(Test Bank) Essentials of Psychiatric Mental Health Nursing: Concepts of Care in Evidence-Based Practice

Townsend, 5

Nursing

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Essential s of Psychiatric Mental Health Nursing Mary C. Townsend Test Bank 2021 Copyright © 2017 F. A. Davis Company Bonus Chapter 1: Concepts of Personality Development Multiple Choice Identify the choice that best completes the statement or answers the question. ____ 1. A jilted college student is admitted to a hospital following a suicide attempt and states, “No one will ever love a loser like me.” According to Erikson’s theory of personality development, a nurse should recognize that this patient has a deficit in which developmental stage? 1. Trust versus mistrust 2. Initiative versus guilt 3. Intimacy versus isol ation 4. Ego integrity versus despair ____ 2. A nurse observes a 3 -year-old client willingly sharing candy with a sibling. According to Peplau, which psychological stage of development should the nurse determine that this child has completed? 1. Learni ng to count on others 2. Learning to delay satisfaction 3. Identifying oneself 4. Developing skills in participation ____ 3. A 9-month -old child screams every time his mother leaves and will not tolerate anyone else changing his diaper. The nurse sho uld determine that, according to Mahler’s developmental theory, this child’s development was arrested at which phase? 1. The autistic phase 2. The symbiotic phase 3. The separation -individuation phase 4. The rapprochement phase ____ 4. According to P eplau, a nurse who provides an abandoned child with parental guidance and praise following small accomplishments is serving which therapeutic role? 1. Technical expert 2. Resource person 3. Surrogate 4. Leader ____ 5. When assessing clients, a psychi atric nurse should understand that psychoanalytic theory is based on which underlying concept? 1. A possible genetic basis for the client’s problems 2. The structure and dynamics of the personality 3. Behavioral responses to stressors 4. Maladaptive cog nitions ____ 6. Which underlying concept should a nurse associate with interpersonal theory when assessing a client? 1. The effects of social processes on personality development 2. The effects of unconscious processes and personality structures 3. The effects on thoughts and perceptual processes 4. The effects of chemical and genetic influences Copyright © 2017 F. A. Davis Company ____ 7. A physically healthy, 35 -year-old, single client lives with his parents, who provide total financial support. According to Erikson’s theory, which developmental task should a nurse assist the client to accomplish? 1. Establishing the ability to control emotional reactions 2. Establishing a strong sense of ethics and character structure 3. Establishing and maintaining self -esteem 4. Establishing a career, personal relationships, and societal connections ____ 8. A 1-month -old infant is left alone for extended periods, has little physical stimulation, and is malnourished. Based on this infant’s situation, in which phase of development, according to Mahler’s theory, should a nurse expect to see a potential deficit? 1. The symbiotic phase 2. The autistic phase 3. The consolidation phase 4. The rapprochement phase ____ 9. A 6-year-old boy uses his father’s flashlight to explore his 3 -year-old sis ter’s genitalia. According to Freud, in which stage of psychosocial development should a nurse identify this behavior as normal? 1. Oral 2. Anal 3. Phallic 4. Latency ____ 10. A married, 26 -year-old client works as a schoolteacher. She and her husban d have just had their first child. A nurse should recognize that this client is successfully accomplishing which stage of Erikson’s developmental theory? 1. Industry versus inferiority 2. Identity versus role confusion 3. Intimacy versus isolation 4. Generativity versus stagnation ____ 11. A 10 -year-old child wins the science fair competition and is chosen as a cheerleader for the basketball team. A nurse should recognize that this child is in the process of successfully accomplishing which stage of E rikson’s developmental theory? 1. Industry versus inferiority 2. Identity versus role confusion 3. Intimacy versus isolation 4. Generativity versus stagnation ____ 12. A client has flashbacks of sexual abuse by her uncle. She did not have these memor ies until recently, when she became sexually active with her boyfriend. A nurse should identify this experience as which part of Sullivan’s concept of the self -system? 1. The good me 2. The bad me 3. The not me 4. The bad you ____ 13. According to Fr eud, which statement should a nurse associate with predominance of the superego? Copyright © 2017 F. A. Davis Company 1. “No one is looking, so I will take three cigarettes from Mom’s pack.” 2. “I don’t ever cheat on tests; it is wrong.” 3. “If I skip school, I will get into trouble and fai l my test.” 4. “Dad won’t miss this little bit of vodka.” ____ 14. A female complains that her husband only satisfies his sexual needs and never her needs. According to Freud, which personality structure should a nurse identify as predominantly driving the husband’s actions? 1. The id 2. The superid 3. The ego 4. The superego ____ 15. A father of a 5 -year-old demeans and curses his child for disobedience. In turn, when upset, the child uses swear words at kindergarten. A school nurse recognizes th is behavior as unsuccessful completion of which stage of development, according to Peplau? 1. Learning to count on others 2. Learning to delay satisfaction 3. Identifying oneself 4. Developing skills in participation ____ 16. A nurse is caring for a hospitalized client who is quarrelsome, opinionated, and has little regard for others. According to Sullivan’s interpersonal theory, the nurse should associate the client’s behaviors with a previous deficit in which stage of development? 1. Infancy 2. Childhood 3. Early adolescence 4. Late adolescence Completion Complete each statement. 17. “It is never right to take something that doesn’t belong to you.” According to Sigmund Freud, this statement reflects the predominance of the _______________ str ucture of the personality. Copyright © 2017 F. A. Davis Company Bonus Chapter 1: Concepts of Personality Development Answer Section MULTIPLE CHOICE 1. ANS: 3 Chapter: Bonus Chapter 1, Concepts of Personality Development Objective: Theory of psychosocial development —Erikson Page: 7 Heading : Theory of Psychosocial Development > Erikson’s Stages of Personality Development Integrated Processes: Nursing Process Client Need: Safe and Effective Care Environment: Management of Care Cognitive Level: Application [Applying] Concept: Stress Difficulty : Moderate Feedback 1 The trust versus mistrust stage occurs from birth to 18 months. 2 Initiative versus guilt occurs between ages 3 to 6 years 3 The nurse should recognize that the client who states, “No one will ever love a loser like me” has not a dequately completed the intimacy versus isolation stage of development. The intimacy versus isolation stage is presumed to occur in young adulthood between the ages of 20 and 30 years. The major developmental task in this stage is to establish intense, las ting relationships or commitment to another person, cause, institution, or creative effort. 4 Ego integrity versus despair occurs between age 65 and death. PTS: 1 CON: Stress 2. ANS: 2 Chapter: Bonus Chapter 1, Concepts of Personality Development Objective: A Nursing model of interpersonal development —Peplau Page: 13 Heading: A Nursing Model —Hildegard E. Peplau > Peplau’s Stages of Personality Development Integrated Processes: Nursing Process Client Need: Psychosocial Integrity Cognitive Level: Appl ication [Applying] Concept: Family Dynamics Difficulty: Moderate Feedback 1 Learning to count on others occurs during the first stage of Peplau’s theory. 2 The nurse should determine that this client has completed the learning to delay satisfaction sta ge of development, according to Peplau’s interpersonal theory. This stage typically occurs in toddlerhood when one learns the satisfaction of pleasing others. Copyright © 2017 F. A. Davis Company 3 Identifying oneself occurs during the third stage. 4 Developing skills in participation occur s during the fourth stage. PTS: 1 CON: Family Dynamics 3. ANS: 2 Chapter: Bonus Chapter 1, Concepts of Personality Development Objective: Theory of object relations development —Mahler Page: 10 Heading: Theory of Object Relations > Phase II: The Sym biotic Phase Integrated Processes: Nursing Process Client Need: Psychosocial Integrity Cognitive Level: Application [Applying] Concept: Growth and Development Difficulty: Moderate Feedback 1 Phase I is the autistic phase, which the child has completed. 2 The nurse should understand that this client’s development was halted in the symbiotic phase of Mahler’s developmental theory, which usually occurs between 1 and 5 months of age. 3 The child has not entered into the separation -individuation phase of development, in which a child establishes the understanding of being separate from the mother. 4 The rapprochement phase occurs in phase III, sub -phase 3. PTS: 1 CON: Growth and Development 4. ANS: 3 Chapter: Bonus Chapter 1, Concepts of Personality Dev elopment Objective: A Nursing model of interpersonal development —Peplau Page: 13 Heading: A Nursing Model —Hildegard E. Peplau Integrated Processes: Nursing Process Client Need: Safe and Effective Care Environment: Management of Care Cognitive Level: App lication [Applying] Concept: Growth and Development Difficulty: Moderate Feedback 1 A technical expert performs medical interventions in the best interest of the patient. 2 A resource person provides specific, needed information to help the client with a problem. 3 The nurse who provides an abandoned child with parental guidance and praise is serving the role of the surrogate, according to Peplau’s interpersonal theory. A surrogate serves as a substitute for another person —in this case, the child’s parent. 4 A leader directs nurse -client interaction to facilitate achievement of goals. Copyright © 2017 F. A. Davis Company PTS: 1 CON: Growth and Development 5. ANS: 2 Chapter: Bonus Chapter 1, Concepts of Personality Development Objective: Psychoanalytic theory —Freud Page: 2 Heading: P sychoanalytic Theory > Structures of the Personality Integrated Processes: Nursing Process Client Need: Psychosocial Integrity Cognitive Level: Application [Applying] Concept: Cognition Difficulty: Moderate Feedback 1 Freud did not consider genetics as t he basis to psychoanalytic theory. 2 The nurse should understand that psychoanalytic theory is based on the underlying concepts of the structure and dynamics of personality. Psychoanalytic theory was developed by Sigmund Freud and explains the structure o f personality in three different components: the id, the ego, and the superego. 3 Freud did not consider stressors as the basis to psychoanalytic theory. 4 Freud did not consider maladaptive cognitions as the basis to psychoanalytic theory. PTS: 1 CON : Cognition 6. ANS: 1 Chapter: Bonus Chapter 1, Concepts of Personality Development Objective: Interpersonal Theory —Sullivan Page: 5 Heading: Interpersonal Theory Integrated Processes: Nursing Process Client Need: Psychosocial Integrity Cognitive Level: Application [Applying] Concept: Cognition Difficulty: Moderate Feedback 1 The nurse should associate interpersonal theory with the underlying concept of effects of social process on personality development. Sullivan developed stages of personality devel opment based on his theory of interpersonal relationships and their effect on personality and individual behavior. 2 Sullivan’s theory did not include unconscious processes and personality structures. 3 Sullivan’s theory did not include thoughts and perc eptual processes. 4 Sullivan’s theory did not include chemical and genetic influences. PTS: 1 CON: Cognition 7. ANS: 4 Copyright © 2017 F. A. Davis Company Chapter: Bonus Chapter 1, Concepts of Personality Development Objective: Theory of psychosocial development —Erikson Page: 9 Headi ng: Theory of Psychosocial Development >Erikson’s Stages of Personality Development Integrated Processes: Nursing Process Client Need: Psychosocial Integrity Cognitive Level: Application [Applying] Concept: Family Dynamics Difficulty: Moderate Feedback 1 The ability to control emotional reactions occurs in the initiative versus guilt stage. 2 Establishing a strong sense of ethics and character occurs in the identity versus role confusion stage. 3 Establishing and maintaining self -esteem occurs in the i ndustry versus inferiority stage. 4 The nurse should assist the client in establishing a career, personal relationships, and societal connections. According to Erikson, non -achievement of the generativity versus stagnation stage results in self -absorption , including withdrawal from others and having no capacity for giving of the self to others. PTS: 1 CON: Family Dynamics 8. ANS: 2 Chapter: Bonus Chapter 1, Concepts of Personality Development Objective: Theory of object relations development —Mahler Page: 10 Heading: Theory of Object Relations > Phase I: The Autistic Phase Integrated Processes: Nursing Process Client Need: Physiological Integrity: Physiological Adaptation Cognitive Level: Application [Applying] Concept: Growth and Development Difficul ty: Moderate Feedback 1 The symbiotic phase occurs at 1 –5 months of age. 2 The nurse should expect that a 1 -month -old infant who is left alone, has little physical stimulation, and is malnourished would not meet the autistic phase of development. The a utistic phase of development usually occurs from birth to 1 month, at which time the infant’s focus is on basic needs and comfort. 3 The consolidation phase occurs at ages 24 –36 months. 4 The rapprochement phase occurs at ages 16 –24 months. PTS: 1 CON : Growth and Development 9. ANS: 3 Chapter: Bonus Chapter 1, Concepts of Personality Development Objective: Psychoanalytic theory —Freud Copyright © 2017 F. A. Davis Company Page: 5 Heading: Psychosocial Development > Phallic Stage 3 -6 years Integrated Processes: Assessment Client Need: Psy chosocial Integrity Cognitive Level: Application [Applying] Concept: Growth and Development Difficulty: Moderate Feedback 1 The oral stage occurs at ages birth to 18 months and includes: chewing, sucking and biting behaviors. 2 The anal phase occurs 18 months to 3 years and involves gaining independence and control. 3 The nurse should identify this behavior as normal, because the 6 -year-old client who focuses on genital organs is in the phallic stage of Freud’s psychosexual stages of development. Childr en in the phallic stage of development focus on genital organs and develop a sense of sexual identity. Identification with the same -sex parent also occurs at this stage. 4 The latency phase occurs ages 6 –12 years old and involves socialization with peers. PTS: 1 CON: Growth and Development 10. ANS: 3 Chapter 1: Bonus Chapter 1, Concepts of Personality Development Objective: Theory of psychosocial development —Erikson Page: 9 Heading: Theory of Psychosocial Development > Erikson’s Stages of Personality Development Integrated Processes: Nursing Process Client Need: Psychosocial Integrity Cognitive Level: Application [Applying] Concept: Growth and Development Difficulty: Moderate Feedback 1 Industry versus inferiority occurs between ages 6 and 12 years old. 2 Identity versus role confusion occurs between ages 12 and 20 years old. 3 The nurse should recognize that a 26 -year-old client who is married and has a child has successfully accomplished the intimacy versus isolation stage of Erikson’s developmen tal theory. The intimacy versus isolation stage of young adulthood involves forming lasting relationships. Achievement of this task results in the capacity for mutual love and respect. 4 Generativity versus stagnation occurs between ages 30 and 65 years o ld. PTS: 1 CON: Growth and Development 11. ANS: 1 Chapter: Bonus Chapter 1, Concepts of Personality Development Objective: Theory of psychosocial development Page: 8 Copyright © 2017 F. A. Davis Company Heading: Theory of Psychosocial Development > Erikson’s Stages of Personality Develo pment Integrated Processes: Nursing Process Client Need: Psychosocial Integrity Cognitive Level: Application [Applying] Concept: Growth and Development Difficulty: Moderate Feedback 1 The nurse should recognize that a 10 -year-old child who is successful in school both academically and socially has effectively accomplished the industry versus inferiority developmental stage of Erikson’s psychosocial theory. The industry versus inferiority stage of development usually occurs between 6 and 12 years of age, a t which time individuals achieve a sense of self -confidence by learning, competing, performing successfully, and receiving recognition from others. 2 Identity versus role confusion occurs between the ages of 12 and 20 years. 3 Intimacy versus isolation o ccurs between the ages of 20 and 30 years. 4 Generativity versus stagnation occurs between the ages of 30 and 65. PTS: 1 CON: Growth and Development 12. ANS: 3 Chapter: Bonus Chapter 1, Concepts of Personality Development Objective: Interpersonal the ory—Sullivan Page: 5 Heading: Interpersonal Theory Integrated Processes: Nursing Process Client Need: Psychosocial Integrity Cognitive Level: Application [Applying] Concept: Violence Difficulty: Moderate Feedback 1 The good me develops in response to po sitive feedback. 2 The bad me develops in response to negative feedback. 3 The nurse should identify a client remembering sexual abuse when becoming sexually active with her boyfriend as experiencing the not me part of the personality. According to Sulli van, the not me part of the personality develops in response to situations that produced intense anxiety in childhood. 4 The bad you is not a component of Sullivan’s self -system. PTS: 1 CON: Violence 13. ANS: 2 Chapter: Bonus Chapter 1, Concepts of P ersonality Development Objective: Psychoanalytic theory —Freud Page: 2 –3 Heading: Psychoanalytic Theory > Structure of the Personality Integrated Processes: Nursing Process Client Need: Psychosocial Integrity Cognitive Level: Application [Applying] Copyright © 2017 F. A. Davis Company Concept : Growth and Development Difficulty: Moderate Feedback 1 Option 1 indicates the predominance of the id, or the pleasure principle. 2 The nurse should associate the statement “I don’t ever cheat on tests; it is wrong” as indicative of the predominance o f the superego. Freud described the superego as the part of the personality that internalizes the values and morals set forth by primary caregivers. The superego can be referred to as the “perfection principle.” 3 Option 3 indicates the predominance of th e ego, or the reality principle. 4 Option 4 indicates the predominance of the id, or the pleasure principle. PTS: 1 CON: Growth and Development 14. ANS: 1 Chapter: Bonus Chapter 1, Concepts of Personality Development Objective: Psychoanalytic theory —Freud Page: 2 –3 Heading: Psychoanalytic Theory > Structure of the Personality Integrated Processes: Nursing Process Client Need: Psychosocial Integrity Cognitive Level: Application [Applying] Concept: Addiction and Behaviors Difficulty: Moderate Feedbac k 1 The nurse should identify that the husband’s actions are driven by the predominance of the id. According to Freud, the id is the part of the personality that is identified as the pleasure principle. The id is the locus of instinctual drives. 2 The su perid is not one of Freud’s components of personality. 3 The ego is the reality principle. 4 The superego is the perfection principle. PTS: 1 CON: Addiction and Behaviors 15. ANS: 3 Chapter: Bonus Chapter 1, Concepts of Personality Development Obje ctive: A nursing model of interpersonal development —Peplau Page: 11 –12 Heading: A Nursing Model —Hildegard E. Peplau > Peplau’s Stages of Personality Development Integrated Processes: Nursing Process Client Need: Psychosocial Integrity Cognitive Level: App lication [Applying] Concept: Growth and Development Difficulty: Moderate Copyright © 2017 F. A. Davis Company Feedback 1 Learning to count on others occurs in stage one when newborns have needs met. 2 Learning to delay satisfaction occurs in stage two. 3 The nurse should identify that th e child using swear words in kindergarten has not successfully completed the identifying oneself stage, according to Peplau’s interpersonal theory. During this stage of early childhood, a child learns to structure self -concept by observing how others inter act with him or her. 4 Developing skills in participation occurs in stage four. PTS: 1 CON: Growth and Development 16. ANS: 2 Chapter 1: Bonus Chapter 1, Concepts of Personality Development Objective: Interpersonal Theory —Sullivan Page: 6 Heading: I nterpersonal Theory Integrated Processes: Nursing Process Client Need: Psychosocial Integrity Cognitive Level: Application [Applying] Concept: Growth and Development Difficulty: Moderate Feedback 1 A deficit in the infancy stage of development would not cause the client to have anxiety with delayed gratification. 2 The nurse should associate the client’s behavior with a deficit in the childhood stage of Sullivan’s interpersonal theory. The childhood stage in Sullivan’s interpersonal theory typically occu rs from 18 months to 6 years of age, during which the child learns to experience a delay in personal gratification without undue anxiety. 3 A deficit in the early adolescence stage of development would not cause the client to have anxiety with delayed gra tification. 4 A deficit in the late adolescence stage of development would not cause the client to have anxiety with delayed gratification. PTS: 1 CON: Growth and Development COMPLETION 17. ANS: superego Chapter 1: Bonus Chapter 1, Concepts of Pers onality Development Objective: Psychoanalytic theory —Freud Page: 2 –3 Heading: Psychoanalytic Theory > Structure of the Personality Integrated Processes: Teaching and Learning Client Need: Psychosocial Development Cognitive Level: Analysis[Analyzing] Copyright © 2017 F. A. Davis Company Conce pt: Growth and Development Difficulty: Moderate Feedback: According to Sigmund Freud, the statement “It is never right to take something that doesn’t belong to you” reflects the predominance of the superego structure of the personality. Freud organized th e structure of personality into three major components: the id, the ego, and the superego, which are distinguished by their unique functions and different characteristics. The superego is the perfection principle, in which the values and morals set forth b y primary caregivers are internalized. PTS: 1 CON: Growth and Development Copyright © 2017 F. A. Davis Company Bonus Chapter 2: Complementary and Psychosocial Therapies Multiple Choice Identify the choice that best completes the statement or answers the question. ____ 1. A nursing instructor is teaching about complementary therapies. Which student statement indic ates that learning has occurred? 1. “Complementary therapies view all humans as being biologically similar.” 2. “Complementary therapies view a person as a combination of multiple, integrated elements.” 3. “Complementary therapies focus on p rimarily the structure and functions of the body.” 4. “Complementary therapies view disease as a deviation from a normal biological state.” ____ 2. A client reports taking St. John’s wort for a major depressive episode. The client states, “I’ m taking the recommended dose, but it seems like if two capsules are good, four would be better!” Which is an appropriate nursing response? 1. “Herbal medicines are more likely to cause adverse reactions than prescription medications.” 2. “Increasing the amount of herbal preparations can lead to overdose and toxicity.” 3. “The U.S. Food and Drug Administration does not regulate herbal remedies, therefore, ingredients are often unknown.” 4. “Certain companies are better than others. Always buy a reputable brand.” ____ 3. A client with chronic lower back pain says, “My nurse practitioner told me that acupuncture may enhance the effect of the medications and physical therapy prescribed.” What type of therapy is the nurse practitioner recommending? 1. Alternative therapy 2. Physiotherapy 3. Complementary therapy 4. Biopsychosocial therapy ____ 4. A client diagnosed with chronic migraine headaches is considering acupuncture. The client asks a clinic nurse, “How does this treatment work?” Which is the best response by the nurse? 1. “Western medicine believes that acupuncture stimulates the body’s release of pain-fighting chemicals called endorphins.” 2. “I’m not sure why he suggested acupuncture. There are a lot of risks, including HIV.” 3. “Acupuncture works by encouraging the body to increase its development of serotonin and norepinephrine.” 4. “Your acupuncturist is your best resource for answering your specific questions.” ____ 5. Alternative approaches refer to interventions that are used instead of conventional treatment. A client asks a nurse to explain the difference between alternative and complementary medicine. Which is an appropriate nursing response? 1. “Alternative medicine is a more acceptable practice than complementary Copyright © 2017 F. A. Davis Company medicine.” 2. “Alternative and complementary medicine are terms that essentially mean the same thing.” 3. “Complementary medicine disregards traditional medical approaches.” 4. “Compl ementary therapies partner alternative approaches with traditional medical practice.” ____ 6. A lethargic client is diagnosed with major depressive disorder. After taking antidepressant therapy for 6 weeks, the client’s symptoms have not resolved. Which nutritional deficiency should a nurse identify as potentially contributing to the client’s symptoms? 1. Vitamin A deficiency 2. Vitamin C deficiency 3. Iron deficiency 4. Folic acid deficiency ____ 7. A client inquires about the practice of therapeutic touch. Which nursing response best explains the goal of this therapy? 1. “The goal is to improve circulation to the body by deep, circular massage.” 2. “The goal is to re -pattern the body’s energy field by the use of rhythmic hand motions.” 3. “The goal is to improve breathing by increasing oxygen to the brain and body tissues.” 4. “The goal is to decrease blood pressure by body toxin release.” ____ 8. A nursing student, having no knowledge of alternative treatments, states, “Aren’t these therapies ‘bogus’ and, like a fad, will eventually fade away?” Which is an accurate nursing response? 1. “Like nursing, complementary therapies take a holistic approach to healing.” 2. “The American Nurses Association is researching the effectiveness of these therapies.” 3. “It is important to remain nonjudgmental about these therapies.” 4. “Alternative therapy concepts are rooted in psychoanalysis.” ____ 9. Herbs and plants can be useful in treating a variety of conditions. Which treatment should a nurse determine is appropriate for a client experiencing frequent migraine headaches? 1. Saint John’s wort combined with an antidepressant 2. Ginger root combined with a beta -blocker 3. Feverfew, used according to directions 4. Kava -kava added to a regular diet ____ 10. A nurse teaches a client about alternative therapies for back pain. When a practitioner cor rects subluxation by manipulating the vertebrae of the spinal column, what therapy is the practitioner employing? 1. Allopathic therapy 2. Therapeutic touch therapy 3. Massage therapy 4. Chiropractic therapy Multiple Response