Nokea
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.
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A 4-year-old child grabs toys from siblings, saying, 'I want that toy now!' The siblings cry, and the child's parent becomes upset with the behavior. Using the Freudian theory, a nurse can interpret the child's behavior as a product of impulses originating in the:
- A. id.
- B. ego.
- C. superego.
- D. preconscious.
Correct Answer: A
Rationale: The id operates on the pleasure principle, seeking immediate gratification of impulses. The ego acts as a mediator of behavior and weighs the consequences of the action, perhaps determining that taking the toy is not worth the parent's wrath. The superego would oppose the impulsive behavior as 'not nice.' The preconscious is a level of awareness.
What cognitive strategy should a nurse use to assist a very dependent patient achieve independence?
- A. Reveal dream content.
- B. Take prescribed medications.
- C. Examine thoughts about being autonomous.
- D. Role model ways to ask for help from others.
Correct Answer: C
Rationale: Cognitive therapy examines thoughts to change behavior. Dream content is psychoanalytic, medications are biological, and role modeling is not cognitive.
An advanced practice nurse determines that a group of patients would benefit from opportunities to practice appropriate social behaviors and learn about basic living skills. The nurse would arrange for what form of therapy?
- A. Milieu therapy
- B. Cognitive therapy
- C. Short-term dynamic therapy
- D. Systematic desensitization
Correct Answer: A
Rationale: Milieu therapy provides a safe environment for practicing social and living skills. The other therapies are individual-focused and do not address group social behavior.
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 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.