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A patient reports a pattern of being suspicious and mistrusting of others, causing difficulty in sustaining lasting relationships. Which stage according to Erikson's psychosocial development was not successfully completed?
- A. Trust
- B. Autonomy
- C. Initiative
- D. Industry
Correct Answer: A
Rationale: Failure to develop trust during Erikson's trust vs. mistrust stage can lead to suspicion and difficulty in relationships throughout life. The other stages (autonomy, initiative, industry) focus on different developmental tasks not directly related to trust issues.
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A client is supposed to be ambulating ad lib. Instead, he refuses to get out of bed, asks for a bed bath, and makes many demands of the nurses. He also yells that they are lazy and incompetent. The nurse recognizes this behavior as which of the following defense mechanisms?
- A. Introjection
- B. Projection
- C. Rationalization
- D. Reaction formation
Correct Answer: B
Rationale: Projection involves attributing one's own unacceptable thoughts or feelings, such as laziness, to others, as seen in the client's accusations toward the nurses.
A client begins to take stock of his life and look into the future. The nurse assesses that this client is in which of Erikson's developmental stages?
- A. Identity versus role confusion
- B. Industry versus inferiority
- C. Integrity versus despair
- D. Generativity versus stagnation
Correct Answer: C
Rationale: Erikson's integrity vs. despair stage, occurring in later adulthood, involves reflecting on one's life and future, as described in the client's behavior.
A teenaged client is playing a video game when the nurse says it is time to go to sleep. The teen says angrily, 'You sound just like my mother at home!' and continues to play the video game. The nurse understands that this statement likely indicates
- A. The need of firm limit-setting
- B. Transference
- C. Ineffective parenting
- D. A personality disorder
Correct Answer: B
Rationale: Transference occurs when a client projects attitudes or feelings from past relationships, such as those with a parent, onto the therapist. The teen's reaction reflects this dynamic, not necessarily ineffective parenting, a disorder, or the need for limit-setting.
The primary purpose for generalist nurses to develop skills with psychosocial interventions is
- A. Psychosocial interventions are included on the nursing licensure examinations.
- B. Psychosocial interventions are needed in all nursing practice settings.
- C. Nurses will be consulted to assist in the care of psychiatric patients in acute care settings.
- D. There are a growing number of nursing practice opportunities in mental health settings.
Correct Answer: B
Rationale: Psychosocial interventions are essential across all nursing settings to address clients' emotional and behavioral needs, not just in mental health or for licensure purposes.
Which cognitive mode, according to Harry Stack Sullivan, begins in early childhood as the child begins to connect experiences in sequence?
- A. Prototaxic mode
- B. Parataxic mode
- C. Bitaxic mode
- D. Syntaxic mode
Correct Answer: B
Rationale: Sullivan's parataxic mode involves children connecting experiences in sequence, though not always logically, marking an early cognitive developmental stage.