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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.
- 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.
Correct Answer: A
Rationale: These negative behaviors are typical of a child around the age of 2 years whose developmental task is to develop autonomy. The incorrect options indicate the child's behavior is abnormal.
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The parent of a child diagnosed with schizophrenia tearfully asks a nurse, 'What could I have done differently to prevent this illness?' Select the nurse's most caring response.
- A. Although schizophrenia is caused by impaired family relationships, try not to feel guilty. No one can predict how a child will respond to parental guidance.'
- B. Most of the damage is done, but there is still hope. Changing your parenting style can help your child learn to cope more effectively with the environment.'
- C. Schizophrenia is a biological illness with similarities to diabetes and heart disease. You are not to blame for your child's illness.'
- D. Most mental illnesses result from genetic inheritance. Your genes are more at fault than your parenting.'
Correct Answer: C
Rationale: Schizophrenia is biological, not caused by parenting. This response reassures parents, relieving guilt. The other options inaccurately blame family dynamics or genes without empathy.
A single parent is experiencing feelings of inadequacy related to work and family since one teenaged child ran away several weeks ago. The parent seeks the help of a therapist specializing in cognitive therapy. The psychotherapist who uses cognitive therapy will introduce what intervention?
- A. Discussing ego states
- B. Focusing on unconscious mental processes
- C. Negatively reinforcing an undesirable behavior
- D. Helping the parent identify and change faulty thinking.
Correct Answer: D
Rationale: Cognitive therapy changes faulty beliefs to improve behavior. Ego states are transactional analysis, unconscious processes are psychoanalytic, and reinforcement is behavioral.
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?
- A. Psychoanalysis
- B. Milieu therapy
- C. Systematic desensitization
- D. Short-term dynamic therapy
Correct Answer: C
Rationale: Systematic desensitization extinguishes specific fears like flying. Psychoanalysis and short-term therapy explore conflicts, and milieu involves environmental adjustments.
A patient states, 'I'm starting cognitive behavioral therapy. What can I expect from the sessions?' Which responses by the nurse are appropriate?
- A. The therapist will be active and questioning.'
- B. You may be given homework assignments.'
- C. The therapist will ask you to describe your dreams.'
- D. The therapist will help you look at ideas and beliefs you have about yourself.'
- E. The goal is to increase your subjectivity about thoughts that govern your behavior.'
Correct Answer: A,B,D
Rationale: Cognitive therapists are active, assign homework, and help identify irrational thoughts. Dream analysis is psychoanalytic, and the goal is objectivity, not subjectivity.
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?
- 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.
Correct Answer: C
Rationale: Operant conditioning uses positive reinforcement, like treats, to encourage desired behaviors like speech. Ignoring silence is not reinforcing, observation is modeling, and relaxation is desensitization.