may or may not indicate mania.

Rationale 4: How people think and react and remember is their cognitive style or overall pattern of thought. The nurses actions indicate an understanding of the way the client thinks. The clients behavior is neither positive nor negative. The client being hyperverbal may or may not indicate mania.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: Describe how your personal characteristics might influence your effectiveness in using cognitive behavioral therapies.

Question 29

Type: MCSA

A nurse comes to the mental health clinic tired, angry, and in a hurry. After making several minor mistakes, the nurse realizes that in order to help clients and improve their functioning through the development of behavioral contracts, he/she must first take his/her time and change his/her attitude in order to:

1. Formulate practical and measurable objectives.

2. Develop goals based on client and family needs.

3. Normalize the familys experience.

4. Teach the client communication skills.

Correct Answer: 1

Rationale 1: Formulating practical and measurable objectives and goals is the next step in developing a behavioral contract. Objectives are small steps leading to goal attainment; goals represent the overall desired outcomes. Learning communication skills may be a result of a successful behavioral contract. Normalizing the familys experience is not part of a behavioral contract.

Rationale 2: Formulating practical and measurable objectives and goals is the next step in developing a behavioral contract. Objectives are small steps leading to goal attainment; goals represent the overall desired outcomes. Learning communication skills may be a result of a successful behavioral contract. Normalizing the familys experience is not part of a behavioral contract.

Rationale 3: Formulating practical and measurable objectives and goals is the next step in developing a behavioral contract. Objectives are small steps leading to goal attainment; goals represent the overall desired outcomes. Learning communication skills may be a result of a successful behavioral contract. Normalizing the familys experience is not part of a behavioral contract.

Rationale 4: Formulating practical and measurable objectives and goals is the next step in developing a behavioral contract. Objectives are small steps leading to goal attainment; goals represent the overall desired outcomes. Learning communication skills may be a result of a successful behavioral contract. Normalizing the familys experience is not part of a behavioral contract.

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: Describe how your personal characteristics might influence your effectiveness in using cognitive behavioral therapies.

Question 30

Type: MCSA

The nursing instructor notes a nursing student is very imaginative. When teaching students about designing and adjusting behavioral contracts, the nursing instructor knows that this particular student will have an advantage in developing contracts because:

1. Monitoring nonverbal communication is a secondary goal.

2. Effective communication skill is the key negotiating tool.

3. Reprioritization of goals is the most important issue.

4. Creativity is an essential component.

Correct Answer: 4

Rationale 1: Designing a contract to which the client can adhere will maximize the chance of success. Creativity is an essential component in negotiating an effective behavioral contract. Effective communication skills and reprioritization are important, but are not necessarily the most important aspects of developing behavioral contracts. The students inventiveness is not related to monitoring nonverbal communication.

Rationale 2: Designing a contract to which the client can adhere will maximize the chance of success. Creativity is an essential component in negotiating an effective behavioral contract. Effective communication skills and reprioritization are important, but are not necessarily the most important aspects of developing behavioral contracts. The students inventiveness is not related to monitoring nonverbal communication.

Rationale 3: Designing a contract to which the client can adhere will maximize the chance of success. Creativity is an essential component in negotiating an effective behavioral contract. Effective communication skills and reprioritization are important, but are not necessarily the most important aspects of developing behavioral contracts. The students inventiveness is not related to monitoring nonverbal communication.

Rationale 4: Designing a contract to which the client can adhere will maximize the chance of success. Creativity is an essential component in negotiating an effective behavioral contract. Effective communication skills and reprioritization are important, but are not necessarily the most important aspects of developing behavioral contracts. The students inventiveness is not related to monitoring nonverbal communication.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: Describe how your personal characteristics might influence your effectiveness in using cognitive behavioral therapies.

Kneisl, Contemporary Psychiatric-Mental Health Nursing, 3/e Test Bank

Copyright 2012 by Pearson Education, Inc.

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