2204 Behavior Therapy
Test 2 Psych NCLEX style questions
Terms in this set (20)
A kindergarten rule states that if unacceptable behavior occurs, a child's personalized fish will be moved to the sea grass. Children who behave keep their fish out of the sea grass. The school nurse should identify this intervention as based on which principle of behavior therapy?
A. Classical conditioning
B. Conditioned response
C. Positive reinforcement
D. Negative reinforcement
Negative reinforcement is increasing the probability that behavior (appropriate classroom behavior) will recur by removal of an undesirable reinforcing stimulus (personalized fish in sea grass).
An adolescent comes from a dysfunctional family where physical and verbal abuse prevail. At school this adolescent bullies and fights with classmates. Based on principles of behavior therapy, what is the probable source of this behavior?
C. Premack principle
D. Reciprocal inhibition
Modeling is the learning of new behaviors by imitating the behaviors of others. This adolescent, witnessing physical and verbal abuse in the home, models this behavior in school.
A third-grader feigns illness in order to avoid doing homework. The teacher recommends an educational program that uses a token economy. How should a school nurse explain a token economy to this child's parent?
A. "Your child will receive green tokens for completing homework that can be cashed in for desired rewards."
B. "Your child will receive red tokens when homework is incomplete and this will result in school suspension."
C. "Your child will receive a time out for each homework assignment not completed."
D. "Your child, with your assistance, will envision receiving rewards for completed homework."
In a token economy, tokens are a form of contingency contracting in that tokens immediately reinforce appropriate behavior (completed homework) and are exchanged later for a desired reward.
A client is diagnosed with an anxiety disorder. The nurse counselor recommends intervention with the behavioral technique of reciprocal inhibition. The client asks, "What's that?" Which is the most appropriate nursing reply?
A. "At the beginning of this intervention, a contract will be drawn up explicitly stating the behavior change agreed upon."
B. "By introducing an adaptive behavior that is mutually exclusive to your maladaptive behavior, we will expect subsequent behavior to improve."
C. "Through a series of increasingly anxiety-provoking steps, we will gradually increase your tolerance to anxiety."
D. "In one intense session, you will be exposed to a maximum level of anxiety that you will learn to tolerate."
Reciprocal inhibition decreases or eliminates an undesired behavior by introducing a more adaptive behavior that is incompatible with the undesired behavior.
A client reports, "My friend panicked at the site of spiders. Her therapist used gradual exposure to spiders that initially made her increasingly more anxious." Which technique was the friend's therapist most likely using?
B. Covert sensitization
C. Systematic desensitization
D. Reciprocal inhibition
Systematic desensitization is a treatment for phobias in which a phobic individual is gradually exposed to increasing amounts of the phobic stimulus while practicing relaxation techniques. Eventually, the phobic stimulus causes little or no anxiety.
A 2-year-old engages in frequent temper tantrums that usually result in the parents giving in to demands. During family therapy, how should a nurse counsel the parents?
A. "You are shaping your child's behavior."
B. "Your child has modeled your behavior."
C. "You are positively reinforcing your child's behavior."
D. "You are negatively reinforcing your child's behavior."
A child always chooses to ask mother over father when seeking special privileges. The father is more apt to disagree than agree with the child's requests while the mother usually consents. The child's choice is the result of which component of operant conditioning?
A. Conditioned stimuli
B. Unconditioned stimuli
C. Aversive stimuli
D. Discriminative stimuli
This child is able to discriminate between stimuli. This child can predict with assurance that asking mother (not father) will result in a desired response.
Parents decide to try the nurse practitioner's suggestion of time out when their child misbehaves. What teaching should the nurse practitioner provide the parents?
A. "Correct your child's behavior by using social isolation."
B. "Ignore the child's negative behavior."
C. "Add positive reinforcement for acceptable behavior."
D. "Temporarily move your child to an area where behavior is not being reinforced."
A time out is an aversive stimulus or punishment during which the client is removed from the environment where the unacceptable behavior is occurring. Usually during a time out, the person is temporarily isolated so there is no reinforcing attention. This discourages a reoccurrence of the undesired behavior.
Parents of a 3-year-old have noticed an improvement in behavior because of using a "time out" behavioral approach. What aspect of "time out" therapy may be responsible for this child's improved behavior?
A. "Negative reinforcement discourages maladaptive behavior."
B. "Positive reinforcement is removed."
C. "Covert sensitization is being applied.
D. "Reciprocal inhibition is eliminated."
In a "time out," the positive reinforcement of attention is removed from the child during inappropriate behavior.
A client is in therapy with a nurse practitioner for the treatment of arachnophobia. The nurse practitioner decides to use the technique of "flooding." Which intervention best exemplifies this technique?
A. Giving rewards for demonstrating a decrease in fear of spiders
B. Encouraging the client to sit through the movie "Spiderman"
C. Accompanying the client to a 1-hour visit to the local zoo's spider room
D. Offering a computer program that progressively presents anxiety-producing spider scenarios
Visiting the spider room would flood the client with the phobic stimuli of real spiders. This would continue until the stimulus no longer creates anxiety.
During a smoking cessation group, the community health nurse explains that in their effort to quit smoking, a reciprocal inhibition approach will be used. The nurse should give the group which example of this technique?
A. "Before you can smoke, you must first take a half-hour walk."
B. "When you have the urge to smoke, imagine being short of breath."
C. "You'll receive $1 for each cigarette not smoked and forfeit $2 for each cigarette smoked."
D. "When you have the urge to smoke, hold your breath, then rhythmically breathe."
These breathing exercises cannot be done while the client smokes. Therefore, they decrease or eliminate the undesired behavior (smoking) that is incompatible with the desired behavior (smoking cessation). This is an example of the behavior therapy of reciprocal inhibition.
A mother states, "You are old enough to clean your own bedroom." Later inspection finds the floor clear, but with everything stacked in a chair. The mother praises the child for clearing the floor. This is consistent with which technique of behavior modification?
C. Stimulus generalization
D. Reciprocal inhibition
In shaping, behavior is molded in a desired direction by reinforcing each small step toward the desired behavior. The child is praised for clearing the floor, the first step toward cleaning the room.
During hospitalization, an attention-seeking client has repeatedly cut self. After threatening to cut self again, the nurse states, "Here are some Band-Aids so you won't bleed on the sheets." Which is the underlying reason for this nurse's response?
A. The nurse is using an aversive stimulus in response to the client's manipulative cutting behavior.
B. The nurse is using negative reinforcement in response to the client's behavior.
C. The nurse is minimizing reinforcement of the client's manipulative behavior with the goal of extinction.
D. The nurse lacks empathy for the client's recurring self-injurious behavior.
Extinction is the gradual decrease in frequency or disappearance of a response when a positive reinforcement is withheld. The nurse is withholding attention to the client who is exhibiting manipulative, attention-seeking behavior. The lack of positive response (attention) should cause extinction of the undesired behavior.
A nursing instructor is teaching about the behavior technique of modeling. When asked to give an example of this behavioral intervention, which student statement meets the learning objective?
A. "A child is first rewarded for using a spoon to eat and then rewarded for using a fork, and finally rewarded for cutting food with a knife."
B. "An adolescent imitates Dad by using and caring for tools appropriately."
C. "A client and therapist agree to conditions of therapy stating explicitly in writing the behavior change that is desired."
D. "A mother tells her child that television can be watched only after homework is completed."
Modeling refers to the learning of new behaviors by imitating the behavior of others.
A mother tells her teenager that in order for college tuition to be paid, the teenager must quit smoking. They develop a written agreement stipulating time frames and consequences. This is an example of which technique of behavior modification?
D. Premack principle
Contracting occurs when the mother and teenager together develop a written agreement related to desired behavior (smoking cessation) and positive reinforcement (paid college tuition).
When asked to identify principles that define the term "maladaptive behavior," which nursing student statement indicates that further teaching is needed?
A. "Behavior is maladaptive when it is age inappropriate."
B. "Behavior is maladaptive when it interferes with adaptive functioning."
C. "Behavior is maladaptive when others misunderstand it related to cultural inappropriateness."
D. "Behavior is maladaptive when there is environmental interaction with genetic endowment."
Adaptive, not maladaptive, behaviors occur through learning processes or, more correctly, through the interaction of the environment with an individual's genetic endowment.
Which assumption is most reflective of a behavioral theory model?
A. Mental illness is characterized by structural and biochemical alterations.
B. Thought processes influence behaviors.
C. All personality development has a social context.
D. There is a basic relationship between stimulus and response.
That there is a basic relationship between stimulus and response is an assumption of a behavioral theory model. The connection between a stimulus and a response is strengthened or weakened by the consequences of the response.
A nurse should recognize which intervention as most appropriate within a behavioral therapy program?
A. A child is given a Popsicle for staying dry and clean.
B. A child is put in time-out after soiling his or her undergarments.
C. A child is allowed to remain in soiled undergarments.
D. A child is taught the advantages of staying dry and clean.
A stimuli that follows a behavior or response is called a reinforcing stimulus or reinforcer. The reward of a Popsicle is a reinforcer for the child staying dry and clean. This is an example of operant conditioning, a form of behavioral therapy.
An adolescent client was recently admitted to the psychiatric unit because of impulsivity and acting-out behavior at school. The nurse should initially implement which nursing action?
A. Redirect the client to activities to decrease stress.
B. Explain the unit rules and consequences of breaking the rules.
C. Place the client on close observation to insure a trusting relationship.
D. Administer an anti-anxiety medication.
It is important for the nurse to initially explain the unit rules and consequences of breaking the rules. It is imperative that consequences of rule infractions are explained early in treatment to avoid misunderstanding and manipulation.
According to behavioral theory, the treatment of phobic symptoms should involve which action?
A. The manipulation of the environment
B. The use of desensitization
C. The use of family therapy
D. The uncovering of past events
Systematic desensitization is a technique for assisting individuals to overcome their fear of a phobic stimulus. It is "systematic" in that there is a hierarchy of anxiety-producing events through which the individual progresses during therapy.
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