1. The nurse planning care for a 14-year-old needs to take into account that the developmental task of adolescence is to 

    B. achieve identity.

    According to Erikson, the task of adolescence is to achieve identity rather than to be left in role confusion. A sense of identity is essential to making the transition into adulthood.Text page: 29, Table 2-2
  2. Which behavior, seen in a 30-year-old patient, would alert the nurse to the fact that the patient is not in his appropriate developmental stage according to Erikson?

    A. Says “I’m still trying to find myself.”

    A 30-year old patient should be in Erikson’s stage of intimacy versus isolation. Acknowledging meaningful interpersonal relationships reflects that the patient has successfullyresolved this crisis. The statement “I’m still trying to find myself” reflects that the patient has notsuccessfully resolved this crisis and is actually still in the stage of identity versus role confusion,when the individual experiences confusion about who he is.
  3. The nurse is planning care for a patient with anxiety who will be admitted to the unit shortly. Which nursing action is most important?

    C. Identify a room where the patient will have comfortable surroundings, and order a balanced meal plan.

    Identifying comfortable surroundings and ordering a balanced meal plan involvesphysiological needs. Based on Maslow’s hierarchy, food, oxygen, water, and sleep are among themost basic needs of each human. These needs take priority because they are on the lowest planeof the pyramid. Once these needs are met, higher needs are able to emerge. According toMaslow’s hierarchy, considering ways to assist the patient to feel valued involves esteem needs,and encouraging friendship involves belongingness and love needs. There are more importantprocesses that must first be addressed. Decreasing stimuli addresses safety needs, according toMaslow’s hierarchy. Although safety is a priority, there is a more important process that mustfirst be addressed.
  4. One implication of Freud's theory of the unconscious on psychiatric mental health nursing is related to the consideration that conscious and unconscious influences can help nurses better understand

    A. the root causes of client suffering.

    Freud's theory of the unconscious is particularly valuable as a baseline for considering the complexity of human behavior. By considering conscious and unconscious influences, a nurse can develop and begin to think about the root causes of client suffering. Text page: 25
  5. According to Freud, the nurse recognizes that a client experiencing dysfunction of the conscious as the part of the mind will have problems with:

    B. all material that the person is aware of at any one time.

    Freud described the conscious part of the mind as the tip of the iceberg. It contains all of the material that the person is aware of at any one time. Text page: 25
  6. The nurse explains to a depressed client who was abused physical as a child that his id is:

    D. the source of his instincts to save himself from hurting himself.

    At birth we are all id. The id is the source of all drives, instincts, reflexes, needs, genetic inheritance, and capacity to respond as well as all the wishes that motivate us. Text page: 26
  7. As a result of Harry Stack Sullivan, the nurse in virtually all residential and day hospital settings is involved in providing clients with:

    A. A psychotherapeutic environment

    Sullivan demonstrated that a psychotherapeutic environment, revolving around an accepting atmosphere that provides numerous opportunities for practicing interpersonal skills and developing relationships, is an invaluable treatment tool. This method is used today in virtually all residential and day hospital settings. Text page: 30
  8. The nurse uses Maslow's model of needs to direct the identification of an anxious client' priority intervention to be:

    C. assessing the client for her strengths upon which a nurse-client relationship can be based.

    The value of Maslow's model in nursing practice is twofold. First, the emphasis on human potential and the client's strengths is key to successful nurse-client relationships. The second value lies in establishing what is most important in sequencing of nursing actions in the nurse-client relationship. Text page: 40
  9. A suspicious client smokes several packs of cigarettes daily and drinks as much coffee or soda as he is able to afford. The nurse finds that every nursing intervention is met with sarcasm. When she asks for advice from a peer, the most helpful response would be

    B. "It might help if you remember that sarcasm represents oral-stage fixation."

    According to Freud's psychosexual stages of development, this client is exhibiting the oral (0-1 year) personality traits: fixation at the oral stage is associated with passivity, gullibility, and dependence; the use of sarcasm; and the development of orally focused habits (e.g., smoking, nail biting) .Text page: 27
  10. A client comes to the clinic asking for help because his third fiancée has broken their engagement. He states "I don't know what is wrong with me, but my friends tell me I am too possessive." The type of therapy that might address his interpersonal deficit is

    A. interpersonal psychotherapy.

    Interpersonal psychotherapy is considered to be effective in resolving problems of grief, role disputes, role transition, and interpersonal deficit. Text page: 30
  11. Which of the following is considered a primary behavioral theorist?

    B. Skinner

    B.F. Skinner (1904-1990) represented the second wave of behavioral theorists and is recognized as one of the prime movers behind the behavioral movement. Text page: 32
  12. The nurse is working with a patient who lacks the ability to problem solve and seeks ways to self-satisfy without regard for others. The nurse understands that which system of the patient’s personality is most pronounced?

    D. Id

    Freud’s distinct yet interactive systems of the personality include the id, the ego, and the superego.

    The id cannot tolerate frustration and seeks to discharge tension and return to a more comfortable level of energy, lacks the ability to problem solve, is not logical, and operates according to the pleasure principle.

    The ego is able to differentiate subjective experiences, memory images, and objective reality; it is logical and operates based in reality.

    The superego, comprising the conscience and the ego ideal, is the moral component of the personality; it seeks perfection rather than pleasure or reason.

    This patient is seeking self-satisfaction without regard for others and cannot problem solve, which is reflective of the id.
Card Set
Relevant Theories and Therapies for Nursing Practice