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A nurse assesses that a patient is suspicious and frequently manipulates others. Using the Freudian theory, these traits are related to which psychosexual stage?
- A. Oral
- B. Anal
- C. Phallic
- D. Genital
Correct Answer: A
Rationale: According to Freud, suspiciousness and manipulation develop during the oral stage, when an infant learns to relate to the environment. Anal stage traits include orderliness or messiness, phallic stage traits include vanity or sexual identity issues, and genital stage traits involve mature relationships.
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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 ego ideal will most likely result?
- A. Curiosity
- B. Awareness
- C. Honesty
- D. Self-esteem
Correct Answer: D
Rationale: The individual will be living up to the ego ideal, which will result in positive feelings about self. None of the other characteristics are as closely associated with the ego.
A nurse psychotherapist works with an anxious, dependent patient. What therapeutic strategy is most consistent with the framework of psychoanalytic psychotherapy?
- 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
Correct Answer: D
Rationale: Transference, a psychoanalytic concept, involves exploring feelings toward the therapist to resolve conflicts. Medication is biological, strengths are supportive, and education is cognitive.
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 by providing what response?
- 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.'
Correct Answer: A
Rationale: Sullivan's theory emphasizes interpersonal relationships. Interaction is essential for nurses to model mutuality and empathy. Observation alone lacks subjective data, and the other responses align with different theories.
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.
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.