Question 1

A 26-month-old child displays negative behavior, refuses toilet training, and often shouts, "No!" when given direction. The nurse's counseling with the parent should be based on the premise that the child is engaged in which of Erikson's psychosocial crises?

Accepted Answer

A)   Trust versus Mistrust
B)   Initiative versus Guilt
C)   Industry versus Inferiority
D)   Autonomy versus Shame and Doubt D

Question 2

Cognitive behavioral therapy was provided for a patient who frequently said, "I'm stupid." Which statement by the patient indicates the therapy was effective?

Accepted Answer

A)   "I'm disappointed in my lack of ability."
B)   "I always fail when I try new things."
C)   "Things always go wrong for me."
D)   "Sometimes I do stupid things." D

Question 3

A nurse uses Maslow's hierarchy of needs to plan care for a psychotic patient. Which problem will receive priority? The patient:

Accepted Answer

A)   refuses to eat or bathe.
B)   reports feelings of alienation from family.
C)   is reluctant to participate in unit social activities.
D)   needs to be taught about medication action and side effects. A

Question 4

A cognitive strategy a nurse could use to assist a very dependent patient would be to help the patient:

Accepted Answer

A)   reveal dream content.
B)   take prescribed medications.
C)   examine thoughts about being autonomous.
D)   role model ways to ask for help from others.

Question 5

A 26-month-old child displays negative behaviors. The parent says, "My child refuses toilet training and shouts, 'No!' when given direction. What do you think is wrong?" Select the nurse's best reply.

Accepted Answer

A)   "This is normal for your child's age. The child is striving for independence."
B)   "The child needs firmer control. Punish the child for disobedience and say, 'No.'"
C)   "There may be developmental problems. Most children are toilet trained by age 2 years."
D)   "Some undesirable attitudes are developing. A child psychologist can help you develop a remedial plan."

Question 6

Operant conditioning will be used to encourage speech in a child who is nearly mute. Which technique would a nurse include in the treatment plan?

Accepted Answer

A)   Ignore the child for using silence.
B)   Have the child observe others talking.
C)   Give the child a small treat for speaking.
D)   Teach the child relaxation techniques, then coax speech.

Question 7

A patient underwent psychotherapy weekly for 3 years. The therapist used free association, dream analysis, and facilitated transference to help the patient understand unconscious processes and foster personality changes. Which type of therapy was used?

Accepted Answer

A)   Short-term dynamic psychotherapy
B)   Transactional analysis
C)   Cognitive therapy
D)   Psychoanalysis

Question 8

A patient comments, "I never know the right answer" and "My opinion is not important." Using Erikson's theory, which psychosocial crisis did the patient have difficulty resolving?

Accepted Answer

A)   Initiative versus Guilt
B)   Trust versus Mistrust
C)   Autonomy versus Shame and Doubt
D)   Generativity versus Self-Absorption

Question 9

A basic level registered nurse works with patients in a community setting. Which groups should this nurse expect to lead? (Select all that apply.)

Accepted Answer

A)   Symptom management
B)   Medication education
C)   Family therapy
D)   Psychotherapy
E)   Self-care

Question 10

An adult expresses the wish to be taken care of and often behaves in a helpless fashion. This adult has needs related to which of Freud's stages of psychosexual development?

Accepted Answer

A)   Latency
B)   Phallic
C)   Anal
D)   Oral

Question 11

A 4-year-old child grabs toys from siblings, saying, "I want that toy now!" The siblings cry, and the child's parent becomes upset with the behavior. Using the Freudian theory, a nurse can interpret the child's behavior as a product of impulses originating in the:

Accepted Answer

A)   id.
B)   ego.
C)   superego.
D)   preconscious.

Question 12

A nurse psychotherapist works with an anxious, dependent patient. The therapeutic strategy most consistent with the framework of psychoanalytic psychotherapy is:

Accepted Answer

A)   emphasizing medication compliance.
B)   identifying the patient's strengths and assets.
C)   offering psychoeducational materials and groups.
D)   focusing on feelings developed by the patient toward the nurse.

Question 13

A nurse listens to a group of recent retirees. One says, "I volunteer with Meals on Wheels, coach teen sports, and do church visitation." Another laughs and says, "I'm too busy taking care of myself to volunteer. I don't have time to help others." These comments contrast which developmental tasks?

Accepted Answer

A)   Trust versus Mistrust
B)   Industry versus Inferiority
C)   Intimacy versus Isolation
D)   Generativity versus Self-Absorption

Question 14

A person tells a nurse, "I was the only survivor in a small plane crash, but three business associates died. I got anxious and depressed and saw a counselor three times a week for a month. We talked about my feelings related to being a survivor, and now I'm fine, back to my old self." Which type of therapy was used?

Accepted Answer

A)   Milieu therapy
B)   Psychoanalysis
C)   Behavior modification
D)   Interpersonal therapy

Question 15

Which patient statement would lead a nurse to suspect that the developmental task of infancy was not successfully completed?

Accepted Answer

A)   "I have very warm and close friendships."
B)   "I'm afraid to let anyone really get to know me."
C)   "I am always right and confident about my decisions."
D)   "I'm ashamed that I didn't do it correctly in the first place."

Question 16

A nurse supports parental praise of a child who is behaving in a helpful way. When the individual behaves with politeness and helpfulness in adulthood, which feeling will most likely result?

Accepted Answer

A)   Guilt
B)   Anxiety
C)   Loneliness
D)   Self-esteem

Question 17

A person received an invitation to be in the wedding of a friend who lives across the country. The individual is afraid of flying. What type of therapy should the nurse recommend?

Accepted Answer

A)   Psychoanalysis
B)   Milieu therapy
C)   Systematic desensitization
D)   Short-term dynamic therapy

Question 18

An advanced practice nurse determines that a group of patients would benefit from opportunities to practice appropriate social behaviors and learn about basic living skills. The nurse would arrange for:

Accepted Answer

A)   milieu therapy.
B)   cognitive therapy.
C)   short-term dynamic therapy.
D)   systematic desensitization.

Question 19

A student nurse tells the instructor, "I don't need to interact with my patients. I learn what I need to know by observation." The instructor can best interpret the nursing implications of Sullivan's theory to the student by responding:

Accepted Answer

A)   "Nurses cannot be isolated. We must interact to provide patients with opportunities to practice interpersonal skills."
B)   "Observing patient interactions can help you formulate priority nursing diagnoses and appropriate interventions."
C)   "I wonder how accurate your assessment of the patient's needs can be if you do not interact with the patient."
D)   "Noting patient behavioral changes is important because these signify changes in personality."

Question 20

The parent of a 4-year-old rewards and praises the child for helping a younger sibling, being polite, and using good manners. A nurse supports the use of praise because, according to the Freudian theory, these qualities will likely be internalized and become part of the child's:

Accepted Answer