Question 1

A nurse is working with a 9-year-old girl who has been diagnosed with leukemia. Using Piaget's cognitive theory of development, what are some specific ways in which the nurse should interact with the child? Select all that apply.

Accepted Answer

1. The child is at the concrete operational stage when reasoning begins; she should be able to understand when clear information is presented and concrete items are used in explanations. Encouraging participation in favorite activities supports normal developmental processes. The need for privacy is usually typical of adolescence. Touching and playing with equipment is advised at an earlier developmental stage.
3. The child is at the concrete operational stage when reasoning begins; she should be able to understand when clear information is presented and concrete items are used in explanations. Encouraging participation in favorite activities supports normal developmental processes. The need for privacy is usually typical of adolescence. Touching and playing with equipment is advised at an earlier developmental stage.
4. The child is at the concrete operational stage when reasoning begins; she should be able to understand when clear information is presented and concrete items are used in explanations. Encouraging participation in favorite activities supports normal developmental processes. The need for privacy is usually typical of adolescence. Touching and playing with equipment is advised at an earlier developmental stage.

Question 2

A school nurse is explaining to a student that, as a result of an eye exam, it is likely that the student will need to get eyeglasses. The student says, "I guess even though I don't like glasses, I'll get them because they will help me see better." Which of Piaget's intellectual components of development does this statement indicate to the nurse?

Accepted Answer

2. Equilibrium represents a balance between taking in new information and changing schemas to meet a new reality. A schema is a category of knowledge that helps individuals interpret and understand the world. Assimilation is the process of taking in new information into previously existing schemas; it is a thought process that does not involve behavioral change. Accommodation involves changing behavior to account for new knowledge.

Question 3

Which theorist is the nurse modeling when encouraging the patient to develop, strengthen, and use self-efficacy to maintain or regain mental health and wellness?

Accepted Answer

2. Bandura contended that an individual not only reacts to a stimulus but also has the ability to adapt and reinforce positive, healthier responses to the stimulus. This concept, known as self-efficacy, is best reflected when the nurse encourages the patient to develop, strengthen, and use self-efficacy to maintain or regain mental health and wellness. Skinner examined human responses to stimuli. Piaget's theory involved components that explained children and adolescent behavior according to various ages. Freud's theory focuses on psychoanalysis, not self-efficacy.

Question 4

A nurse is providing counseling services to flood victims who are staying in a shelter. According to Maslow's hierarchy of needs, on what category should the nurse focus in order to provide effective assistance?

Accepted Answer

3. Safety and security include emotional and physical security in home, neighboring, and work environments. Until these needs are met, higher order needs cannot be addressed. The services at the shelter provide for the physiological needs of food and housing. The needs of love and belonging and self-actualization must follow meeting more basic needs.

Question 5

A patient tells the nurse that she is extremely unhappy at her job and she doesn't know what to do. Using Rogerian therapeutic techniques, how might the nurse respond?

Accepted Answer

3. Using the Rogerian approach, the clinician should focus on clarifying the client's experience and feelings. Rogers's theory stresses unconditional positive regard, so the clinician should not be critical. Using the Rogerian approach, the clinician should avoid giving advice. This nondirective approach doesn't facilitate changes that clients may need to make to alleviate stress.

Question 6

The psychiatric-mental health nurse uses an eclectic clinical approach with newly admitted patients who are diagnosed with schizophrenia. Which statement most accurately reflects the therapeutic value of an eclectic approach?

Accepted Answer

4. Eclectic approaches various features from several psychiatric theories and therapies to determine what assessment information, interventions, approaches, and evaluation criteria are needed for any given patient. An eclectic approach does not indicate indecision or use of interventions that are unsupported by evidence. An eclectic approach does not indicate a nurse is non-philosophical; rather, this demonstrates that a range of theories are used to understand the best way to approach assessing and planning care for different patients.

Question 7

How might a nurse describe the relationship between mental health treatment and humanism?

Accepted Answer

2. In humanistic philosophy, healing and caring are approached holistically. The philosophy accounts for well-being within the limitations of life in today's world. Humanism purports that service to benefit humanity is accomplished through reason, science, and democracy. Patients are not passive recipients of care but, rather, have the potential to solve their own problems. Patients need to be supported and empowered to develop new perspectives and make self-directed choices.

Question 8

The patient's family brings him to the emergency department because he has been threatening suicide. The patient tells the nurse that he is too hungry to talk and she should just go away. The nurse decides to bring the patient some food before she does a complete assessment. Whose theory would most support the nurse's action?

Accepted Answer

2. Orlando focuses on responding to the patient's immediate needs. Peplau's theory emphasizes the psychodynamic process. Neuman sees the client as a system that seeks homeostasis. Leininger addresses cultural beliefs and values.

Question 9

Which components of Abraham Maslow's humanistic theory support the outcome of a person-centered motivation to grow and develop in a healthy way? Select all that apply.

Accepted Answer

1. Components of Maslow's humanistic theory that support the outcome of person-centered motivation to grow and develop in a healthy way include Maslow's focus on health, needs and self-actualization, and holistic and interactive approach. The human potential for goodness and the use of empathy and positive regard are components of Carl Rogers's humanistic theory.
2. Components of Maslow's humanistic theory that support the outcome of person-centered motivation to grow and develop in a healthy way include Maslow's focus on health, needs and self-actualization, and holistic and interactive approach. The human potential for goodness and the use of empathy and positive regard are components of Carl Rogers's humanistic theory.
3. Components of Maslow's humanistic theory that support the outcome of person-centered motivation to grow and develop in a healthy way include Maslow's focus on health, needs and self-actualization, and holistic and interactive approach. The human potential for goodness and the use of empathy and positive regard are components of Carl Rogers's humanistic theory.

Question 10

A 54-year-old patient tells the nurse that she is very upset that her son has become involved in demonstrations protesting corporate lobbying. Which of Kohlberg's stages of moral development does the nurse identify as her patient's current stage?

Accepted Answer

1. In the conventional stage, the individual focuses on doing his or her duty to keep the social order, which the patient would prefer her son to do. Adaptation and assimilation are concepts of Piaget's cognitive theory, not Kohlberg's stages of moral development. The pre-conventional stage is characterized by avoidance of punishment.

Question 11

A nurse is working with a patient who needs to change unwanted or undesired behavior. The nurse recognizes that which patient response indicates that patient is at the pre-contemplation stage of the stages of change model? Select all that apply.

Accepted Answer

1. The stages of change model include pre-contemplation, contemplation, preparation, action, and maintenance stages. In the pre-contemplation stage, the patient denies a problem and has no desire to change the problem. In the contemplation stage, the patient acknowledges the problem exists and begins to seriously consider changing the problem. In the preparation stage, the patient begins to make plans to change the problem.
3. The stages of change model include pre-contemplation, contemplation, preparation, action, and maintenance stages. In the pre-contemplation stage, the patient denies a problem and has no desire to change the problem. In the contemplation stage, the patient acknowledges the problem exists and begins to seriously consider changing the problem. In the preparation stage, the patient begins to make plans to change the problem.

Question 12

The patient, who is in recovery for alcohol addiction and is a heavy smoker, tells his nurse that he can never stop smoking because it is the only way he can relieve stress. He thinks his other problems are much more serious than his smoking. Having assessed that the patient is at the pre-contemplation stage of change, what would be an appropriate action for the nurse to take?

Accepted Answer

3. At the pre-contemplation stage, without directly addressing or confronting behaviors that require change, nurses can help patients identify helpful techniques to reduce stress. At the contemplation stage, nurses and other clinicians may begin offering treatment options. In the preparation stage, individuals may plan to make changes.

Question 13

A Native American patient diagnosed with lung cancer wants to have a shaman come to the hospital to perform a healing ceremony at his bedside. Using Leininger's theory, how should the nurse respond?

Accepted Answer

1. According to Leininger, the role of the nurse is to provide culturally congruent care. The nurse's first obligation is to her patient. She can help mitigate any impact the ceremony may have on the other patients. There is no indication that the shaman's visit would interfere with other treatment. Care procedures should support an individual's values and beliefs.

Question 14

According to Piaget's cognitive theory of development, which nursing considerations are most appropriate when caring for a 6-year-old child? Select all that apply.

Accepted Answer

2. According to Piaget, the 6-year-old child is in the preoperational stage of cognitive development. Children in this stage benefit from the nurse offering explanations of assessments and procedures and providing opportunities to touch or play with medical equipment prior to assessments and procedures. Promoting interaction with peers and providing information in both verbal and written form are interventions best used for children ages 11 and older, who are at the formal operational stage. Providing consistency of caregiver as well as addressing stranger anxiety are interventions best provided for children up to age two, who are in the sensorimotor stage of cognitive development.
5. According to Piaget, the 6-year-old child is in the preoperational stage of cognitive development. Children in this stage benefit from the nurse offering explanations of assessments and procedures and providing opportunities to touch or play with medical equipment prior to assessments and procedures. Promoting interaction with peers and providing information in both verbal and written form are interventions best used for children ages 11 and older, who are at the formal operational stage. Providing consistency of caregiver as well as addressing stranger anxiety are interventions best provided for children up to age two, who are in the sensorimotor stage of cognitive development.

Question 15

A patient tells her therapist that she is having an affair because she needs more attention and her husband won't give it to her. What component of personality functioning does the patient's statement indicate to the therapist?

Accepted Answer

1. When the id dominates in making decisions, impulsive and perhaps reckless behavior may result. When the ego is able to supersede the id's wishes, the individual can delay gratification. Sensorimotor is not a component of personality function; rather, it is a stage in Piaget's cognitive theory development. Self-esteem is not a component of personality function; rather, it is a level in Maslow's hierarchy of needs.

Question 16

A nurse is making a presentation at her facility in order to promote the Tidal Model of care. What does the nurse describe as some of the commitments made between patients and providers in this model? Select all that apply.

Accepted Answer

1. The Tidal Model represents an interdisciplinary approach to patient care and is informed by the work of Harry Stack Sullivan and Hildegard Peplau. Various commitments are emphasized in this approach, including: providing transparency, becoming the apprentice, developing genuine curiosity, and determining the next steps in recovery. Teaching appropriate language is not a commitment according to this approach.
2. The Tidal Model represents an interdisciplinary approach to patient care and is informed by the work of Harry Stack Sullivan and Hildegard Peplau. Various commitments are emphasized in this approach, including: providing transparency, becoming the apprentice, developing genuine curiosity, and determining the next steps in recovery. Teaching appropriate language is not a commitment according to this approach.
3. The Tidal Model represents an interdisciplinary approach to patient care and is informed by the work of Harry Stack Sullivan and Hildegard Peplau. Various commitments are emphasized in this approach, including: providing transparency, becoming the apprentice, developing genuine curiosity, and determining the next steps in recovery. Teaching appropriate language is not a commitment according to this approach.
5. The Tidal Model represents an interdisciplinary approach to patient care and is informed by the work of Harry Stack Sullivan and Hildegard Peplau. Various commitments are emphasized in this approach, including: providing transparency, becoming the apprentice, developing genuine curiosity, and determining the next steps in recovery. Teaching appropriate language is not a commitment according to this approach.

Question 17

A 74-year-old male patient is distressed that he has not accomplished all that he hoped to in his life. Based on Erikson's developmental stages, which conflict does the nurse consider this patient to be experiencing?

Accepted Answer

1. Integrity vs. despair occurs during late adulthood and involves finding satisfaction or dissatisfaction from examining one's past. Generativity vs. stagnation happens during middle adulthood and involves accomplishment and concern for future generations. Identity vs. identity confusion is characteristic of an adolescent developing a sense of self. Autonomy vs. shame and doubt is the toddler's developmental stage.

Question 18

Which theory or concept does a psychiatric nurse consider to be most closely aligned with Erikson's developmental theory?

Accepted Answer

3. Like Erikson, Sullivan believed that learning and development occur across the life span and that individuals can relearn tasks previously unaccomplished at earlier stages of life. Freud believed all developmental tasks were accomplished by a certain age, and tasks that remained unaccomplished resulted in fixation and caused lifelong psychiatric problems. Freud did not develop behaviorist concepts; furthermore, behaviorist concepts do not account for developmental tasks. Maslow proposed an order of basic human needs that were not linked to developmental stages or tasks. According to Maslow, physiologic needs must be met before higher-level needs such as self-esteem and self-actualization.

Question 19

Which theory does the nurse recognize as the approach that explains how the patient's transformation of information is used?

Accepted Answer

2. Cognitive theory focuses on the internal knowing and thinking processes of individuals. Cognitive theorists examine cognitive development-how perception, organization, and transformation of information occur. Psychoanalytic theory proposes that personality develops in a progressive manner grounded in psychosexual stages. Psychosocial theory focuses on the achievement and mastery of life challenges that occur within certain time periods. Humanistic theory is a holistic perspective that concentrates on the ability of humans to control their everyday events and determine what they want to accomplish in the future.

Question 20

When planning care for patients on the mental health unit, which statement will the nurse consider as using principles associated with the humanistic theory?

Accepted Answer

1. Humanistic theory views physical and mental factors as interrelated and recognizes that a change in one may result in a change in another. This holistic perspective is the major concept of the humanistic theory. Principles of this theory stress that people have the power or potential to solve their own problems and are not passive recipients of care given by psychiatric professionals. Individuals are influenced by their past and the full range of life experiences, not simply by the present situation.

Quiz 4: Psychological Concepts: Theories and Therapies