Deck 4: Relevant Theories and Therapies for Nursing Practice

Question 1

The parent of a 4-year-old rewards and praises the child for helping a younger sibling, being polite, and using good manners. The nurse supports this use of praise related to these behaviours. These qualities are likely to be internalized and become part of which system of the personality?

A) Id
B) Ego
C) Superego
D) Preconscious

Answer 1

Superego

Question 2

An adult says, "I never know the answers," and "My opinion doesn't count." Which psychosocial crisis was unsuccessfully resolved for this adult?

A) Initiative versus guilt
B) Trust versus mistrust
C) Autonomy versus shame and doubt
D) Generativity versus self-absorption

Answer 2

Autonomy versus shame and doubt

Question 3

Although ego defence mechanisms and security operations are mainly unconscious and designed to relieve anxiety, the major difference is which of the following?

A) Defence mechanisms are intrapsychic and not observable.
B) Defence mechanisms cause arrested personal development.
C) Security operations are masterminded by the id and superego.
D) Security operations address interpersonal relationship activities.

Answer 3

Security operations address interpersonal relationship activities.

Question 4

The parent of a child diagnosed with schizophrenia tearfully asks the nurse, "What could I have done differently to prevent this illness?" Select the nurse's best response.

A) "Although schizophrenia results from impaired family relationships, try not to feel guilty. No one can predict how a child will respond to parental guidance."
B) "Schizophrenia is a biological illness resulting from changes in how the brain and nervous system function. You are not to blame for your child's illness."
C) "There is still hope. Changing your parenting style can help your child learn to cope effectively with the environment."
D) "Most mental illnesses result from genetic inheritance. Your genes are more at fault than your parenting."

Question 5

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 to help others." Which developmental task do these statements contrast?

A) Trust and mistrust
B) Intimacy and isolation
C) Industry and inferiority
D) Generativity and self-absorption

Question 6

Consider this comment from a therapist: "The patient is homosexual but has kept this preference secret. Severe anxiety and depression occur when the patient anticipates family reactions to this sexual orientation." Which perspective is evident in the speaker?

A) Theory of interpersonal relationships
B) Classical conditioning theory
C) Psychosexual theory
D) Behaviourism theory

Question 7

Which patient statement would lead the nurse to suspect unsuccessful completion of the developmental task of infancy?

A) "I have very warm and close friendships."
B) "I'm afraid to allow anyone to really get to know me."
C) "I'm always absolutely right, so don't bother saying more."
D) "I'm ashamed that I didn't do things correctly in the first place."

Question 8

A nurse influenced by Peplau's interpersonal theory works with an anxious, withdrawn patient. Interventions should focus on which of the following?

A) Rewarding desired behaviours
B) Use of own capacities
C) Changing the patient's self-concept
D) Administering medications to relieve anxiety

Question 9

A 26-month-old displays negative behaviour, refuses toilet training, and often says, "No!" Which stage of psychosexual development is evident?

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

Question 10

A nurse uses Maslow's hierarchy of needs to plan care for a patient with mental illness. Which problem will receive priority?

A) The patient refuses to eat or bathe.
B) The patient reports feelings of alienation from family.
C) The patient is reluctant to participate in unit social activities.
D) The patient is unaware of medication action and adverse effects.

Question 11

A patient is suspicious and frequently manipulates others. To which psychosexual stage do these traits relate?

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

Question 12

Operant conditioning is part of the treatment plan to encourage speech in a child who is nearly mute. Which technique applies?

A) Encourage the child to observe others talking.
B) Include the child in small group activities.
C) Give the child a small treat for speaking.
D) Teach the child relaxation techniques.

Question 13

A 4-year-old grabs toys from siblings and says, "I want that now!" The siblings cry, and the child's parent becomes upset with the behaviour. According to Freudian theory, this behaviour is a product of impulses originating in which system of the personality?

A) Id
B) Ego
C) Superego
D) Preconscious

Question 14

A 26-month-old displays negative behaviour, refuses toilet training, and often says, "No!" Which psychosocial crisis is evident?

A) Trust versus mistrust
B) Initiative versus guilt
C) Industry versus inferiority
D) Autonomy versus shame and doubt

Question 15

A patient had psychotherapy weekly for 5 months. The therapist used free association, dream analysis, and facilitated transference to help the patient understand conflicts and foster change. Select the term that applies to this method.

A) Rational-emotive behaviour therapy
B) Psychodynamic therapy
C) Cognitive-behavioural therapy
D) Operant conditioning

Question 16

A student nurse says, "I don't need to interact with my patients. I learn what I need to know by observation." An instructor can best interpret the nursing implications of Sullivan's theory to this student by responding with which of the following?

A) "Interactions are required in order to help you develop therapeutic communication skills."
B) "Nurses cannot be isolated. We must interact to provide patients with opportunities to practice interpersonal skills."
C) "Observing patient interactions will help you formulate priority nursing diagnoses and appropriate interventions."
D) "It is important to pay attention to patients' behavioural changes because these signify adjustments in personality."

Question 17

A nurse consistently encourages a patient to do his or her own activities of daily living (ADLs). If the patient is unable to complete an activity, the nurse helps until the patient is once again independent. This nurse's practice is most influenced by which theorist?

A) Betty Neuman
B) Patricia Benner
C) Dorothea Orem
D) Joyce Travelbee

Question 18

A parent says, "My 2-year-old child refuses toilet training and shouts "No!" when given directions. What do you think is the challenge for the child in this situation?" Select the nurse's best reply.

A) "Your child needs firmer control. It is important to set limits now."
B) "This is normal for your child's age and developmental stage. The child is striving for independence."
C) "There may be developmental problems. Most children are toilet trained by age 2."
D) "Some undesirable attitudes are developing. A child psychologist can help you develop a plan."

Question 19

Which stage of psychosexual development is most relevant to the patient that expresses a desire to be cared for by others and often behaves in a helpless fashion?

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

Question 20

A nurse supports a parent for praising a child behaving in a helpful way. When this child behaves with politeness and helpfulness in adulthood, which feeling will most likely result?

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

Question 21

A psychotherapist works with an anxious, dependent patient. Which strategy is most consistent with psychoanalytic psychotherapy?

A) Identifying the patient's strengths and assets
B) Praising the patient for describing feelings of isolation
C) Focusing on feelings developed by the patient toward the therapist
D) Providing psychoeducation and emphasizing medication adherence

Question 22

Which activities represent the art of nursing?

A) Administering medications on time to a group of patients
B) Listening to a new widow grieve her husband's death
C) Helping a patient obtain groceries from a food bank
D) Teaching a patient about a new medication
E) Holding the hand of a frightened patient

Question 23

A patient says, "All my life I've been surrounded by stupidity. Everything I buy breaks because the entire American workforce is incompetent." Which of the following is this patient experiencing?

A) A self-esteem deficit
B) A cognitive distortion
C) A deficit in motivation
D) A deficit in love and belonging

Question 24

A patient states, "I'm starting cognitive-behavioural therapy. What can I expect from the sessions?" Which responses by the nurse would be appropriate?

A) "The therapist will be active and questioning."
B) "You will be given some homework assignments."
C) "The therapist will ask you to describe your dreams."
D) "The therapist will help you look at your ideas and beliefs about yourself."
E) "The goal is to increase subjectivity about thoughts that govern your behaviour."

Question 25

A nurse and patient discuss a problem the patient has kept secret for many years. Afterward, the patient says, "I feel so relieved that I finally told somebody." Which term best describes the patient's feeling?

A) Catharsis
B) Superego
C) Cognitive distortion
D) Counter-transference

Question 26

A patient repeatedly stated, "I'm stupid." Which statement by that patient would show progress resulting from cognitive behavioural therapy?

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

Question 27

A patient says to the nurse, "My father has been dead for over 10 years, but talking to you is almost as comforting as the talks he and I had when I was a child." Which term applies to the patient's comment?

A) Superego
B) Transference
C) Reality testing
D) Counter-transference

Question 28

Which technique is most applicable to aversion therapy?

A) Punishment
B) Desensitization
C) Role modeling
D) Positive reinforcement

Question 29

A patient says, "I always feel good when I wear a size 2 petite." Which type of cognitive distortion is evident?

A) Disqualifying the positive
B) Overgeneralization
C) Catastrophizing
D) Personalization

Question 30

Which comments by an elderly person best indicate successful completion of the developmental task?

A) "I am proud of my children's successes in life."
B) "I should have given to community charities more often."
C) "My relationship with my father made life more difficult for me."
D) "My experiences in the war helped me appreciate the meaning of life."
E) "I often wonder what would have happened if I had chosen a different career."

Question 31

A patient is fearful of riding on elevators. The therapist first rides an escalator with the patient. The therapist and patient then stand in an elevator with the door open for five minutes and later with the elevator door closed for five minutes. Which technique has the therapist used?

A) Classic psychoanalytic therapy
B) Systematic desensitization
C) Rational emotive therapy
D) Biofeedback

Question 32

A college student received an invitation to attend the wedding of a close friend who lives across the country. The student is afraid of flying. Which type of therapy would be most helpful for this patient?

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

Question 33

Which patient is the best candidate for brief psychodynamic therapy?

A) An accountant with a loving family and successful career who was involved in a short extramarital affair
B) An adult with a long history of major depression who was charged with driving under the influence (DUI)
C) A woman with a history of borderline personality disorder who recently cut both wrists
D) An adult male recently diagnosed with anorexia nervosa

Question 34

Which comments by an adult best indicate self-actualization?

A) "I am content with a good book."
B) "I often wonder if I chose the right career."
C) "Sometimes I think about how my parents would have handled problems."
D) "It's important for our country to provide basic health care services for everyone."
E) "When I was lost at sea for 2 days, I gained an understanding of what is important."

Question 35

Which comment best indicates a patient is self-actualized?

A) "I have succeeded despite a world filled with evil."
B) "I have a plan for my life. If I follow it, everything will be fine."
C) "I'm successful because I work hard. No one has ever given me anything."
D) "My favourite leisure is walking on the beach, hearing soft sounds of rolling waves."

Question 36

Which approach would be best to provide therapy in which peers as well as staff have a voice in determining patients' privileges and psychoeducational topics?

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

Question 37

A person says, "I was the only survivor in a small plane crash. Three business associates died. I got depressed and saw a counsellor twice a week for 4 weeks. We talked about my feelings related to being a survivor, and I'm better now." Which type of therapy was used?

A) Milieu therapy
B) Psychoanalysis
C) Behaviour modification
D) Interpersonal psychotherapy