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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. I don't have time to help others.' These comments contrast which developmental tasks?
- A. Trust versus Mistrust
- B. Industry versus Inferiority
- C. Intimacy versus Isolation
- D. Generativity versus Self-Absorption
Correct Answer: D
Rationale: Both retirees are in middle adulthood, facing Generativity versus Self-Absorption. One shows generativity through volunteering, the other self-absorption. Trust versus Mistrust involves trust issues, Industry versus Inferiority work competence, and Intimacy versus Isolation emotional connection.
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A 4-year-old child grabs toys from siblings, saying, 'I want that toy now!' The siblings cry, and the child's parent becomes upset with the behavior. Using the Freudian theory, a nurse can interpret the child's behavior as a product of impulses originating in the:
- A. id.
- B. ego.
- C. superego.
- D. preconscious.
Correct Answer: A
Rationale: The id operates on the pleasure principle, seeking immediate gratification of impulses. The ego acts as a mediator of behavior and weighs the consequences of the action, perhaps determining that taking the toy is not worth the parent's wrath. The superego would oppose the impulsive behavior as 'not nice.' The preconscious is a level of awareness.
An advanced practice nurse determines that a group of patients would benefit from opportunities to practice appropriate social behaviors and learn about basic living skills. The nurse would arrange for what form of therapy?
- A. Milieu therapy
- B. Cognitive therapy
- C. Short-term dynamic therapy
- D. Systematic desensitization
Correct Answer: A
Rationale: Milieu therapy provides a safe environment for practicing social and living skills. The other therapies are individual-focused and do not address group social behavior.
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.
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.
What cognitive strategy should a nurse use to assist a very dependent patient achieve independence?
- A. Reveal dream content.
- B. Take prescribed medications.
- C. Examine thoughts about being autonomous.
- D. Role model ways to ask for help from others.
Correct Answer: C
Rationale: Cognitive therapy examines thoughts to change behavior. Dream content is psychoanalytic, medications are biological, and role modeling is not cognitive.