NSG 526 X2

Question 1

02 During a multifamily support group, a patient who has schizophrenia says, “Sometimes I feel very sad that I will never have a good job like my brother, who is an executive. Then I dwell on it, and maybe I should not.” The nurse leader can best facilitate discussion of this issue by responding:

A. “Grieving for what is lost is a normal part of having a mental disorder.”

B. “How have others in the group handled painful feelings like these?”

C. “It is often better to focus on our successes rather than our failures.”

D. “I wonder if you might also experience feelings of anger and helplessness.”

Answer 1

B. “How have others in the group handled painful feelings like these?”

Question 2

04 According to Yalom, the expression of ideas, thoughts, and suppressed material that is accompanied by an emotional response that produces a state of relief in the patient is referred to as:

a. cohesion

b. catharsis

c. universality

d. insight

Answer 2

b. catharsis

Question 3

05 A college student received an invitation to attend the wedding of a close friend who lives across the country. The student is afraid of flying. What type of therapy would the nurse suggest?

a. modeling

b. flooding

c. systemic desensitization

d. assertiveness training

Answer 3

c. systemic desensitization

Question 4

06 A PMHNP working in addictions may often refer clients to Alcoholics Anonymous and Narcotics Anonymous meetings. Which of the following therapeutic factors emerge in peer led groups according to Yalom’s group dynamic process?

a reflection on existential matters

b. psychological relief

c. altruism

d. hopefulness

Answer 4

d. hopefulness

Final answer:
In peer-led support groups, therapeutic factors identified in Yalom’s group dynamics process include peer support, hopefulness, and reflection on existential matters, which contribute to the support, hope, and personal growth participants gain from these meetings.

Explanation:
The therapeutic factors that occur in peer-led support group meetings, such as those held by Alcoholics Anonymous and Narcotics Anonymous, according to Irvin Yalom’s group dynamics process, include peer support, hopefulness, and the opportunity for reflection on existential matters. Peer support enables participants to feel understood and valued by others with similar experiences. The hopefulness factor emerges as participants witness others coping or recovering, which can foster a positive outlook. Lastly, opportunities for reflecting on existential matters can catalyze deep introspection and personal growth.

[cross-verify this data]

Question 5

07 A patient tells the psychiatric advanced practice nurse she is going to try supplementing her selective serotonin reuptake inhibitor with St. John’s wort. Which action should the psychiatric advanced practice nurse take first?

a. assess the patient for depression and risk for suicide.

b. suggest that aromatherapy may produce even better results

c. advise her of the danger of serotonin syndrome

d. suggest she consider decreasing the dosage of her antidepressant.

Answer 5

c. advise her of the danger of serotonin syndrome

Question 6

08 Which goal represents the cognitive-behavioral model according to Beck and Ellis?

a. Developing satisfactory relationships, maturity, and relative freedom from anxiety.

b. Substituting rational beliefs for irrational beliefs and eliminating self-defeating
behaviors.

c. Facing reality and developing standards for behaving responsibly.

d. Reducing bodily tensions and managing stress by biofeedback and relaxation
training.

Answer 6

b. Substituting rational beliefs for irrational beliefs and eliminating self-defeating behaviors is a goal of cognitive-behavioral theory subscribed to by Beck and Ellis.

Question 7

10 A form of learning in which behavioral frequency is altered through the application of positive and negative consequences is termed

a. avoidance learning

b. discrimination learning

c. aversive learning

d. operant conditioning

Answer 7

d. operant conditioning

Question 8

11 In cognitive therapy, therapists focuses on patients’:

A. Use of immature defense mechanisms

B. Learned behavior of helplessness

C. Automatic negative thoughts

D. Attachment patterns

Answer 8

C. Automatic negative thoughts

Question 9

13 In Cognitive Behavior Therapy, it is often helpful to prescribe the symptom that is bothersome as the treatment. This is known as the paradoxical directive. Which type of therapy would utilize this assignment?

a. psychoanalysis

b. narrative therapy

c. strategic therapy

d. psychodynamic therapy

Answer 9

c. strategic therapy

Question 10

14 A group member comments: “I never knew so many people felt like I did.” This is an example of which one of Yalom’s cutative(?) factors?

a. imitative behavior

b. universality

c. corrective reenactment of the primary family group

d. installation of hope

Answer 10

b. universality

Question 11

15 When assessing a depressed client according to Beck’s Cognitive Triad, the psychiatric advanced practice nurse would expect that the patients thinking is:

a. slower because of brain chemical depletion

b. negative in view of self, ongoing events, and future possibilities

c. based on interjected anger

d. reflective of irrational thoughts, ideas, and cognitions

Answer 11

b. negative in view of self, ongoing events, and future possibilities

Question 12

16 An 8-year-old has experienced inconsistent discipline. The parents are learning to change the parenting behavior in an effort to stop the patient’s out-of-control behavior. The psychiatric advanced practice nurse has advised that the use positive reinforcement with tokens to help the patient learn new behavior. This approach is typical of which theoretical perspective?

a. psychoanalytic theory

b. behavioristic theory

c. cognitive theory

d. systems theory

Answer 12

b. behavioristic theory

Question 13

17 In a closed therapy group for adults dealing with a family of origin conflict issue, members have begun to model aspects of other group members and the group leader. Which group dynamic has manifest?

a. imitative behavior

b. confrontational behavior

c. avoidant behavior

d. mocking behavior

Answer 13

a. imitative behavior

Question 14

18 Which of the following statements provides the most appropriate comment about therapists’ sharing of personal information with patients?

A. Sharing may be used to enhance trust or show interest.

B. Sharing may be used to show that the therapist has similar difficulties.

C. Sharing may include offering friendship outside of sessions.

D. Sharing may be used to reduce therapists’ discomfort with silence in the session.

Answer 14

A. Sharing may be used to enhance trust or show interest.

Question 15

19 Irvin Yalom identified 11 curative factors that are part of a successful group therapy experience. One of the factors is altruism. Altruism is:

a. the ability of group members to rework family issues.

b. the ability of group members to express pain and success.

c. the gaining of increased self-esteem related to helping others.

d. recognition by group members that they are not alone and that other members share similar thoughts and feelings.

Answer 15

c. the gaining of increased self-esteem related to helping others.

Question 16

20 The psychiatric advanced practice nurse is developing
the care plan for an 8-year-old child with intermittent
explosive disorder. Based on Piaget, which of the
following goals would be appropriate? The child will:

a) connect consequences of his behavior with the behavior itself.

b) generalize the consequences of his anger and aggression to different situations

c) identify situations in which he is likely to feel abandoned.

d) experience an increase in autonomous behavior.

Answer 16

a) connect consequences of his behavior with the behavior itself.

Question 17

21 A client tells the nurse “I always buy St. John’s wort manufactured by Company X so I know what I am getting.” The best response for the nurse would be

a. “That is fine. This will ensure continuity of therapy.”

b. “That is not really necessary because industry standards exist.”

c. “No manufacturing standards exist, so you may get variations even from CompanyX.”

d. “You should really use a drug rather than an herbal preparation to treat your depression.”

Answer 17

ANS: C

No standards for preparation of herbal remedies exist, so dosages may vary widely even in preparations made by one company. Option A: Continuity is not guaranteed. Option D is not advisable because it does not recognize the importance of the alternative treatment to the client.

Question 18

22 A patient tells members of a therapy group, “I hear voices saying my doctor is poisoning me.” Another patient replies, “I used to hear voices too. They sounded real, but I found out later they were not. The voices you hear are not real either.” Which therapeutic factor is exemplified in this interchange?

a. Ventilation
b. Universality
c. Imitative behavior
d. Interpersonal learning

Answer 18

d. Interpersonal learning

Question 19

24 A patient plans to go to the acupuncturist for complementary treatment of alcoholism. He asks the psychiatric advanced practice nurse to explain how acupuncture works. The most accurate response would be that acupuncture is a traditional Chinese medical treatment based on the belief that:

a. pressure on meridian points will correct problems in the patient’s energy flow.

b. the insertion of needles modulates the flow of energy along body meridians.

c. taking very small doses of noxious substances will alleviate specific symptoms.

d. the insertion of needles in key locations will drain away any toxic energy.

Answer 19

b. the insertion of needles modulates the flow of energy along body meridians.

Question 20

27 Which remark by a group participant would the nurse expect during the working stage of group therapy?

a. “My problems are very personal and private. How do I know people in this group will not tell others what you hear?”

b. “I have enjoyed this group. It’s hard to believe that a few weeks ago I couldn’t even bring myself to talk here.”

c. “One thing everyone seems to have in common is that sometimes it’s hard to be honest with those you love most.”

d. “I don’t think I agree with your action. It might help you, but it seems like it would upset your family.”

Answer 20

d. “I don’t think I agree with your action. It might help you, but it seems like it would upset your family.”

ANS: D

In the working stage, members actively interact to help each other accomplish goals, and because trust has developed, conflict and disagreement can be expressed. Focusing on trust and confidentiality typically occur in the orientation phase as part of establishing group norms. Commonality and universality are also themes typically expressed in the orientation phase, whereas reflecting on progress is a task addressed in the termination phase.

Question 21

28 A cognitive strategy the psychiatric advanced practice nurse could use to help a dependent patient would be:

a. avoidance training

b. filling the patient’s pill reminder

c. interpreting the patient’s dream content

d. examining the patient’s fears related to being independent.

Answer 21

d. examining the patient’s fears related to being independent.

Question 22

29 A patient tells the nurse, “I prefer to treat my physical problems with herbs and vitamins. They are natural substances, and natural products are safe.” Which response by the nurse would be most appropriate?

a. “Natural substances tend to be safer than conventional medical remedies.”

b. “Natural remedies give you the idea that you are controlling your treatment.”

c. “The word natural can be a marketing term used to imply a product is healthy, but that’s not always true.”

d. “You should not treat your own physical problems. You should see your health care provider for these problems.”

Answer 22

ANS: C

CAM remedies are usually natural substances, but it is a fallacy that products labeled natural are safer than conventional medicines. Some natural products contain powerful ingredients that can cause illness and damage to the body if taken inappropriately and, for some persons, can be dangerous even when used as directed. This is the most important message for the nurse to convey to the patient. So-called natural substances can have a number have significant side effects. Natural substances may give one the belief that he is controlling his own treatment, but that is not the message that most needs to be communicated here. Many patients can safely self-manage minor physical problems.

Question 23

30 A single parent who is employed full time complains of feelings of inadequacy related to work and family. The parent seeks help from a therapist who specializes in cognitive behavioral therapy. The therapist will treat the parent by:

a. discussing ego states the parent experiences.

b. negatively reinforcing undesirable behaviors.

c. promoting assertive behavior at home and work.

d. helping the parent identify and change faulty thinking.

Answer 23

c. promoting assertive behavior at home and work.

Question 24

31 Support groups differ from self-help groups by:

a. use of a drop-in approach

b. professional leadership

c. theory of empowerment

d. emphasis on mastery

Answer 24

b. professional leadership

Question 25

32 According to Skinner, the definition of operant behavior is an activity that is: a. randomly occurring b. not under an individual's control c. instinctual d. strengthened or weakened by its consequences

Answer 25

d. strengthened or weakened by its consequences

Question 26

34 The primary purpose of group psychotherapy is to facilitate changes by the patient in order to: a. improve vocational functioning b. reduce symptoms of distress c. reduce burden on the family d. address identified problems

Answer 26

d. address identified problems

Question 27

35 According to Beck, negative schemas such as "mind reading" and "catastrophizing" are types of: a. emotional processing b. cognitive distortions c. skills used to maintain adaptive functioning d. skills used to process emotions.

Answer 27

b. cognitive distortions

Question 28

36. A young female member in a therapy group relates to an older female patient as one might to a mother, accusing her of trying to control her whenever the older member offers observations or suggestions to her. Which therapeutic factor of a group is represented by this behavior? a. Instillation of hope b. Existential resolution c. Development of socializing techniques d. Corrective recapitulation of the primary family

Answer 28

d. Corrective recapitulation of the primary family

Question 29

37 According to Dolores Krieger, the premise for therapeutic touch is that healing is promoted by: a. balancing the body's energies b. sense of spirituality c. sense of belonging d. a state of unconsciousness

Answer 29

a. balancing the body's energies https://quizlet.com/891526249/exam-2-nsg-526-flash-cards/

Question 30

38 An advanced practice psychiatric nurses is conducting a therapy session with her patient, who is a student at a local college. The patient tells the nurse that because she failed an important test in school, she will never have an opportunity for good job. Using cognitive theory, the psychiatric advanced practice nurse would identify the patient's misperception as: a. overgeneralization b. minimization c. reaction formation d. dichotomous thinking

Answer 30

A.

Question 31

39 The single most important aspect of an effective leader is that the leader: a. must be able to develop congruent groups b. must be cohesive with the group c. must be able to alter the style of leadership according to the situation d. has the responsibility to see that the group moves according to plans

Answer 31

C

Question 32

40 When a patient wishes to learn more about complementary and alternative therapies (CAM), the psychiatric advanced practice nurse should refer the patient to the: a. American Medical Association b. American Nurses Association c. National League for Nursing d. National Center for Complementary and Alternative Medicine

Answer 32

D. Found in module

Question 33

41 The psychiatric advanced practice nurse is co-leader of a group. The guidelines followed by the leaders include focusing on recognizing dysfunctional behavior and thinking patterns, then identifying and practicing alternative behaviors and thinking that are more adaptive. What theory is represented by this group approach? a. behavioral b. Cognitive-behavioral c. interpersonal d. psychodynamic

Answer 33

b. Cognitive-behavioral The characteristics described are those of cognitive-behavioral therapy, in which patients learn to reframe dysfunctional thoughts and extinguish maladaptive behaviors. Behavioral therapy focuses solely on changing behavior rather than thoughts, feelings, and behaviors together. Interpersonal theory focuses on interactions and relationships. Psychodynamic groups focus on developing insight to resolve unconscious conflicts. https://quizlet.com/171297445/mental-health-nursing-chapter-33-therapeutic-groups-flash-cards/

Question 34

42 the psychiatric advanced practice nurse is teaching a class on stress management. During the session, he is questioned about the use of alternative treatments, such as herbal therapy and therapeutic touch. He explains that the advantage of these methods would include all of the following except: a. they are congruent with many cultural belief systems b. they encourage the consumer to take an active role in health management c. they promote interrelationships within the mind-body-spirit d. they usually work better than traditional medicine practice

Answer 34

d. they usually work better than traditional medicine practice https://quizlet.com/525945211/mental-health-lesson-2-flash-cards/

Question 35

43 A patient asks the psychiatric advanced practice nurse, "What is the major difference between traditional medicine and complementary and alternative therapies (CAM?" The best reply is that traditional medicine: a. focuses on what is done to the patient for treatment, and CAM focuses on body-mind interaction in an actively involved patient b. treats illnesses and is symptom specific, whereas CAM is focused more on health promotion than illness treatment c. is controlled by doctors and the health care industry, but CAM is the people's medicine and not motivated by profit d. has been tested by research and is regulated, but CAM is religiously based and not nearly as regulated

Answer 35

A

Question 36

44 group psychotherapy best correlates to which of Maslow's hierarchy of needs? a. the need for love and belonging b. the need for safety c. the need for self-actualization d. all of the above

Answer 36

a. the need for love and belonging https://quizlet.com/576004920/exam-2-nsg-526-flash-cards/ This correlated to Maslow’s third level in his hierarchy of needs; the need for love and belonging.

Question 37

45 The psychiatric advanced practice nurse is conducting a symptom-management group. Which outcome would be most appropriate for a symptom-management group for persons with schizophrenia? Group members: a. state the names of their medications b. resolve conflicts within their families c. describe ways to cope with their illness d. rate anxiety at least two points lower

Answer 37

c. describe ways to cope with their illness An appropriate psychoeducational focus for patients with schizophrenia is managing their symptoms; coping with symptoms such as impaired memory or impaired reality testing can improve functioning and enhance their quality of life. Names of medications might be appropriate for a medication education group but would be a low priority for symptom management. Addressing intra-family issues would be more appropriate within a family therapy group or possibly a support group. Rating anxiety lower would be an expected outcome for a stress-management group. https://quizlet.com/171297445/mental-health-nursing-chapter-33-therapeutic-groups-flash-cards/

Question 38

46 A patient would benefit from therapy in which peers as well as staff have a voice in determining patient privileges and psychoeducational topics. Which approach would be best? a. milieu therapy b. cognitive therapy c. aversion therapy d. systematic desensitization

Answer 38

a. milieu therapy https://quizlet.com/246199123/chapter-02-relevant-theories-and-therapies-for-nursing-practice-flash-cards/

Question 39

47 Psychotherapy groups most often employ this leadership style? a. laissez-faire leader b. democratic c. autocratic d. communistic

Answer 39

b. democratic https://quizlet.com/851115584/clinical-modalities-exam-2-flash-cards/

Question 40

48. Characteristics of cognitive-behavioral therapy include: (Select all that apply) a. Not time limited b. active c. directive d. collaborative e. unstructured

Answer 40

b. active c. directive d. collaborative ***not A or E + Collaborative + Structured and active + Time-limited and brief + Empirical + Problem-oriented https://quizlet.com/603297549/cognitive-behavior-therapy-2-distinctive-characteristics-of-cbt-flash-cards/

Question 41

49 The psychiatric advanced practice nurse is reviewing the various types of groups available on the unit. One group adds new members as others leave. The psychiatric advanced practice nurse recognizes this type of group as a(n) _________ group. a. closed b. homogenous c. open d. heterogenous

Answer 41

c. open https://quizlet.com/171297445/mental-health-nursing-chapter-33-therapeutic-groups-flash-cards/

Question 42

50 A group has two more sessions before it ends. One member who previously has been vocal and has shown much progress has grown silent. What explanation most likely underlies his current silence? a. He has said what is on his mind and now has nothing more to offer b. He wants to give quieter members a chance to talk in the time remaining c. Quiet members are dominating now in order to talk more before group ends d. He is having trouble dealing with his feelings about the group's ending

Answer 42

d. He is having trouble dealing with his feelings about the group's ending A chief task during the termination phase of a group is to take what has been learned in group and transition to life without the group. The end of a group can be a significant loss for members, who may experience loss and grief and respond with sadness or anger. It is unlikely he would have nothing to say; at the very least, he could be responding to the comments of others even if not focusing on his own issues. He may wish to give quieter members a chance to talk, but again, this would not require or explain his complete silence. Some members, faced with only two remaining sessions, may be becoming more dominant under this pressure of time, but here too this is unlikely to lead a previously active participant to fall completely silent. The member is not attention-seeking. https://quizlet.com/251657495/chapter-33-therapeutic-groups-flash-cards/

Question 43

01 Which of the following is an essential principle of cognitive behavioral therapy? a. recognizing and accepting automatic thoughts b. recognizing and changing automatic thoughts c. seeing reality as the provider sees it d. changing reality through environmental restructuring.

Answer 43

??? B CHARACTERISTICS & PRINCIPLES: The therapist needs to be aware of his/her own possibly dysfunctional cognitions. Negative thinking makes problem-solving difficult. Thinking is learned and can be changed. Different thinking leads to changed emotions. The client needs to learn the following: Monitor his/her negative, automatic thoughts (cognitions) Recognize the connections between cognition, affect, and behavior Examine the evidence for and against his/her distorted automatic thoughts Substitute more reality-oriented interpretations for these biased cognitions Identify and alter dysfunctional beliefs which predispose them to distort his/her experiences https://live.wilkes.edu/d2l/le/content/350878/viewContent/4084851/View

Question 44

03 The primary use of yoga is to: a. promote healing b. promote relaxation c. enhance spirituality d. relieve pain

Answer 44

????? B? By controlling breathing and holding the body in steady poses, yoga creates body, mind, and spirit harmony and promotes relaxation. https://live.wilkes.edu/d2l/le/content/350878/viewContent/4084858/View

Question 45

09 A distinguishing characteristic of the self-help group is its: a. heterogeneity b. stability c. homogeneity d. lack of initiative

Answer 45

C.

Question 46

12 What is the major assumption of cognitive therapy? a. clients know their perceptions are wrong b. attachments are critical components to approach c. distorted thinking contributes to and maintains behaviors d. all of the above

Answer 46

C https://live.wilkes.edu/d2l/le/content/350878/viewContent/4084851/View Topic B: Overview of Cognitive Therapy

Question 47

23 In order for a patient to truly benefit from milieu therapy, which of the following initial conditions must be met? a. voluntary participation b. consistent and fairly delivered therapy c. approach should be empathetic, include accurate information, and proper orientation to the unit d. supported by the patient's family

Answer 47

????? C? Seems to be the most correct answer

Question 48

25 Which of the following underlying assumptions will the psychiatric advanced practice nurse use in the planning of behavioral approaches? a. behavior is separate from the individual b. behavior results from the unconscious c. all behavior is meaningful d. all behavior is learned

Answer 48

D The module implies D is the correct answer.

Question 49

26 During the group sessions, a member states, "In my experience, I've always tried to give myself some time away from the situation. After all, everybody needs some rest and relaxation." The PMHNP interprets the statement as indicating that the member is assuming which of the following group roles? a. harmonizer b. gatekeeper c. opinion giver d. information giver

Answer 49

D https://live.wilkes.edu/d2l/le/content/350878/viewContent/4084841/View could be D, information giver?

Question 50

33 The PMHNP understands that elements of Cognitive Behavioral Therapy (CBT) inform dialectical behavioral therapy (DBT). Which of the following are characteristic of DBT? a. learned behavior, homework, and emotional regulation b. systematic desensitization, reintegration, attachment c. reduction, systematic desensitization, aversion therapy d. aversion therapy, mindfulness, systematic desensitization

Answer 50

A https://www.goodtherapy.org/learn-about-therapy/types/dialectical-behavioral-therapy For example, if someone participates in multiple treatment programs within one agency, the therapist might make sure each program was set up to reinforce all the positive skills and behaviors learned. The groups are designed to help those in treatment develop behavioral skills through group work and homework assignments. Capability enhancement. DBT provides opportunities for the development of existing skills. In treatment, four basic skill sets are taught. These are emotion regulation, mindfulness, interpersonal effectiveness, and distress tolerance.