A nurse practitioner uses cognitive behavior therapy with depressed clients. The nurse asks clients to keep a daily record of dysfunctional thoughts (DRDT). Which of the following are appropriate nursing replies to a client asking about the purpose of this exercise? Select all that apply.
“The purpose of this exercise is to identify automatic thoughts.”
“The purpose of this exercise is to monitor thoughts related to self-esteem.”
“The purpose of this exercise is to eliminate irrational beliefs.”
“The purpose of this exercise is to identify rational alternatives.”
“The purpose of this exercise is to modify cognitive errors.”
Correct Answer : A,B,D,E
Choice A reason: Automatic thoughts are the immediate, often unconscious responses that individuals have to situations. In depression, these thoughts are frequently negative and distorted. Identifying them is a cornerstone of cognitive behavior therapy because it allows the client to recognize patterns that contribute to their mood disturbances. By recording these thoughts daily, the nurse helps the client become aware of triggers and maladaptive responses.
Choice B reason: Monitoring thoughts related to self-esteem is appropriate because depression often involves pervasive feelings of worthlessness and low self-worth. Keeping a record allows the client to see how frequently these thoughts occur and how they influence emotions and behaviors. This monitoring provides data for the therapist and client to challenge and restructure these negative self-perceptions.
Choice C reason: Eliminating irrational beliefs is not the direct purpose of the DRDT exercise. While CBT does aim to challenge irrational beliefs, the exercise focuses more on identifying and restructuring thoughts rather than outright elimination. The process is gradual and involves replacing distorted cognitions with healthier alternatives, not simply erasing them.
Choice D reason: Identifying rational alternatives is a key goal of CBT. Once dysfunctional thoughts are recognized, clients are guided to generate more balanced, rational interpretations of events. This helps reduce emotional distress and promotes adaptive coping strategies. The DRDT provides the raw material for this restructuring process.
Choice E reason: Modifying cognitive errors is central to CBT. Cognitive errors such as overgeneralization, catastrophizing, or personalization are common in depression. By recording daily thoughts, clients and nurses can pinpoint these distortions and work to correct them. This modification reduces depressive symptoms and improves functioning.
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Related Questions
Correct Answer is D
Explanation
Choice A reason: Obedience to authority is characteristic of the Pre-conventional level, where moral reasoning is based on avoiding punishment or gaining rewards.
Choice B reason: Personal interest also reflects the Pre-conventional level, where actions are guided by self-interest rather than societal norms.
Choice C reason: Universal ethical principles are part of the Post-conventional level, where moral reasoning is guided by internalized principles of justice and equality.
Choice D reason: Social approval reflects the Conventional level, where individuals conform to social norms and laws to gain approval from others and maintain social order.
Correct Answer is ["B","C","E"]
Explanation
Choice A reason: Sliced bananas are soft and appropriately sized for a 10-month-old, posing minimal choking risk.
Choice B reason: Whole grapes are a common choking hazard for infants and should be avoided or cut into small pieces.
Choice C reason: Hot dogs, especially in rounds, are firm and slippery, posing a high choking risk.
Choice D reason: Large chunks of raw vegetables are also a choking risk; caregivers should offer soft, appropriately sized pieces.
Choice E reason: Popcorn is a major choking hazard for infants and young children and should be avoided entirely.
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