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A student nurse tells the instructor, 'I don't need to interact with my patients. I learn what I need to know by observation.' The instructor can best interpret the nursing implications of Sullivan's theory by providing what response?
- A. Nurses cannot be isolated. We must interact to provide patients with opportunities to practice interpersonal skills.'
- B. Observing patient interactions can help you formulate priority nursing diagnoses and appropriate interventions.'
- C. I wonder how accurate your assessment of the patient's needs can be if you do not interact with the patient.'
- D. Noting patient behavioral changes is important because these signify changes in personality.'
Correct Answer: A
Rationale: Sullivan's theory emphasizes interpersonal relationships. Interaction is essential for nurses to model mutuality and empathy. Observation alone lacks subjective data, and the other responses align with different theories.
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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 basic level registered nurse works with patients in a community setting. Which groups should this nurse expect to lead?
- A. Symptom management
- B. Medication education
- C. Family therapy
- D. Psychotherapy
- E. Self-care
Correct Answer: A,B,E
Rationale: Basic level nurses lead psychoeducational groups like symptom management, medication education, and self-care. Family therapy and psychotherapy require advanced practice.
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.
Cognitive behavioral therapy was provided for a patient who frequently said, 'I'm stupid.' Which statement by the patient indicates the therapy was effective?
- A. I'm disappointed in my lack of ability.'
- B. I always fail when I try new things.'
- C. Things always go wrong for me.'
- D. Sometimes I do stupid things.'
Correct Answer: D
Rationale: I'm stupid' is an irrational thought. 'Sometimes I do stupid things' is more rational, promoting self-control. The other options reflect persistent irrational thinking.
A person received an invitation to be in the wedding of a friend who lives across the country. The individual is afraid of flying. What type of therapy should the nurse recommend?
- A. Psychoanalysis
- B. Milieu therapy
- C. Systematic desensitization
- D. Short-term dynamic therapy
Correct Answer: C
Rationale: Systematic desensitization extinguishes specific fears like flying. Psychoanalysis and short-term therapy explore conflicts, and milieu involves environmental adjustments.