A client with depression states, “I’m a complete failure. Everything I do goes wrong.” This is an example of which cognitive distortion?

All-or-nothing thinking

Overgeneralization

Catastrophizing

Personalization

Answer and Explanation

The Correct Answer is B

Overgeneralization occurs when a person interprets a single event as a never-ending pattern of defeat. It is a common maladaptive thought seen in depression, reinforcing hopelessness. This type of distortion leads to pervasive negativity based on limited experiences.

Rationale for correct answers

B. Global conclusions based on single events define overgeneralization, as seen in the client’s sweeping negative statements.

Rationale for incorrect answers

A. All-or-nothing thinking involves viewing things as all good or all bad, not repeated failure.

C. Catastrophizing exaggerates possible outcomes, not patterns of failure.

D. Personalization blames oneself for external events, not generalizing failure.

Take Home Points

Overgeneralization is a key cognitive distortion in depression.
It leads to irrational global beliefs based on one event.
Differentiating among distortions is vital for cognitive therapy.
Identifying thinking errors helps restructure thought patterns.

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Correct Answer is A

Explanation

In a therapeutic milieu, rules are necessary for safety and therapeutic function. They are designed to protect both clients and staff, reduce chaos, and model appropriate behavior. Structure promotes emotional containment and teaches self-control, especially in clients with impaired judgment or impulse control.

Rationale for correct answers

A. Safety maintenance is the central reason for rules, especially in psychiatric environments where behavioral dysregulation may occur.

Rationale for incorrect answers

B. Order is a benefit but not the primary purpose.

C. Rules help treatment indirectly, but their immediate goal is client protection.

D. Rules are implemented by staff but designed for therapeutic purpose, not just team preference.

Take Home Points

Rules maintain physical and psychological safety in mental health settings.
They are essential to therapeutic consistency and boundary setting.
Safety takes priority over order or convenience.
Clients benefit from predictable, enforced limits.

A. De-escalate the client’s agitation. B. Provide for a safe, therapeutic milieu. C. Assess the client’s agitation level. D. Eliminate the source of agitation.

Correct Answer is A

Explanation

Aggression management in psychiatric settings focuses on early intervention through de-escalation techniques before behavior becomes violent. Recognizing early agitation signs allows verbal redirection, setting limits, and reducing stimulation. Addressing the escalation quickly prevents injury and maintains a safe milieu.

Rationale for correct answers

A. Early de-escalation and verbal intervention are best to prevent physical aggression, allowing the client to regain control before becoming violent.

Rationale for incorrect answers

B. While a therapeutic milieu is important, it is not an immediate response to active agitation.

C. Assessing agitation is already evident and should not delay action to de-escalate.

D. Eliminating the source may not be immediately possible and is secondary to calming the client.

Take Home Points

Immediate response to aggression is de-escalation.
Early recognition prevents escalation to violence.
Staff should use calm, clear communication.
Environmental and emotional triggers should be addressed after safety is ensured.

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A client with depression states, “I’m a complete failure. Everything I do goes wrong.” This is an example of which cognitive distortion?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is providing care for a client in a therapeutic milieu. The client asks, “Why do we have to follow all these rules?” The best response by the nurse is:

Correct Answer is A

Explanation

A nurse observes a client who has a history of aggressive behavior toward others swearing and kicking the furniture in the dayroom. Based on the client’s behavior, what should be the nurse’s priority of care?

Correct Answer is A

Explanation

A client recently diagnosed with depression tells a nurse that she is 2 months pregnant and is reluctant to take an antidepressant medication. The client asks what other treatment options are available. Which type of therapy should a nurse recommend as an alternate treatment for depression?

The nurse is teaching a client with an eating disorder about cognitive restructuring. Which statement by the client indicates understanding of this technique?

Which of the following best describes the goal of cognitive therapy?

The primary goal of cognitive therapy is to help clients:

A client states: “My husband didn’t call me today. He must be having an affair.” Which of the following cognitive distortions is the client exhibiting?

The nurse is implementing operant conditioning with a client who has a substance use disorder. Which intervention is an example of positive reinforcement?

A nurse is evaluating a client who threatens suicide. The nurse’s primary responsibility to the client is to provide a safe, therapeutic environment. Which nursing intervention is most effective in establishing a safe environment for the client?