Nokea
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.
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The parent of a child diagnosed with schizophrenia tearfully asks a nurse, 'What could I have done differently to prevent this illness?' Select the nurse's most caring response.
- A. Although schizophrenia is caused by impaired family relationships, try not to feel guilty. No one can predict how a child will respond to parental guidance.'
- B. Most of the damage is done, but there is still hope. Changing your parenting style can help your child learn to cope more effectively with the environment.'
- C. Schizophrenia is a biological illness with similarities to diabetes and heart disease. You are not to blame for your child's illness.'
- D. Most mental illnesses result from genetic inheritance. Your genes are more at fault than your parenting.'
Correct Answer: C
Rationale: Schizophrenia is biological, not caused by parenting. This response reassures parents, relieving guilt. The other options inaccurately blame family dynamics or genes without empathy.
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 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.
Operant conditioning will be used to encourage speech in a child who is nearly mute. Which technique would a nurse include in the treatment plan?
- A. Ignore the child for using silence.
- B. Have the child observe others talking.
- C. Give the child a small treat for speaking.
- D. Teach the child relaxation techniques, then coax speech.
Correct Answer: C
Rationale: Operant conditioning uses positive reinforcement, like treats, to encourage desired behaviors like speech. Ignoring silence is not reinforcing, observation is modeling, and relaxation is desensitization.
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.