Nokea
A 26-month-old child displays negative behavior, refuses toilet training, and often shouts, 'No!' when given directions. Using Freud's stages of psychosexual development, a nurse would assess the child's behavior is based on which stage?
- A. Oral
- B. Anal
- C. Phallic
- D. Genital
Correct Answer: B
Rationale: In Freud's stages of psychosexual development, the anal stage occurs from age 1 to 3 years and has, as its focus, toilet training and learning to delay immediate gratification. The oral stage occurs between birth and 1 year, the phallic stage occurs between 3 and 5 years, and the genital stage occurs between 13 and 20 years.
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A psychiatric technician says, 'Little of what takes place on the behavioral health unit seems to be theory based.' A nurse educates the technician by identifying which common use of Sullivan's theory?
- A. Structure of the therapeutic milieu of most behavioral health units
- B. Frequent use of restraint and seclusion for behavior modification
- C. Assessment tools based on age-appropriate versus arrested behaviors
- D. Use of the nursing process to determine the best sequence for nursing actions
Correct Answer: A
Rationale: Sullivan's theory informs the therapeutic milieu, fostering an accepting environment for practicing interpersonal skills. Restraint is not part of his theory, developmental assessments align with Erikson, and the nursing process is multi-theoretical.
Which patient statement would lead a nurse to suspect that the developmental task of infancy was not successfully completed?
- 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.'
Correct Answer: B
Rationale: According to Erikson, the developmental task of infancy is trust. Fear of letting others know oneself shows mistrust. Warm friendships indicate successful trust development. Confidence suggests rigidity, and shame relates to Initiative versus Guilt.
A nurse uses Peplau's interpersonal therapy while working with an anxious, withdrawn patient. What should the focus of the interventions be?
- A. Changing the patient's perceptions about self
- B. Improving the patient's interactional skills.
- C. Using medications to relieve anxiety
- D. Reinforcing specific behaviors
Correct Answer: B
Rationale: Peplau's therapy focuses on improving interpersonal relationships. Changing perceptions is cognitive therapy, medications are biological therapy, and reinforcing behaviors is behavioral therapy.
A basic level registered nurse works with patients in a community setting. Which groups should this nurse expect to lead?
- A. Symptom management
- B. Medication education
- C. Family therapy
- D. Psychotherapy
- E. Self-care
Correct Answer: A,B,E
Rationale: Basic level nurses lead psychoeducational groups like symptom management, medication education, and self-care. Family therapy and psychotherapy require advanced practice.
Cognitive behavioral therapy was provided for a patient who frequently said, 'I'm stupid.' Which statement by the patient indicates the therapy was effective?
- 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.'
Correct Answer: D
Rationale: I'm stupid' is an irrational thought. 'Sometimes I do stupid things' is more rational, promoting self-control. The other options reflect persistent irrational thinking.