Lone Star College System, North Harris - PSYC 1301

Chapter 27: Behavior Change and Cognitive Interventions Test Bank

MULTIPLE CHOICE

1)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:

1. 1. “How do you want your partner to show you that you’re loved?”
   2. “When was the last time your partner made you feel really loved?”
   3. “Everyone deserves to be shown by their partners that they are loved. What did your partner have to say in his defense?”
   4. “Let me see if I understand you. You think your partner doesn’t love you because the gifted roses were of the wrong color?”

2. A patient says, “I’ve been sick a lot this last year but I’m still the biggest seller. I think my boss wants me to leave because a big change in our health insurance plan was implemented last week.” The nurse responds:
   1. “So you’ve been sick but you’re the best seller. That makes you a valued employee.”
   2. “It’s hard to get up one day and find that you’re the oldest person in any group. It’s only natural that you’d be sicker than everyone else.”
   3. “You’re still the best seller. It’s important not to be suspicious of what is probably only a necessary change in health insurance coverage.”
   4. “So you think that while you’re still the best seller the fact you’ve been sick a lot this year is a problem? You feel that your employer’s change in health insurance indicates they want you to leave?”

3. A patient tearfully says to a nurse, “I don’t want to go on living now that my spouse has left me for someone else after 20 years. Our children are grown and don’t need me. I just want to die.” Which response is the most therapeutic?
   1. “You’re young, and you will manage well. I know several people your age who’ve

actually done better after divorcing their spouses.”

1. 2. “It always seems bleak when we lose someone we’ve loved. Don’t worry, it will work out—we just need to think this through.”
   3. “So your spouse is off having a midlife crisis and you are here thinking of killing yourself. Let’s focus on how to make you feel better.”
   4. “I am very concerned about you wanting to die because your spouse left. Rather than trying to solve all the problems immediately let’s focus on your feelings of hopelessness right now.”

4. 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?
   1. “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?”
   2. “It’s hard to feel excluded, but isolating yourself is not the answer. Perhaps you might try watching football with him.”
   3. “Don’t you think your roommate will be more likely to think you’re gay if you get a private room?”
   4. “Well, you must realize that most men like football, but that doesn’t mean he will think you are gay.”

5. 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?
   1. Implosion therapy
   2. Relaxation technique
   3. Interoceptive exposure
   4. Progressive muscle relaxation

6. 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?
   1. “Would you like to take a 10-minute time-out to get your anger under control?”
   2. “It is good that you can display anger. Now, can you tell us what it is you really want to say?”
   3. “Would you consider joining Alcoholics Anonymous and offering this up to a higher power?”
   4. “Can you feel the love and concern that prompted your family to say these things to you?”

7. 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:
   1. shaping.
   2. modeling.
   3. role playing.
   4. positive reinforcement.

8. Which strategy will help evoke relaxation when using meditation?
   1. Playing soft background music
   2. Ten-second deep breathing and exhaling
   3. Ten-second tensing and relaxing of muscle groups
   4. Providing a word or scene on which the patient can focus

9. Which behavior would a nurse focus upon when using a token economy as a method of positive reinforcement?
   1. Altering cognitive perceptions
   2. Reinforcing cognitive congruence
   3. Performing assigned tasks in a cooperative manner
   4. Pairing desired behaviors with undesired behaviors

10. 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:
    1. “A social skills training program would be helpful.”
    2. “Do you really want to stop being rude when you become angry?”
    3. “Patients who have trouble controlling their tempers are often helped by talking with a counselor.”
    4. “I could recommend for you to enter into therapy with a psychiatrist who is an expert in communications theory.”

11. 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:
    1. “I think you might want to change your thinking since no one is perfect.”
    2. “It seems as if you think of people as being either all good or all bad.”
    3. “So, when did you start seeing your husband as a very bad person?”
    4. “It is good to be able to both externalize and objectify your anger.”

12. 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:
    1. “If making the honor role every term was the admissions criterion, very few people would get into college.”
    2. “I can understand your concern. The pressures are truly great to assure acceptance into college today.”
    3. “It’s true that a consistent record of academic achievement will ensure college acceptance.”
    4. “It sounds as if you believe that colleges will only admit students that are perfect academically.”

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:
    1. “It seems like you’re in a very difficult position. No job is worth that kind of stress. Why not change jobs?”
    2. “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?”
    3. “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.”
    4. “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.”

14. A patient says, “When I lost weight, everyone was so nice to me. Now that I’ve regained the weight, people don’t want anything to do with me. They think I’m just a fat pig.” The nurse’s initial response should be:
    1. “It sounds as if your interpersonal relationships improved when you lost weight and now that you have regained the weight, you feel people don’t want to be with you.”
    2. “Yes, there is a stigma about obesity. People are judged harshly for their weight.”
    3. “So, if you lose all the weight again do you think your relationships will improve?”
    4. “Do you really believe that your friends think that you are a ‘fat pig’?”

15. 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?
    1. “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?”
    2. “I can understand your concern. But keep telling yourself not to worry because panic attacks go away as quickly as they appear.”
    3. “I can understand that your anxiety over the possibility of experiencing another panic attack could paralyze you with fear.”
    4. “Let me understand this. You’re not afraid of much, but these attacks cause you to be fearful?”

16. A nurse teaches a group of parents about positive and negative reinforcement in shaping behavior. Which is an example of a positive reinforcer?
    1. A parent who kisses a child who is crying to make the crying stop
    2. An adolescent who runs away from home because of trouble in school
    3. A parent who praises a child for putting toys away after playtime
    4. An adolescent who drives within the speed limit to avoid getting a ticket

17. 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?
    1. Ignoring a temper tantrum
    2. Taking away an allowance for not keeping a clean room
    3. Sending children to their rooms after fighting with each other
    4. Not allowing children to play with friends because homework is not completed

18. 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?
    1. Ignoring a temper tantrum
    2. Taking away the privilege to watch television until homework is finished
    3. Grounding a child for a month after a very poor report card is received
    4. Making a young child sit in a corner after fighting with a younger sibling

19. An important characteristic of cognitive behavioral therapy is its focus on the:
    1. authoritarian role assumed by the therapist.
    2. consistent collaboration with the patient.
    3. subjective experiences of the patient.
    4. approach to treatment.

20. A nurse instructing a group of patients in the sequence of progressive muscle relaxation tells the group to tense and relax which area first?
    1. Eyes
    2. Toes
    3. Hands
    4. Mouth

21. A nurse determines that a patient with a fear of insects has mastered the first step in a systematic desensitization process when the patient is able to:
    1. relax the muscles of the body.
    2. look at a picture of an insect in a book.
    3. rate anxiety produced by various insects.
    4. touch a clear glass bottle containing an insect.

22. A nurse would implement social skills training for a patient with which problem?
    1. Anxiety
    2. Binge eating
    3. Poor impulse control
    4. Obsessive-compulsive disorder

23. Which strategy for assisting patients to learn new behavior is considered by some to be questionable?
    1. Shaping
    2. Token economy
    3. Aversion therapy
    4. Contingency training

24. The most appropriate nursing intervention for a patient in the third stage of change is:
    1. helping the patient see the benefit of changing the problematic behavior.
    2. assisting the patient with the development of realistic treatment goals.
    3. developing relapse prevention plans in anticipation of potential failures.
    4. providing nurse-patient interactions that discuss change in a relaxed environment.

25. What is the correct order for performing progressive muscle relaxation (PMR)?
    1. Tensing and relaxing muscle groups from the middle of the body outward to the extremities
    2. Relaxing and tensing muscle groups from the middle of the body outward to the extremities
    3. Tensing and releasing muscle groups from the facial muscles and moving down to the muscles in the feet
    4. Relaxing and tightening muscle groups from the facial muscles and moving down to the muscles in the feet

MULTIPLE RESPONSE

1. Which clinical manifestation would indicate to a nurse that a patient has been employing relaxation training successfully? (Select all that apply.)
   1. Decreased blood pressure
   2. Decreased bowel sounds
   3. Decreased respirations
   4. Decreased apical pulse
   5. Decreased pupil size

2. When describing cognitive behavioral therapy, it would be stressed that nursing is responsible for: (Select all that apply.)
   1. providing direct patient care.
   2. assisting in actual psychotherapy sessions.
   3. participating in planning the treatment program.
   4. teaching family members how to use cognitive behavioral techniques.