Chapter 28: Psychotherapies
MULTIPLE CHOICE
1. Which intervention best reflects the nursing role regarding effective implementation of
behavioral therapy goals?
a. Administering the prescribed medications accurately
b. Interacting effectively with members of the health care team
c. Being aware of all the patient related therapeutic modalities
d. Evaluating patient behaviors to reward economic tokens appropriately
ANS: D
The primary role of the nurse who is involved in behavioral therapy is to assess and identify the
patients problem behaviors in collaboration with the multidisciplinary team. A token economy is
a system of behavior reinforcements in which patients earn tokens by performing predetermined
desired behaviors. The remaining options are generalized responsibilities that are relevant to any
therapy format.
2. A new nurse asks the mentor, How can I be sure Im developing a therapeutic environment for
my unit? The mentor uses as a basis for the response the fact that a therapeutic milieu is
characterized by:
a. Rigid adherence to timelines and unit routine
b. Relaxation of boundaries when doing so is accepted by all
c. The focus of the staff is directed to the most critically disturbed patients
d. Specific patient-centered goals are established mutually by patient and staff
ANS: D
Factors that determine the therapeutic effectiveness of the social environment includes the
presence of two-way communication between the patients and the members of the
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,multidisciplinary team for purposes of goal setting. In a therapeutic relationship, boundaries are
established early and maintained throughout and although adherence to routine is important,
there is room for adjustment when it benefits the therapeutic nature of the milieu. Although
short-term attention may require focus on the patient in crisis, attention of the staff is equally
shared.
3. To plan care for a patient with a psychiatric disorder, the nurse keeps in mind that the primary
nursing role related to therapeutic activities is:
a. Assisting the patient in accomplishing the activity
b. Ensuring that the patient will comply with the rules of the activity
c. Ensuring that the patient can accomplish the activity in a timely manner
d. Providing a support system for the patient if they fail to complete the activity
ANS: A
The nurses role in therapeutic activities is that of a professional observer and participant who
works with the therapist to enhance the patients capabilities and functioning within the
parameters of the assigned activity. Assuring accomplishment, compliance, or providing failure
support are not nursing roles.
4. Which statement would the nurse use to describe the primary purpose of boundaries?
a. Boundaries define responsibilities and duties to ones self in relation to others.
b. Boundaries determine objectives of the various working stage of the relationship.
c. Boundaries differentiate the assumed roles of both the nurse and of the patient.
d. Boundaries prevent undesired material from emerging during the interaction.
ANS: A
Boundaries are the social, physical, and emotional limits of the interaction. As such, they serve
to define the responsibilities and duties of the nurse in relation to the patient. Objectives and
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,roles are determined during the orientation stage. Emergence of undesired material may be a
significant issue for the patient.
5. Which action will best facilitate the development of trust between a nurse and patient?
a. Responding positively to the patients demands
b. Following through with whatever was promised
c. Clarifying with the patient whenever there is doubt
d. Staying available to the patient for the entire shift
ANS: B
Being consistent in keeping ones word implies that the nurse is trustworthy and does what is
agreed upon. Being responsive to demands may not be therapeutic. Instead, the patient will need
to learn new techniques for meeting needs. Clarification is important but is not the best method
for promoting trust. Trust is better served by shorter contacts at agreed-upon intervals.
6. Which statement best defines the nurses initial role as the patients source of help in addressing
interpersonal problems?
a. Ill work with your doctor to help you get better.
b. Ill be working with you to help solve your marital troubles.
c. Your medications will help you feel better as soon as they take effect.
d. You will be expected to attend the group activities while you are here.
ANS: B
This statement clearly specifies the nurses purpose as a helping professional, and establishes the
relationship as therapeutic, rather than social. The nurse has independent functions and does not
work exclusively with the doctor. Identifying only medication overlooks the contributions of
staff and the therapeutic milieu. Giving information is appropriate, but this statement does not
define the nurses role as resource.
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, 7. The nurse is determining whether the patients needs could be best met in a task or a process
group. The decision is based on the understanding that a task group focuses on:
a. Content issues
b. The here and now
c. Communication styles
d. Relations among the members
ANS: A
Content-oriented groups focus on goals and tasks of the group. Thus a task-oriented group would
focus on content issues. Process groups focus on interpersonal relationships. Communication
styles are not relevant to describing task-oriented groups. Here and now refers to dealing with
issues that are taking place at the present time.
8. The treatment team was engaged in planning how group therapy could be included as a part of
the structured daily activities of the unit. A new team member asked, Why is it so important to
include group therapy for the patients? The most accurate response would be based on the
assumption that:
a. Hidden agendas frequently surface in group sessions.
b. Some persons do not relate well on an individual basis.
c. Group therapy is far more cost-effective for the patients.
d. Psychopathology has its source in disordered relationships.
ANS: D
A key assumption of group therapy is that psychopathology has its source in disordered
relationships. It follows that individuals will behave in the group as they do in other settings, so
group provides an opportunity to help individuals develop more functional relationships. Ability
to relate is not relevant to group work. It is dealt with in one-to-one therapy. Hidden agenda is
not a reason to offer group therapy. Cost-effectiveness is not an assumption about the reason
group therapy is effective.
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MULTIPLE CHOICE
1. Which intervention best reflects the nursing role regarding effective implementation of
behavioral therapy goals?
a. Administering the prescribed medications accurately
b. Interacting effectively with members of the health care team
c. Being aware of all the patient related therapeutic modalities
d. Evaluating patient behaviors to reward economic tokens appropriately
ANS: D
The primary role of the nurse who is involved in behavioral therapy is to assess and identify the
patients problem behaviors in collaboration with the multidisciplinary team. A token economy is
a system of behavior reinforcements in which patients earn tokens by performing predetermined
desired behaviors. The remaining options are generalized responsibilities that are relevant to any
therapy format.
2. A new nurse asks the mentor, How can I be sure Im developing a therapeutic environment for
my unit? The mentor uses as a basis for the response the fact that a therapeutic milieu is
characterized by:
a. Rigid adherence to timelines and unit routine
b. Relaxation of boundaries when doing so is accepted by all
c. The focus of the staff is directed to the most critically disturbed patients
d. Specific patient-centered goals are established mutually by patient and staff
ANS: D
Factors that determine the therapeutic effectiveness of the social environment includes the
presence of two-way communication between the patients and the members of the
HTTPS://PASINGGRADES.COM/
,multidisciplinary team for purposes of goal setting. In a therapeutic relationship, boundaries are
established early and maintained throughout and although adherence to routine is important,
there is room for adjustment when it benefits the therapeutic nature of the milieu. Although
short-term attention may require focus on the patient in crisis, attention of the staff is equally
shared.
3. To plan care for a patient with a psychiatric disorder, the nurse keeps in mind that the primary
nursing role related to therapeutic activities is:
a. Assisting the patient in accomplishing the activity
b. Ensuring that the patient will comply with the rules of the activity
c. Ensuring that the patient can accomplish the activity in a timely manner
d. Providing a support system for the patient if they fail to complete the activity
ANS: A
The nurses role in therapeutic activities is that of a professional observer and participant who
works with the therapist to enhance the patients capabilities and functioning within the
parameters of the assigned activity. Assuring accomplishment, compliance, or providing failure
support are not nursing roles.
4. Which statement would the nurse use to describe the primary purpose of boundaries?
a. Boundaries define responsibilities and duties to ones self in relation to others.
b. Boundaries determine objectives of the various working stage of the relationship.
c. Boundaries differentiate the assumed roles of both the nurse and of the patient.
d. Boundaries prevent undesired material from emerging during the interaction.
ANS: A
Boundaries are the social, physical, and emotional limits of the interaction. As such, they serve
to define the responsibilities and duties of the nurse in relation to the patient. Objectives and
HTTPS://PASINGGRADES.COM/
,roles are determined during the orientation stage. Emergence of undesired material may be a
significant issue for the patient.
5. Which action will best facilitate the development of trust between a nurse and patient?
a. Responding positively to the patients demands
b. Following through with whatever was promised
c. Clarifying with the patient whenever there is doubt
d. Staying available to the patient for the entire shift
ANS: B
Being consistent in keeping ones word implies that the nurse is trustworthy and does what is
agreed upon. Being responsive to demands may not be therapeutic. Instead, the patient will need
to learn new techniques for meeting needs. Clarification is important but is not the best method
for promoting trust. Trust is better served by shorter contacts at agreed-upon intervals.
6. Which statement best defines the nurses initial role as the patients source of help in addressing
interpersonal problems?
a. Ill work with your doctor to help you get better.
b. Ill be working with you to help solve your marital troubles.
c. Your medications will help you feel better as soon as they take effect.
d. You will be expected to attend the group activities while you are here.
ANS: B
This statement clearly specifies the nurses purpose as a helping professional, and establishes the
relationship as therapeutic, rather than social. The nurse has independent functions and does not
work exclusively with the doctor. Identifying only medication overlooks the contributions of
staff and the therapeutic milieu. Giving information is appropriate, but this statement does not
define the nurses role as resource.
HTTPS://PASINGGRADES.COM/
, 7. The nurse is determining whether the patients needs could be best met in a task or a process
group. The decision is based on the understanding that a task group focuses on:
a. Content issues
b. The here and now
c. Communication styles
d. Relations among the members
ANS: A
Content-oriented groups focus on goals and tasks of the group. Thus a task-oriented group would
focus on content issues. Process groups focus on interpersonal relationships. Communication
styles are not relevant to describing task-oriented groups. Here and now refers to dealing with
issues that are taking place at the present time.
8. The treatment team was engaged in planning how group therapy could be included as a part of
the structured daily activities of the unit. A new team member asked, Why is it so important to
include group therapy for the patients? The most accurate response would be based on the
assumption that:
a. Hidden agendas frequently surface in group sessions.
b. Some persons do not relate well on an individual basis.
c. Group therapy is far more cost-effective for the patients.
d. Psychopathology has its source in disordered relationships.
ANS: D
A key assumption of group therapy is that psychopathology has its source in disordered
relationships. It follows that individuals will behave in the group as they do in other settings, so
group provides an opportunity to help individuals develop more functional relationships. Ability
to relate is not relevant to group work. It is dealt with in one-to-one therapy. Hidden agenda is
not a reason to offer group therapy. Cost-effectiveness is not an assumption about the reason
group therapy is effective.
HTTPS://PASINGGRADES.COM/
