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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.
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An adult expresses the wish to be taken care of and often behaves in a helpless fashion. This adult has needs related to which of Freud's stages of psychosexual development?
- A. Latency
- B. Phallic
- C. Anal
- D. Oral
Correct Answer: D
Rationale: Fixation at the oral stage produces dependent behaviors in adults. Latency fixations lead to social skill deficits, phallic fixations to authority issues, and anal fixations to rigidity or messiness.
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 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 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 patient comments, 'I never know the right answer' and 'My opinion is not important.' Using Erikson's theory, which psychosocial crisis did the patient have difficulty resolving?
- A. Initiative versus Guilt
- B. Trust versus Mistrust
- C. Autonomy versus Shame and Doubt
- D. Generativity versus Self-Absorption
Correct Answer: C
Rationale: These statements show severe self-doubt, indicating that the crisis of gaining control over the environment is not being successfully met. Unsuccessful resolution of Initiative versus Guilt results in guilt, Trust versus Mistrust in poor relationships, and Generativity versus Self-Absorption in self-absorption.