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.
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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 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.
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 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 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.
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