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A nurse uses Maslow's hierarchy of needs to plan care for a psychotic patient. Which problem will receive priority?
- A. Refuses to eat or bathe.
- B. Reports feelings of alienation from family.
- C. Is reluctant to participate in unit social activities.
- D. Needs to be taught about medication action and side effects.
Correct Answer: A
Rationale: Physiological needs like food and hygiene take priority in Maslow's hierarchy over psychological or social needs.
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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.
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.
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.
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.
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.