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A nurse uses Peplau's interpersonal therapy while working with an anxious, withdrawn patient. What should the focus of the interventions be?
- A. Changing the patient's perceptions about self
- B. Improving the patient's interactional skills.
- C. Using medications to relieve anxiety
- D. Reinforcing specific behaviors
Correct Answer: B
Rationale: Peplau's therapy focuses on improving interpersonal relationships. Changing perceptions is cognitive therapy, medications are biological therapy, and reinforcing behaviors is behavioral therapy.
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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.
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.
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.
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.
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.