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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.
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Which patient statement would lead a nurse to suspect that the developmental task of infancy was not successfully completed?
- A. I have very warm and close friendships.'
- B. I'm afraid to let anyone really get to know me.'
- C. I am always right and confident about my decisions.'
- D. I'm ashamed that I didn't do it correctly in the first place.'
Correct Answer: B
Rationale: According to Erikson, the developmental task of infancy is trust. Fear of letting others know oneself shows mistrust. Warm friendships indicate successful trust development. Confidence suggests rigidity, and shame relates to Initiative versus Guilt.
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.
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.
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 26-month-old child displays negative behaviors. The parent says, 'My child refuses toilet training and shouts, 'No!' when given direction. What do you think is wrong?' Select the nurse's best reply.
- A. This is normal for your child's age. The child is striving for independence.
- B. The child needs firmer control. Punish the child for disobedience and say, 'No.'
- C. There may be developmental problems. Most children are toilet trained by age 2 years.
- D. Some undesirable attitudes are developing. A child psychologist can help you develop a remedial plan.
Correct Answer: A
Rationale: These negative behaviors are typical of a child around the age of 2 years whose developmental task is to develop autonomy. The incorrect options indicate the child's behavior is abnormal.