Question 1

Which clinical manifestation would indicate to a nurse that a patient has been employing relaxation training successfully? (Select all that apply.)

Accepted Answer

A)  Decreased blood pressure 
B)  Decreased bowel sounds 
C)  Decreased respirations 
D)  Decreased apical pulse 
E)  Decreased pupil size 
A)  Decreased blood pressure 
B)  Decreased bowel sounds 
C)  Decreased respirations 
D)  Decreased apical pulse 
E)  Decreased pupil size A,C,D,E

Question 2

A patient states,"When I married my husband I thought he was perfect,but now I know that he is certainly far from perfect." The nurse reframes the statement by responding:

Accepted Answer

A)  "I think you might want to change your thinking since no one is perfect." 
B)  "It seems as if you think of people as being either all good or all bad." 
C)  "So, when did you start seeing your husband as a very bad person?" 
D)  "It is good to be able to both externalize and objectify your anger." 
A)  "I think you might want to change your thinking since no one is perfect." 
B)  "It seems as if you think of people as being either all good or all bad." 
C)  "So, when did you start seeing your husband as a very bad person?" 
D)  "It is good to be able to both externalize and objectify your anger." B

Question 3

A nurse would implement social skills training for a patient with which problem?

Accepted Answer

A)  Anxiety 
B)  Binge eating 
C)  Poor impulse control 
D)  Obsessive-compulsive disorder 
A)  Anxiety 
B)  Binge eating 
C)  Poor impulse control 
D)  Obsessive-compulsive disorder C

Question 4

A high school student says to the school nurse,"If I don't make the honor roll every term,a college will never want me." The most therapeutic nurse response is:

Accepted Answer

A)  "If making the honor role every term was the admissions criterion, very few people would get into college." 
B)  "I can understand your concern. The pressures are truly great to assure acceptance into college today." 
C)  "It's true that a consistent record of academic achievement will ensure college acceptance." 
D)  "It sounds as if you believe that colleges will only admit students that are perfect academically." 
A)  "If making the honor role every term was the admissions criterion, very few people would get into college." 
B)  "I can understand your concern. The pressures are truly great to assure acceptance into college today." 
C)  "It's true that a consistent record of academic achievement will ensure college acceptance." 
D)  "It sounds as if you believe that colleges will only admit students that are perfect academically."

Question 5

A nurse explains the technique of response cost to parents who are seeking to reduce the frequency of unwanted behaviors in their children.What is an example of this type of strategy?

Accepted Answer

A)  Ignoring a temper tantrum 
B)  Taking away the privilege to watch television until homework is finished 
C)  Grounding a child for a month after a very poor report card is received 
D)  Making a young child sit in a corner after fighting with a younger sibling 
A)  Ignoring a temper tantrum 
B)  Taking away the privilege to watch television until homework is finished 
C)  Grounding a child for a month after a very poor report card is received 
D)  Making a young child sit in a corner after fighting with a younger sibling

Question 6

An important characteristic of cognitive behavioral therapy is its focus on the:

Accepted Answer

A)  authoritarian role assumed by the therapist. 
B)  consistent collaboration with the patient. 
C)  subjective experiences of the patient. 
D)  approach to treatment. 
A)  authoritarian role assumed by the therapist. 
B)  consistent collaboration with the patient. 
C)  subjective experiences of the patient. 
D)  approach to treatment.

Question 7

Which strategy for assisting patients to learn new behavior is considered by some to be questionable?

Accepted Answer

A)  Shaping 
B)  Token economy 
C)  Aversion therapy 
D)  Contingency training 
A)  Shaping 
B)  Token economy 
C)  Aversion therapy 
D)  Contingency training

Question 8

What is the correct order for performing progressive muscle relaxation (PMR)?

Accepted Answer

A)  Tensing and relaxing muscle groups from the middle of the body outward to the extremities 
B)  Relaxing and tensing muscle groups from the middle of the body outward to the extremities 
C)  Tensing and releasing muscle groups from the facial muscles and moving down to the muscles in the feet 
D)  Relaxing and tightening muscle groups from the facial muscles and moving down to the muscles in the feet 
A)  Tensing and relaxing muscle groups from the middle of the body outward to the extremities 
B)  Relaxing and tensing muscle groups from the middle of the body outward to the extremities 
C)  Tensing and releasing muscle groups from the facial muscles and moving down to the muscles in the feet 
D)  Relaxing and tightening muscle groups from the facial muscles and moving down to the muscles in the feet

Question 9

A patient frequently experiences angry outbursts and asks,"Is there anything I can do to stop being rude every time I get angry?" The nurse responds:

Accepted Answer

A)  "A social skills training program would be helpful." 
B)  "Do you really want to stop being rude when you become angry?" 
C)  "Patients who have trouble controlling their tempers are often helped by talking with a counselor." 
D)  "I could recommend for you to enter into therapy with a psychiatrist who is an expert in communications theory." 
A)  "A social skills training program would be helpful." 
B)  "Do you really want to stop being rude when you become angry?" 
C)  "Patients who have trouble controlling their tempers are often helped by talking with a counselor." 
D)  "I could recommend for you to enter into therapy with a psychiatrist who is an expert in communications theory."

Question 10

Which strategy will help evoke relaxation when using meditation?

Accepted Answer

A)  Playing soft background music 
B)  Ten-second deep breathing and exhaling 
C)  Ten-second tensing and relaxing of muscle groups 
D)  Providing a word or scene on which the patient can focus 
A)  Playing soft background music 
B)  Ten-second deep breathing and exhaling 
C)  Ten-second tensing and relaxing of muscle groups 
D)  Providing a word or scene on which the patient can focus

Question 11

A nurse instructing a group of patients in the sequence of progressive muscle relaxation tells the group to tense and relax which area first?

Accepted Answer

A)  Eyes 
B)  Toes 
C)  Hands 
D)  Mouth 
A)  Eyes 
B)  Toes 
C)  Hands 
D)  Mouth

Question 12

A patient says,"There aren't many things in life that I'm really afraid of,but I'm so afraid that I'll have another panic attack when I least expect it." Which question indicates the nurse is using decatastrophizing?

Accepted Answer

A)  "Okay, let's talk about the worst case scenario. What if you're driving in a snow storm with your children in the car and you have an attack?" 
B)  "I can understand your concern. But keep telling yourself not to worry because panic attacks go away as quickly as they appear." 
C)  "I can understand that your anxiety over the possibility of experiencing another panic attack could paralyze you with fear." 
D)  "Let me understand this. You're not afraid of much, but these attacks cause you to be fearful?" 
A)  "Okay, let's talk about the worst case scenario. What if you're driving in a snow storm with your children in the car and you have an attack?" 
B)  "I can understand your concern. But keep telling yourself not to worry because panic attacks go away as quickly as they appear." 
C)  "I can understand that your anxiety over the possibility of experiencing another panic attack could paralyze you with fear." 
D)  "Let me understand this. You're not afraid of much, but these attacks cause you to be fearful?"

Question 13

A patient says,"The people I work with hate me even though I'm given the hardest assignment.My boss makes it look like I'm doing less than the others." An appropriate response by the nurse would be:

Accepted Answer

A)  "It seems like you're in a very difficult position. No job is worth that kind of stress. Why not change jobs?" 
B)  "You can't have the hardest assignment and yet your co-workers don't see that and hate you. How can you be so sure that you're hated?" 
C)  "I think you should sit down and talk out your feelings with your boss. Perhaps you can come to a more agreeable situation with your co-workers." 
D)  "Let me see if I understand. Your assignment appears to be easy, but it is really difficult. You feel your co-workers won't see that it's hard, and they'll hate you." 
A)  "It seems like you're in a very difficult position. No job is worth that kind of stress. Why not change jobs?" 
B)  "You can't have the hardest assignment and yet your co-workers don't see that and hate you. How can you be so sure that you're hated?" 
C)  "I think you should sit down and talk out your feelings with your boss. Perhaps you can come to a more agreeable situation with your co-workers." 
D)  "Let me see if I understand. Your assignment appears to be easy, but it is really difficult. You feel your co-workers won't see that it's hard, and they'll hate you."

Question 14

Which relaxation technique will a nurse implement for a patient who reports panic attacks that "come over me for no apparent reason" but denies being agoraphobic?

Accepted Answer

A)  Implosion therapy 
B)  Relaxation technique 
C)  Interoceptive exposure 
D)  Progressive muscle relaxation 
A)  Implosion therapy 
B)  Relaxation technique 
C)  Interoceptive exposure 
D)  Progressive muscle relaxation

Question 15

A nurse teaches a group of parents about positive and negative reinforcement in shaping behavior.Which is an example of a positive reinforcer?

Accepted Answer

A)  A parent who kisses a child who is crying to make the crying stop 
B)  An adolescent who runs away from home because of trouble in school 
C)  A parent who praises a child for putting toys away after playtime 
D)  An adolescent who drives within the speed limit to avoid getting a ticket 
A)  A parent who kisses a child who is crying to make the crying stop 
B)  An adolescent who runs away from home because of trouble in school 
C)  A parent who praises a child for putting toys away after playtime 
D)  An adolescent who drives within the speed limit to avoid getting a ticket

Question 16

During a group session a nurse mimics the disruptive behavior of a patient to demonstrate its affect on group work.The teaching strategy the nurse is implementing is:

Accepted Answer

A)  shaping. 
B)  modeling. 
C)  role playing. 
D)  positive reinforcement. 
A)  shaping. 
B)  modeling. 
C)  role playing. 
D)  positive reinforcement.

Question 17

A patient tells a nurse,"I want my own private room because my roommate is always watching football on television.He probably thinks I'm gay because I don't like football." Which communication best reflects a cognitive behavioral assessment by the nurse?

Accepted Answer

A)  "You feel your roommate thinks you're gay because you don't like football and he spends his time watching football? How will getting a private room change things?" 
B)  "It's hard to feel excluded, but isolating yourself is not the answer. Perhaps you might try watching football with him." 
C)  "Don't you think your roommate will be more likely to think you're gay if you get a private room?" 
D)  "Well, you must realize that most men like football, but that doesn't mean he will think you are gay." 
A)  "You feel your roommate thinks you're gay because you don't like football and he spends his time watching football? How will getting a private room change things?" 
B)  "It's hard to feel excluded, but isolating yourself is not the answer. Perhaps you might try watching football with him." 
C)  "Don't you think your roommate will be more likely to think you're gay if you get a private room?" 
D)  "Well, you must realize that most men like football, but that doesn't mean he will think you are gay."

Question 18

A nurse explains the technique of extinction to parents who are seeking to reduce the frequency of unwanted behaviors in their children.What is an example of this type of strategy?

Accepted Answer

A)  Ignoring a temper tantrum 
B)  Taking away an allowance for not keeping a clean room 
C)  Sending children to their rooms after fighting with each other 
D)  Not allowing children to play with friends because homework is not completed 
A)  Ignoring a temper tantrum 
B)  Taking away an allowance for not keeping a clean room 
C)  Sending children to their rooms after fighting with each other 
D)  Not allowing children to play with friends because homework is not completed

Question 19

Which response best indicates that a nurse is employing reframing with a patient who responds angrily and aggressively when family members confront the patient's abusive drinking behavior?

Accepted Answer

A)  "Would you like to take a 10-minute time-out to get your anger under control?" 
B)  "It is good that you can display anger. Now, can you tell us what it is you really want to say?" 
C)  "Would you consider joining Alcoholics Anonymous and offering this up to a higher power?" 
D)  "Can you feel the love and concern that prompted your family to say these things to you?" 
A)  "Would you like to take a 10-minute time-out to get your anger under control?" 
B)  "It is good that you can display anger. Now, can you tell us what it is you really want to say?" 
C)  "Would you consider joining Alcoholics Anonymous and offering this up to a higher power?" 
D)  "Can you feel the love and concern that prompted your family to say these things to you?"

Question 20

A patient says,"My partner doesn't love me! Even the roses I get are the wrong color.It doesn't matter if I am not happy." The nurse responds:

Accepted Answer

A)  "How do you want your partner to show you that you're loved?" 
B)  "When was the last time your partner made you feel really loved?" 
C)  "Everyone deserves to be shown by their partners that they are loved. What did your partner have to say in his defense?" 
D)  "Let me see if I understand you. You think your partner doesn't love you because the gifted roses were of the wrong color?" 
A)  "How do you want your partner to show you that you're loved?" 
B)  "When was the last time your partner made you feel really loved?" 
C)  "Everyone deserves to be shown by their partners that they are loved. What did your partner have to say in his defense?" 
D)  "Let me see if I understand you. You think your partner doesn't love you because the gifted roses were of the wrong color?"

Exam 27: Behavior Change and Cognitive Interventions

Which clinical manifestation would indicate to a nurse that a patient has been employing relaxation training successfully? (Select all that apply.)

A patient states,"When I married my husband I thought he was perfect,but now I know that he is certainly far from perfect." The nurse reframes the statement by responding:

A nurse would implement social skills training for a patient with which problem?

A high school student says to the school nurse,"If I don't make the honor roll every term,a college will never want me." The most therapeutic nurse response is:

A nurse explains the technique of response cost to parents who are seeking to reduce the frequency of unwanted behaviors in their children.What is an example of this type of strategy?

An important characteristic of cognitive behavioral therapy is its focus on the:

Which strategy for assisting patients to learn new behavior is considered by some to be questionable?

What is the correct order for performing progressive muscle relaxation (PMR)?

A patient frequently experiences angry outbursts and asks,"Is there anything I can do to stop being rude every time I get angry?" The nurse responds:

Which strategy will help evoke relaxation when using meditation?

A nurse instructing a group of patients in the sequence of progressive muscle relaxation tells the group to tense and relax which area first?

A patient says,"There aren't many things in life that I'm really afraid of,but I'm so afraid that I'll have another panic attack when I least expect it." Which question indicates the nurse is using decatastrophizing?

A patient says,"The people I work with hate me even though I'm given the hardest assignment.My boss makes it look like I'm doing less than the others." An appropriate response by the nurse would be:

Which relaxation technique will a nurse implement for a patient who reports panic attacks that "come over me for no apparent reason" but denies being agoraphobic?

A nurse teaches a group of parents about positive and negative reinforcement in shaping behavior.Which is an example of a positive reinforcer?

During a group session a nurse mimics the disruptive behavior of a patient to demonstrate its affect on group work.The teaching strategy the nurse is implementing is:

A patient tells a nurse,"I want my own private room because my roommate is always watching football on television.He probably thinks I'm gay because I don't like football." Which communication best reflects a cognitive behavioral assessment by the nurse?

A nurse explains the technique of extinction to parents who are seeking to reduce the frequency of unwanted behaviors in their children.What is an example of this type of strategy?

Which response best indicates that a nurse is employing reframing with a patient who responds angrily and aggressively when family members confront the patient's abusive drinking behavior?

A patient says,"My partner doesn't love me! Even the roses I get are the wrong color.It doesn't matter if I am not happy." The nurse responds:

Roles and Functions of Psychiatric-Mental Health Nurses: Competent Caring

Therapeutic Nurse-Patient Relationship

The Stuart Stress Adaptation Model of Psychiatric Nursing Care

Evidence-Based Psychiatric Nursing Practice

Biological Context of Psychiatric Nursing Care

Psychological Context of Psychiatric Nursing Care

Social, Cultural, and Spiritual Context of Psychiatric Nursing Care

Legal and Ethical Context of Psychiatric Nursing Care

Policy and Advocacy in Mental Health Care

Families as Resources, Caregivers, and Collaborators

Implementing the Nursing Process: Standards of Practice and Professional Performance

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Anxiety Responses and Anxiety Disorders

Psychophysiological Responses and Somatoform and Sleep Disorders

Self-Concept Responses and Dissociative Disorders

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Psychopharmacology

Preventing and Managing Aggressive Behavior

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Hospital-Based Psychiatric Nursing Care

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