A psychotherapist works with an anxious, dependent patient. Which strategy is most consistent with psychoanalytic psychotherapy?
- A. Identifying the patient's strengths and assets
- B. Praising the patient for describing feelings of isolation
- C. Focusing on feelings developed by the patient toward the therapist
- D. Providing psychoeducation and emphasizing medication adherence
Correct Answer: C
Rationale: The correct answer is C because focusing on the patient's feelings developed towards the therapist is consistent with psychoanalytic therapy. This approach allows the therapist to explore transference and countertransference dynamics, which are central in understanding the patient's inner conflicts and relational patterns. By addressing these feelings, the therapist can help the patient gain insight into unresolved issues from their past that are influencing their current behavior.
Choice A is incorrect because while it can be beneficial in therapy, it is more aligned with a strengths-based or humanistic approach rather than psychoanalytic therapy. Choice B is also incorrect because praising the patient for describing feelings of isolation does not directly address the deeper unconscious processes that psychoanalytic therapy aims to explore. Choice D is incorrect because providing psychoeducation and emphasizing medication adherence are more commonly associated with cognitive-behavioral or medication-focused therapies, rather than psychoanalytic therapy.
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A person who has been unable to leave home for more than a week because of severe anxiety says, "I know it does not make sense, but I just can't bring myself to leave my apartment alone." Which nursing intervention is appropriate?
- A. Help the person use online video calls to provide interaction with others.
- B. Advise the person to accept the situation and use a companion.
- C. Ask the person to explain why the fear is so disabling.
- D. Teach the person to use positive self-talk techniques.
Correct Answer: D
Rationale: The correct answer is D, teaching the person to use positive self-talk techniques. This intervention is appropriate because it addresses the cognitive aspect of anxiety. By teaching the person to challenge negative thoughts and replace them with positive affirmations, they can gradually overcome their fear and build confidence in leaving the apartment. Online video calls (A) may provide temporary relief but do not address the root cause of the anxiety. Advising the person to use a companion (B) may enable avoidance of the problem rather than actively working on overcoming it. Asking the person to explain their fear (C) may not be helpful if they are already aware that it is irrational. Positive self-talk techniques empower the individual to change their mindset and behavior effectively.
In the emergency department, the nurse assesses a client who is aggressive and experiencing auditory hallucinations. The client states,"The CIA is plotting to kill me." To which mental health setting would the nurse expect this client to be admitted?
- A. Long-term, inpatient facility.
- B. Day treatment.
- C. Short-term, inpatient, locked unit.
- D. Psychiatric case management.
Correct Answer: C
Rationale: The correct answer is C: Short-term, inpatient, locked unit. This setting is appropriate because the client is exhibiting acute symptoms of aggression and auditory hallucinations, indicating a need for close monitoring and safety precautions in a secure environment. Long-term inpatient facility (choice A) is not suitable for acute episodes. Day treatment (choice B) may not provide the level of supervision needed. Psychiatric case management (choice D) focuses on community-based care, not acute inpatient care. Therefore, choice C is the most appropriate for managing the client's current symptoms.
The nurse has instructed a client with panic disorder about how to use the technique of positive self-talk. The nurse determines that the client has understood the instructions when the client verbalizes which statement to use during an impending panic attack?
- A. I am feeling very nervous right now.
- B. I can handle this anxiety; it will be over shortly.
- C. I am taking medication to eliminate these symptoms.
- D. Relax your muscles, relax your muscles.
Correct Answer: B
Rationale: The correct answer is B: "I can handle this anxiety; it will be over shortly." This statement reflects positive self-talk by acknowledging the anxiety but also affirming the client's ability to cope and that the situation is temporary. This empowers the client to manage the panic attack effectively.
Incorrect Choices:
A: "I am feeling very nervous right now." This choice focuses only on acknowledging the feeling without providing a positive coping strategy.
C: "I am taking medication to eliminate these symptoms." This choice relies solely on medication and does not address the client's ability to cope with the panic attack.
D: "Relax your muscles, relax your muscles." This choice provides a relaxation technique but lacks the empowering and affirming aspect of positive self-talk.
A nurse documents: "Patient is mute despite repeated efforts to elicit speech. Makes no eye contact. Inattentive to staff. Gazes off to the side or looks upward rather than at speaker." Which nursing diagnosis should be considered?
- A. Defensive coping
- B. Decisional conflict
- C. Risk for other-directed violence
- D. Impaired verbal communication
Correct Answer: D
Rationale: The correct answer is D: Impaired verbal communication. The patient's inability to speak, make eye contact, and focus on the speaker indicates a communication issue. Impaired verbal communication relates to difficulty expressing thoughts, feelings, or needs. The patient's behavior aligns with this diagnosis as they are mute, inattentive, and not making eye contact. Defensive coping (A) involves protecting oneself from emotional pain. Decisional conflict (B) pertains to uncertainty about choices. Risk for other-directed violence (C) involves potential harm to others, which is not evident in the scenario. Thus, D is the most appropriate nursing diagnosis.
The parent of a 4-year-old rewards and praises the child for helping a sibling, being polite, and using good manners. These qualities are likely to be internalized and become part of which system of the personality?
- A. Id
- B. Ego
- C. Superego
- D. Preconscious
Correct Answer: C
Rationale: The correct answer is C: Superego. The superego is responsible for internalizing societal norms, values, and moral standards. By rewarding and praising the child for positive behaviors such as helping a sibling and using good manners, the parent is reinforcing these moral values, which are then internalized by the child through the development of the superego. The superego acts as the conscience and strives for perfection based on societal expectations.
Option A (Id) is incorrect because the Id is the instinctual and impulsive part of the personality driven by the pleasure principle. Option B (Ego) is incorrect as the Ego mediates between the Id and the external world, dealing with reality. Option D (Preconscious) is incorrect as it refers to the part of the mind that contains thoughts and memories that are not currently in awareness but can be easily accessed.