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A patient underwent psychotherapy weekly for 3 years. The therapist used free association, dream analysis, and facilitated transference to help the patient understand unconscious processes and foster personality changes. Which type of therapy was used?
- A. Short-term dynamic psychotherapy
- B. Transactional analysis
- C. Cognitive therapy
- D. Psychoanalysis
Correct Answer: D
Rationale: The techniques described are characteristic of psychoanalysis, which explores unconscious processes over a long period. Short-term therapy is briefer, and the others use different methods.
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A 26-month-old child displays negative behavior, refuses toilet training, and often shouts, 'No!' when given direction. The nurse's counseling with the parent should be based on the premise that the child is engaged in which of Erikson's psychosocial crises?
- A. Trust versus Mistrust
- B. Initiative versus Guilt
- C. Industry versus Inferiority
- D. Autonomy versus Shame and Doubt
Correct Answer: D
Rationale: The crisis of Autonomy versus Shame and Doubt is related to the developmental task of gaining control of self and environment, as exemplified by toilet training. This psychosocial crisis occurs during the period of early childhood. Trust versus Mistrust is the crisis of the infant, Initiative versus Guilt is the crisis of the preschool and early school-aged child, and Industry versus Inferiority is the crisis of the 6- to 12-year-old child.
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 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 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.