Pyschosicial Theories

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Chapter 3 Psychosocial Theories ( mental health exam

1)
1. 1. The nurse understands how
that crises are self-limiting.
This implies that upon
eval- uation of crisis
interven- tion, the nurse
should as- sess for which
outcome?
A) The patient will identify
possible causes for the cri-
sis.
B) The patient will discov-
er a new sense of self-
suf- ficiency in coping.
C) The patient will resume
the precrisis level of func-
tioning.
D) The patient will express
anger regarding the crisis
event.

2. 2. A patient who has been


working on controlling im-
pulsive behavior shows a
strengthening ego through
which of the following be-
haviors?
A) Going to therapy only
when there is nothing
more desirable to do
B) Weighing the advan-
tages and disadvantages
before making a decision
C) Telling others in the
group the right way to act
D) Reporting having fun at
a recent social event

3. 3. A patient has just been


told she has cervical can-
cer. When asked about
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Chapter 3 Psychosocial Theories ( mental health exam
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Ans: C Feedback: instant gratification, causes impul- sive
Crises usually exist for 4 to 6 unthinking behavior, and has no regard for
weeks. At the end of that time, rules or social convention. The superego is the
the crisis is resolved in one of part of a person's nature that reflects moral
three ways. In the first two, the and ethical concepts, values, and parental and
person either returns to his or so- cial expectations; therefore, it is in direct
her precrisis level of functioning oppo- sition to the id. The third component, the
or begins to function at a higher ego, is the balancing or mediating force
level; both are positive between the id and the superego. The ego
outcomes for the individual. The represents mature and adaptive behavior that
third resolution is that the allows a person to function successfully in the
person's functioning stabi- lizes world.
at a level lower than precrisis
functioning, which is a negative Ans: D
outcome for the individual. Feedback:
Assisting the person to use Ego defense mechanisms are methods of at-
existing supports or helping the
individual find new sources of
sup- port can decrease the
feelings of being alone or
overwhelmed. The patient may
develop guilt if he or she
examines possible causes for
the crisis. Expression of anger
at 4 to 6 weeks in- dicates a less
than favorable outcome of crisis
intervention.

An
s:
B
Fe
ed
ba
ck:
The id is the part of one's nature
that reflects basic or innate
desires such as pleasure- seek-
ing behavior, aggression, and
sexual impulses. The id seeks
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Chapter 3 Psychosocial Theories ( mental health exam
1)
this is impacting her, she tempting to protect the self and cope with basic
states, ìIt's just an infection; drives or emotionally painful thoughts,
feelings,
it will clear up.î The state- or events. Most defense mechanisms operate
ment indicates that this pa- at the unconscious level of awareness, so
tient peo- ple are not aware of what they are doing
A) needs education on cer- and often need help to see the reality.
vical cancer. Education and referrals are premature at this
B) is unable to express her point in the patient's ability to cope.
true emotions.
C) should be immediately
referred to a cancer sup-
port group.
D) is using denial to
protect herself from an
emotionally painful
thought.
Ans: C
4. 4. A teenage patient de- Feedback:
fies the nurse's repeated Transference occurs when the client displaces
requests to turn off the
video game and go to sleep. onto the therapist attitudes and feelings that
The teen says angrily, ìYou and mistrusting of oth- ers, causing
sound just like my moth- difficulty in
er at home!î and continues
to play the video game.
The nurse understands
that this statement likely
indicates
A) the need of stricter
disci- pline at home.
B) early signs of opposi-
tional defiant disorder.
C) viewing the nurse as
her mother.
D) expression of develop-
ing autonomy.

5. 5. A patient reports a pat-


tern of being suspicious
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Chapter 3 Psychosocial Theories ( mental health exam
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the client originally experienced
in other rela- tionships.
Transference patterns are
automat- ic and unconscious in
the therapeutic rela- tionship.
The occurrence of transference
does not indicate ineffective
parenting or disciplinary
practices, nor is it indicative of a
disorder. Au- tonomy is
developed much earlier in the
toddler years.

An
s:
A
Fe
ed
ba
ck:
The formation of trust is
essential: mistrust, the

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Chapter 3 Psychosocial Theories ( mental health exam
1)
sustaining lasting relation- negative outcome of this stage, will impair the
ships. Which stage accord- person's development throughout his or her
ing to Erikson's psychoso- life.
cial development was not
successfully completed?
A) Trust
B) Autonomy
C) Initiative
D) Industry

6. 6. The nurse has estab-


lished a therapeutic re- Ans: B
lationship with a patient. Feedback:
The patient is beginning to The orientation phase is directed by the nurse
share feelings openly with and involves engaging the client in treatment,
the nurse. The relationship providing explanations and information, and
has entered which phase answering questions. The identification phase
according to Peplau's begins when the client works interdependently
theo- ry? with the nurse, expresses feelings, and
A) Orientation begins to feel stronger. In the exploitation
B) Identification phase, the client makes full use of the
C) Exploitation services offered. In the resolution phase, the
D) Resolution client no longer needs professional services
and gives up dependent behavior and the
7. 7. A nurse is meeting with relationship ends.
a crisis support group. In
ef- forts to help patients Ans: A
iden- tify with one another, Feedback:
the nurse explains which Not all events that result in crisis are
of the following about the ìnegativeî in nature. Events like marriage,
crisis experience? retirement, and childbirth are often desirable
A) ìEven happy events can for the individual but may still present
cause a crisis if the stress overwhelming challenges. All individuals can
is overwhelming.î experience a crisis when they confront some
B) ìOnly people who have life circumstance or stres- sor that they cannot
unfortunate life events will effectively manage through use of their
experience a crisis.î customary coping skills. A number of factors
C) ìA person has no can influence how a person experi- ences a
control over how a crisis crisis.
will affect
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Chapter 3 Psychosocial Theories ( mental health exam
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him or her.î
D) ìPeople can prevent all
crises if they develop good
coping skills early.î

8. 8. Which of the following Ans: B, D


theories could be classi- Feedback:
fied as humanistic theo- Humanism represents a significant shift away
ries? Select all that apply. from the psychoanalytic view of the individ-
A) Cognitive therapy ual as a neurotic, impulse-driven person with
B) Maslow's hierarchy repressed psychic problems and away from
of needs the focus on and examination of the client's
C) Gestalt therapy past experiences. Humanistic theories include
D) Rogers' client-centered Maslow's hierarchy of needs and Rogers'
therapy client-centered therapy. Cognitive therapy is
E) Rational emotive an existential therapy that focuses on
therapy immediate thought processingóhow a person
F) Piaget's cognitive perceives or interprets his or her experience
stages of development and determines how he or she feels and
behaves. Gestalt ther- apy is an existential
therapy that emphasizes the person's feelings
and thoughts in the here and now. Rational
emotive therapy is an exis- tential theory that
looks at irrational beliefs and automatic
thoughts that make people unhappy. Piaget's
cognitive stages of development is a
developmental theory.
9. 9. Which of the following Ans: B, C, D
are examples of adventi- Feedback:
tious crises? Select all that Adventitious crises include natural disasters
apply. like floods, earthquakes, or hurricanes; war,
A) Death of a loved one ter- rorist attacks; riots; and violent crimes
B) Natural disasters such as rape or murder. Maturational or
C) Violent crimes developmen- tal crises are predictable events
D) War in the normal course of life, such as leaving
E) Leaving home for the home for the first time, getting married, having
first time a baby, and beginning a career. Situational
crises are unan- ticipated or sudden events
that threaten the in- dividual's integrity, such
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Chapter 3 Psychosocial Theories ( mental health exam
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as the death of a loved

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Chapter 3 Psychosocial Theories ( mental health exam
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cides to go to a party the night before
a major exam

10. 10. A nursing supervisor


reprimands an employee
for being chronically late
for work. If the employee
handles the reprimand us-
ing the defense
mechanism of
displacement, he would
most likely do which of the
following?
A) Argue with the supervi-
sor that he is usually on
time
B) Make a special effort to
be on time tomorrow
C) Tell fellow employees
that the supervisor is pick-
ing on him
D) Tell the unit
housekeeper that his work
is sloppy

11. 11. The nurse is assessing


a client who is talking
about her son's recent
death but who shows no
emotion of any kind. The
nurse rec- ognizes this
behavior as which of the
following de- fense
mechanisms?
A) Dissociation
B) Displacement
C) Intellectualization
D) Suppression

12. 12. A college student de-


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Chapter 3 Psychosocial Theories ( mental health exam
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one, loss of a job, and physical show the emotions associated with the
or emotional illness in the situation. Dissociation involves deal- ing with
individual or family member. emotional conflict by a temporary al- teration
in consciousness or identity. Displace- ment is
An the ventilation of intense feelings to- ward a
s: person less threatening than the one who
D aroused those feelings. Suppression is re-
Fe placing the desired gratification with one that
ed is more readily available.
ba
ck: Ans: B
Displacement involves venting Feedback:
feelings toward another, less When stating that it wouldn't matter if the stu-
threatening person. Arguing is
denial. Making a special effort is
compensation. Telling fellow
employees that the supervisor is
picking on him is projection.

An
s:
C
Fe
ed
ba
ck:
The client is aware of the facts
of the situation but does not
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Chapter 3 Psychosocial Theories ( mental health exam
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instead of studying. After dent studied, the student is using rationaliza-
receiving a low score on tion, which is excusing own behavior to avoid
the exam, the student tells guilt, responsibility, conflict, anxiety, or loss of
a fel- low student, ìI have self-respect. When stating that the teacher is
to work too much and don't unreasonable, the student is using projection
have time to study. It or the unconscious blaming of unacceptable
wouldn't
matter anyway because the inclinations or thoughts as an external object.
teacher is so unreason- take stock of his life and look
able.î The defense mecha-
nisms the student is using
are
A) denial and displacement
B) rationalization and pro-
jection
C) reaction formation and
resistance
D) regression and compen-
sation

13. 13. A client is supposed to


be ambulating ad lib. In-
stead, he refuses to get
out of bed, asks for a bed
bath, and makes many
demands of the nurses. He
also yells that they are lazy
and in- competent. The
client's be- havior is an
example of which of the
following de- fense
mechanisms?
A) Introjection
B) Projection
C) Rationalization
D) Reaction formation

14. 14. A client begins to


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Chapter 3 Psychosocial Theories ( mental health exam
1)
Denial is the failure to loss of self-concept. Reaction formation is
acknowledge an unbear- able acting the opposite of what one thinks or
condition. Displacement is the feels.
ventilation of intense feelings
toward persons less threat-
ening than the one who aroused
those feelings. Reaction
formation is acting the opposite
of what one thinks or feels. Ans: C
Resistance is overt or covert Feedback:
antagonism toward
remembering or processing
anxiety-producing information.
Re- gression is moving back to
a previous develop- mental
stage to feel safe or have needs
met.
Compensation is
overachievement in one area to
offset real or perceived
deficiencies in anoth- er area.

An
s:
B
Fe
ed
ba
ck:
Projection is blaming
unacceptable thoughts on
others; the client cannot accept
the fact that he may be lazy or
incompetent to care for him- self.
Introjection is accepting another
person's attitudes, beliefs, and
values as one's own.
Rationalization is excusing one's
own behavior to avoid guilt,
responsibility, conflict, anxiety, or
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Chapter 3 Psychosocial Theories ( mental health exam
1)
into the future. The nurse Erikson's stage of integrity versus despair is
assesses that this client is when an adult begins to reflect on his or her
in which of Erikson's life. Identity versus role confusion occurs in
devel- opmental stages? adolescence when the person is forming a
A) Identity versus role con- sense of self and belonging. Integrity versus
fusion despair occurs in maturity; accepting respon-
B) Industry versus inferior- sibility for oneself and life is the corresponding
ity task. Generativity versus stagnation occurs in
C) Integrity versus despair middle adulthood, which includes the tasks of
D) Generativity versus being creative and productive and establishing
stagnation the next generation.
15. 15. A basic assumption of Ans: A
Freud's psychoanalytic Feedback:
the- ory is that Freud believed that everything we do has
A) all human behavior can meaning, whether it is conscious or uncon-
be caused and can be ex- scious. Freud believed that human behavior
plained. can be motivated by subconscious thoughts
B) human behavior is en- and feelings but could also be in the precon-
tirely unconscious. scious or unconscious. Freud based his
C) free association is the theory of childhood development on the belief
key to understanding. that sexual energy, termed libido, was the
D) sexuality does not relate driving force of human behavior.
to behavior.

16. 16. Which of the following is Ans: C


a major developmental task Feedback:
of middle adulthood? An important task for middle-aged adults is
A) Developing intimacy to examine life goals, ideally with some satis-
B) Learning to manage faction. Developing intimacy occurs in young
con- flict adulthood. Learning to manage conflict
C) Reexamining life goals occurs in preschool. Resolving the past and
D) Resolving the past accepting responsibility for oneself and life
occur in matu- rity.

17. 17. Which cognitive mode, Ans: B Feedback:


according to Harry Stack The parataxic mode begins in early childhood
Sullivan, begins in early as the child begins to connect experiences
childhood as the child be- in sequence. The child may not make logical

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Chapter 3 Psychosocial Theories ( mental health exam
1)
gins to connect experi- sense of the experiences, although he or she
ences in sequence? may not understand what he or she is doing.
A) Prototaxic mode The prototaxic mode involves brief,
B) Parataxic mode unconnect- ed experiences that have no
C) Bitaxic mode relationship to one another. In the syntaxic
D) Syntaxic mode mode, the person be- gins to perceive himself
or herself and the world within the context of
the environment and can analyze experiences
in a variety of settings.
There is not a bitaxic mode.
18. 18. Group members are
ac- tively discussing a Ans: C
com- mon topic. Members Feedback:
are sharing that they The working stage of group development be-
identify with what others gins as members begin to focus their attention
are say- ing. The nurse on the purpose or task the group is trying to
leader recog- nizes that accomplish. The beginning stage of group de-
the group is in which velopment, or the initial stage, commences as
stage of group devel- soon as the group begins to meet. Members
opment? introduce themselves, a leader can be select-
A) Planning ed, the group purpose is discussed, and rules
B) Initial and expectations for group participation are
C) Working reviewed. The final stage, or termination, of
D) Termination the group occurs before the group disbands.
The work of the group is reviewed, with the
focus on group accomplishments or growth of
group members.
19. 19. The family members Ans: B
of a patient with bipolar Feedback:
disorder express frustra- Family education discusses the clinical treat-
tion with the unpredictable ment of mental illnesses and teaches the
behaviors of their loved knowledge and skills that family members
one. Which group should need to cope more effectively. The goals of
the nurse suggest as most fami-
helpful to this family? ly therapy groups include understanding how
A) Family therapy group family dynamics contribute to the client's psy-
B) Family education group chopathology, mobilizing the family's inherent
C) Psychotherapy group strengths and functional resources, restructur-
D) Self-help support group ing maladaptive family behavioral styles, and
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Chapter 3 Psychosocial Theories ( mental health exam
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strengthening family problem-
solving behav-

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Chapter 3 Psychosocial Theories ( mental health exam
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A) bring about personal

20. 20. A student nurse


attends a self-help group
as part of a class
assignment. While there
the student recog- nizes a
family friend. Upon
returning home, the stu-
dent talks about the expe-
rience with the family. The
student's actions can be
described as
A) appropriate; persons fa-
miliar with group members
are allowed self-help group
membership.
B) appropriate; self-help
groups are not
professional and therefore
are open to public
knowledge.
C) inappropriate; most
self-help groups have a
rule of confidentiality.
D) inappropriate; the stu-
dent should not have been
allowed to attend the
group.

21. 21. The nurse would


recom- mend individual
therapy for the patient who
expresses a desire to
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Chapter 3 Psychosocial Theories ( mental health exam
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iors. The goal of a
psychotherapy group is for
members to learn about their
behavior and to make positive
changes in their behavior by
interacting and communicating
with others. In a self-help group,
members share a common
experience, but the group is not Ans: A
a formal or structured therapy Feedback:
group. People generally seek individual psychothera-
py based on their desire to understand them-
An selves and their behavior, to make person-
s:
C
Fe
ed
ba
ck:
Most self-help groups have a rule
of confiden- tiality: whoever is
seen and whatever is said at the
meetings cannot be divulged to
others or discussed outside the
group. In many 12-step
programs, such as Alcoholics
Anonymous and Gamblers
Anonymous, people use only
their first names, so their
identities are not divulged
(although in some settings, group
members do know one another's
names).

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Chapter 3 Psychosocial Theories ( mental health exam
1)
changes. al changes, to improve interpersonal relation-
B) gain a sense of belong- ships, or to get relief from emotional pain or
ing. un- happiness. Groups are recommended for
C) develop leadership per- sons to accomplish tasks that require
skills. coopera- tion, collaboration, or working
D) learn more about treat- together.
ment.

22. 22. Which one of the fol-


lowing statements is most Ans: D
accurate regarding the co- Feedback:
hesiveness of a group in Cohesiveness is a desirable group character-
group therapy? istic that is associated with positive group out-
A) It is commonly present comes. It is not common for the group to be
in the first meeting of the cohesive during the first meeting of the group.
group. During the first meeting, or the initial stage,
B) It is necessary for the members introduce themselves and the para-
group to have maximum meters of the group are established. Group
co- hesiveness, the more members begin to ìcheck outî one another
the better. and the leaders as they determine their levels
C) Group cohesiveness is of comfort in the group setting. Cohesiveness
the degree to which mem- is associated with the working stage of a
bers think alike and many group that may take two or three sessions in a
things therapy group because members must
are left unspoken. develop some level of trust before sharing
D) Cohesiveness is a de- personal feelings or difficult situations. If a
group is ìoverly cohe- sive,î in that uniformity
and agreement become
sirable group characteristic the group's implicit goals, there may be a neg-
that is associated with effective ther- apistñclient relationship
pos- itive in individual psychotherapy?
group outcomes.

23. 23. Which one of the


follow- ing is an important
charac- teristic of an

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Chapter 3 Psychosocial Theories ( mental health exam
1)
ative effect on the group
outcome as members may not
offer needed feedback and this
may thwart critical thinking and
creative problem solving. Group
cohesiveness is the degree to
which members work together
cooperatively to accomplish the
purpose.

An
s:
B
Fe
ed
ba
ck:
Compatibility between the
therapist and the client is
required for therapy to be
effective. The client must select
a therapist whose theoretical

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Chapter 3 Psychosocial Theories ( mental health exam
1)
A) Homogeneity between beliefs and style of therapy are congruent with
the client and the the client's needs and expectations of therapy.
therapist. It is not required that the client and therapist
B) Mutual benefit for the be the same. The client's benefit is the most
client and the therapist. important consideration. The client also may
C) The client must adapt to have to try different therapists to find a good
the therapist's style of match.
ther- apy and theoretical
beliefs.
D) Match between the the-
oretical beliefs and style
of therapy and the client's
needs
and expectations of thera-
py.

24. 24. Which of the following is Ans: A


most essential when plan- Feedback:
ning care for a client who Crisis intervention focuses on using the per-
is experiencing a crisis? son's strengths, such as previous coping
A) Explore previous coping skills, and providing support to deal with the
strategies cur- rent situation. Exploring underlying
B) Explore underlying per- personality dynamics and focusing on
sonality dynamics emotional deficits would not help the client in
C) Focus on emotional the crisis situation. When the client is in a
deficits crisis situation, offering a self-help group
D) Offer a referral to would not be appropriate.
a self-help group

25. 25. During the initial inter-


view with a client in crisis, Ans: D
the initial priority is to Feedback:
A) assess the adequacy of Safety is always the priority; clients in crisis
the support system. may be suicidal. Assessing the adequacy of
B) assess for substance the support system, assessing for substance
use. use, and determining the precrisis level of
C) determine the precrisis function- ing would be important assessments
level of functioning. but not as high priority as evaluating the
D) evaluate the potential potential for self-harm.
for self-harm.
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Chapter 3 Psychosocial Theories ( mental health exam
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26. 26. Patients on an starting
inpatient psychiatric unit
can earn off-unit privileges
for dai- ly use of socially
appropri- ate behavior.
This is an ex- ample of
employing which concept
of behavior modifi- cation?
A) Systematic desensitiza-
tion
B) Negative reinforcement
C) Classical conditioning
D) Operant conditioning

27. 27. A patient states, ìI hate


spending time with my
fam- ily. They're always on
my back about something!
I won't do anything they
ask me to do.î Which
response by the nurse
reflects a be- havioral
perspective?
A) ìLet's play like I'm your
parent, and we'll practice
some better ways to
communicate that won't
re- sult in an argument.î
B) ìSome medicines really
help with anger. Are you
in- terested in talking to
your physician about
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Chapter 3 Psychosocial Theories ( mental health exam
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An Feedback:
s: Behaviorism is a school of psychology that
D focuses on observable behaviors and what
Fe one can do externally to bring about behavior
ed changes. It does not attempt to explain how
ba the mind works. Behavior can be changed
ck: through a system of rewards and
The theory of operant punishments. Prac- ticing communication is a
conditioning says peo- ple learn psychotherapy tech- nique to improve
their behavior from their history interpersonal relationships.
or past experiences, particularly Use of medications is not grounded in behav-
those experi- ences that were ioral perspective. Analyzing the reasons for the
repeatedly reinforced. Behav- behavior is not grounded in behavioral per-
ior that is rewarded with spective
reinforcers tends to recur.
Positive reinforcers that follow a
behav- ior increase the
likelihood that the behavior will
recur. In classical conditioning,
behavior can be changed
through conditioning with ex-
ternal or environmental
conditions or stimuli.
Negative reinforcement involves
removing a stimulus immediately
after a behavior occurs so that
the behavior is more likely to
occur again. In systematic
desensitization, the client learns
and practices relaxation
techniques to decrease and
manage anxiety. He or she is
then exposed to the least
anxiety provoking situation and
uses the relaxation techniques
to manage the resulting anxiety.

An
s:
D
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Chapter 3 Psychosocial Theories ( mental health exam
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you on something?î
C) ìThat's probably your
way of getting back at
them for being strict with
you when
you were younger.î
D) ìIf you agree to start
doing what your parents
request, then they have
agreed to
respect your privacy
more.î
Ans: B
28. 28. A nurse is working with Feedback:
a patient with an eating Cognitive therapy focuses on immediate
dis- order who refuses to thought processing, or how a person
eat a muffin. The nurse perceives or interprets his or her experience
asks the patient ìIs there and deter- mines how he or she behaves.
any way that you could see Rational emo- tive therapy considers not only
the muf- fin as just flour thoughts but feelings associated with
and water, basic nutrients thoughts. Gestalt ther- apy focuses on the
your body needs?î In this person's thoughts and feel- ings in the here
statement, the nurse is and now. Reality therapy chal- lenges people
using which type of to examine how behavior inter-
therapy?
A) Rational emotive therapy feres with life goals.
B) Cognitive therapy
C) Gestalt therapy
D) Reality therapy

29. 29. A patient is blaming she should love you as well.î


his impending divorce on B) ìWhat does being di-
the fact that his wife goes
out frequently with her girl-
friends. If using reality
ther- apy, the nurse would
help the patient with which
of the following
responses?
A) ìIf you really love her,
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Chapter 3 Psychosocial Theories ( mental health exam
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An
s:
D
Fe
ed
ba
ck:
Reality therapy challenges
clients to examine the ways in
which their own behavior thwarts
their attempts to achieve life
goals. Others are often assigned
the blame when people hold onto
irrational thinking. The search for
meaning is associated with
logotherapy. Exploring feel- ings
are associated with gestalt
therapy.

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Chapter 3 Psychosocial Theories ( mental health exam
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vorced mean for you?î
C) ìHow do you feel about
your marriage ending?î
D) ìWhat role do you think
you have played in the
end of your marriage?î

30. 30. A nurse is assisting a Ans: A


patient who is working on Feedback:
the technique of system- Systematic desensitization can be used to
atic desensitization. When help clients overcome irrational fears and
the patient feels anxious, anxiety associated with phobias. The client
the nurse can best use the learns and practices relaxation techniques to
principles of this technique decrease and manage anxiety. He or she is
by stating, then ex- posed to the least anxiety provoking
A) ìUse the deep breath- situation and uses the relaxation techniques
ing techniques we prac- to man- age the resulting anxiety. Confronting
ticed yesterday.î irrational thoughts is part of rational emotive
B) ìWhat is the worst that therapy. En- couraging expression of feelings
will happen if you confront is associated with gestalt therapy.
this fear?î
C) ìTell me how you are
feel- ing right now.î
D) ìI can see you are
anxious. Let's stop for
a minute.î

31. 31. The nurse is working Ans: C


with a client who has a Feedback:
history of inflicting Unconditional positive regard involves non-
spousal abuse. Although judgmental caring for the client that is not de-
the nurse does not pendent on the client's behavior. Genuineness
condone domes- tic is a realness or congruence between what the
violence, the nurse treats therapist feels and what he or she says to
the client with un- the client. Empathetic understanding is when
conditional positive regard the therapist senses the feelings and personal
through which of the meaning from the client and communicates
follow- ing? this understanding to the client.
A) The nurse tries to un-
derstand the feelings that
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Chapter 3 Psychosocial Theories ( mental health exam
1)
might have led to violent
behavior.
B) The nurse uses honest
emotional expression in
re- lating to client.
C) The client is still viewed
as someone worthy of re-
spect and assistance.
D) The nurse relates to the
client as if he were her own
spouse.

32. 32. A patient is being ad- Ans: D


mitted to an inpatient unit Feedback:
for treatment of anorex- Maslow's hierarchy of needs hypothesizes
ia nervosa. Of the follow- that the basic needs at the bottom of the pyra-
ing assessment data, mid dominate the person's behavior until
which should the nurse those needs were met, at which time the next
place as highest priority in lev-
the plan of care? el of needs would become dominant. Vomit-
A) Weight 24% below nor- ing threatens fluid and electrolyte balance and
mal for height poses a more acute threat to survival than low
B) Distorted body image weight. Once basic physical needs are met,
C) Feelings of inadequacy the higher level needs such as body image
D) Frequent vomiting after and self-esteem can be addressed.
meals

33. 33. The primary purpose


for generalist nurses to Ans: B
devel- op skills with Feedback:
psychosocial interventions Nurses often use psychosocial interventions
is to help meet clients' needs and achieve
A) psychosocial interven- outcomes in all practice settings, not just
tions are included on the mental health. Psychosocial interventions are
nursing licensure examina- included on the licensing exam, but that is not
tions. the primary rea- son for developing
B) psychosocial interven- proficiency. Any health-care personnel will
tions are needed in all care for psychiatric patients in acute care
nurs- ing practice settings. settings. Current trends reflect a decline in
C) nurses will be consulted mental health services and employ- ment
17 /
Chapter 3 Psychosocial Theories ( mental health exam
1)
opportunities.

18 /
Chapter 3 Psychosocial Theories ( mental health exam
1)
to assist in the care of psy-
chiatric patients in acute
care
settings.
D) there are a growing
num- ber of nursing
practice op- portunities in
mental health settings.

34. 34. Which of the follow- Ans: A


ing considerations should Feedback:
have the most influence in The client's feelings and perceptions about his
the nurse's choice of the or her situation are the most influential factors
treatment for the client? in determining his or her response to thera-
A) The client's feelings and peutic interventions, rather than what the
perceptions about his or nurse believes the client should do. The nurse
her situation must examine his or her beliefs about the
B) The nurse's beliefs theories of psychosocial development and
about the theories of realize that many treatment approaches are
psychoso- cial available. Dif- ferent treatments may work for
development different clients: no one approach works for
C) The nurse's familiarity everyone. Becom- ing familiar with the variety
with the type of treatment of psychosocial approaches for working with
D) Any approach to treat- clients will in- crease the nurse's effectiveness
ment should work with any in promoting the client's health and well-being.
client.
Ans: C
35. 35. Which approach to Feedback:
ther- apy is most effective Cognitive therapy focuses on changing the
when planning for a client client's thinking first, in the belief that then
with negative thinking? feelings and behavior can change as well. Be-
A) Behavior modification havior modification is a method of attempting
B) Client-centered therapy to strengthen a desired behavior or response
C) Cognitive therapy by reinforcement, either positive or negative.
D) Reality therapy Client-centered therapy focuses on the role of
the client, rather than the therapist, as the key
to the healing process. Reality therapy
focuses on the person's behavior and how
that behavior keeps him or her from achieving
life goals.
19 /

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