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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.
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A psychiatric technician says, 'Little of what takes place on the behavioral health unit seems to be theory based.' A nurse educates the technician by identifying which common use of Sullivan's theory?
- A. Structure of the therapeutic milieu of most behavioral health units
- B. Frequent use of restraint and seclusion for behavior modification
- C. Assessment tools based on age-appropriate versus arrested behaviors
- D. Use of the nursing process to determine the best sequence for nursing actions
Correct Answer: A
Rationale: Sullivan's theory informs the therapeutic milieu, fostering an accepting environment for practicing interpersonal skills. Restraint is not part of his theory, developmental assessments align with Erikson, and the nursing process is multi-theoretical.
A 26-month-old child displays negative behavior, refuses toilet training, and often shouts, 'No!' when given directions. Using Freud's stages of psychosexual development, a nurse would assess the child's behavior is based on which stage?
- A. Oral
- B. Anal
- C. Phallic
- D. Genital
Correct Answer: B
Rationale: In Freud's stages of psychosexual development, the anal stage occurs from age 1 to 3 years and has, as its focus, toilet training and learning to delay immediate gratification. The oral stage occurs between birth and 1 year, the phallic stage occurs between 3 and 5 years, and the genital stage occurs between 13 and 20 years.
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.
The parent of a 4 year old rewards and praises the child for helping a younger sibling, being polite, and using good manners. A nurse supports the use of praise because, according to the Freudian theory, these qualities will likely be internalized and become what part of the child's personality?
- A. Id
- B. Ego
- C. Superego
- D. Preconscious
Correct Answer: C
Rationale: In the Freudian theory, the superego contains the 'thou shalts' or moral standards internalized from interactions with significant others. Praise fosters internalization of desirable behaviors. The id is the center of basic instinctual drives, and the ego is the mediator. The preconscious is a level of awareness.
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.