Question 1

A group of nursing students is reviewing information about Freud's personality structure. The students demonstrate understanding of this information when they identify the ability to form mutually satisfying relationships as a function of what element of personality?

Accepted Answer

In Freud's personality structure, the ability to form mutually satisfying relationships is a fundamental function of the ego and is formed throughout a child's development. Defense mechanisms are coping styles that protect a person from unwanted anxiety. The unconscious refers to feelings and thoughts outside awareness and not remembered. The id is formed by unconscious desires, primitive instincts, and unstructured drives.

Question 2

When describing the influence of Harry Stack Sullivan on psychiatric-mental health nursing, which would an instructor address as a major concept?

Accepted Answer

Harry Stack Sullivan (1892-1949), an American psychiatrist, extended the concept of interpersonal relations to include characteristic interaction patterns. Rogers addressed the concept of unconditional positive regard. Fromm addressed the need for harmony and understanding between an individual and society. Jung addressed the collective unconscious such that individuals had both extroverted and introverted tendencies.

Question 3

A nursing student is to provide a class presentation about interpersonal and psychoanalytic theories. As part of this presentation, the student is planning to address the major way these two categories differ. Which would the student include as key to interpersonal theories?

Accepted Answer

Although there are similarities between psychoanalytic and interpersonal theories, the major difference is that interpersonal theories acknowledge the importance of individual relationships in personality development. Instincts and drives are less important. The potential for goodness forms the basis of humanistic theories.

Question 4

A psychiatric-mental health nurse is integrating Carl Rogers's theory into the plan of care for a client with a mental illness. The nurse incorporates understanding of this theory through which action?

Accepted Answer

Carl Rogers advocated developing unconditional positive regard for the client (i.e., a nonjudgmental caring for the client). Genuineness of the therapist was also an important factor. Rogers did not address validation, instinctual drives, and basic needs.

Question 5

A nurse performs behaviors that the treatment team would like the client to develop. The client internalizes these behaviors through pervasive imitation. The treatment team is integrating which cognitive theory in the client's treatment?

Accepted Answer

Bandura developed his ideas after being concerned about violence on television contributing to aggression in children. He believes that important behaviors are learned by internalizing the behaviors of others. His initial contribution was identifying the process of modeling: pervasive imitation, or one person trying to be similar to another. Erickson identified eight stages of psychosocial development. Skinner proposed that if a behavior is reinforced or rewarded, the behavior will probably be repeated. Freud's psychoanalytic model identified the human mind as composed of conscious and unconscious mental processes.

Question 6

A psychiatric-mental health nurse is preparing a review class for a group of colleagues on the various theoretical models used in psychiatric-mental health nursing. When describing cognitive theories, which statement would the nurse practitioner most likely include about what these theories attempt to do?

Accepted Answer

Cognitive theories attempt to link internal thought processes with human behavior. Psychodynamic theories attempt to explain mental processes and how they affect behavior. Behavioral theories attempt to describe how people learn and act. Developmental theories attempt to explain normal human growth and development over time.

Question 7

When integrating the Neuman systems model while caring for a client diagnosed with a mood disorder, which would a nurse focus on with regard to the client?

Accepted Answer

The Neuman systems model focuses on the client system interacting with the environment. Neuman was one of the first psychiatric nurses to include the concept of stressors in understanding nursing care. Behaviors, relationships, and self-care activities would not be addressed.

Question 8

A nurse is integrating Peplau's model when providing care to a client with a mental illness. Which would the nurse identify as a key component?

Accepted Answer

Anxiety is a key concept of Peplau's model. According to her, anxiety is the energy that arises when expectations that are present are not met. If anxiety is not recognized, it continues to rise and escalates toward panic. Suffering and nonverbal behaviors are not addressed with Peplau's model. Orem focused on self-care.

Question 9

A group of nursing students is reviewing information about the various nursing theorists and their application to psychiatric-mental health nursing. The students demonstrate understanding when they identify which theorist as responsible for developing the theory of cultural care diversity and universality?

Accepted Answer

The nurse-anthropologist who developed the theory of cultural care diversity and universality is Madeleine Leininger. Calista Roy developed an adaptation model. Hildegard Peplau focused on the nurse-client relationship and emphasized the power of empathy. Dorothea Orem developed the self-care deficit nursing theory.

Question 10

A client is being discharged from the psychiatric unit this afternoon, and a nurse needs to teach the client about discharge medications. The client is exhibiting signs of moderate anxiety about the upcoming discharge. Based on Peplau's views regarding anxiety, the nurse would expect to implement the education plan at which time?

Accepted Answer

Mild anxiety is useful for learning; therefore, it would be appropriate to begin educating the client when anxiety decreases to a mild level. Severe anxiety interferes with learning. Anxiety should be relieved as much as possible, but it would be unrealistic to expect that the client would become completely free of anxiety.

Question 11

A nursing instructor is integrating Piaget's theory of cognitive development into the discussion of learning and mental health issues affecting adolescents. The instructor would identify this age group as in what stage?

Accepted Answer

Adolescents are in the formal operations stage of development. School-age children are in the concrete operations stage. Children between the ages of 2 and 7 years are in the preoperational stage of cognitive development. Infants and toddlers to age 2 years are in the sensorimotor stage.

Question 12

While working with an older client, a nurse begins to think of the client as a grandparent and responds to the client as a grandchild. The nurse is developing what type of emotional reaction?

Accepted Answer

The nurse, upon feeling that the client reminds the nurse of a grandparent, is developing countertransference. The nurse is developing an attachment to the client, thus treating the client as a grandparent. Empathy refers to the ability to feel what the client is feeling. Transference is the displacement of the thoughts, feelings, and behaviors originally associated with a significant other from childhood onto a person in a current therapeutic relationship. Modeling is pervasive imitation, or one person trying to be similar to another.

Question 13

A psychiatric-mental health nurse is working on an inpatient unit that uses a privilege system. The nurse understands that this intervention integrates which group of theories?

Accepted Answer

Interventions such as privilege systems and token economies are interventions based on behavioral theories. Understanding childhood and adolescent experiences and their manifestations as adult problems reflects developmental theories. Exploring personal capabilities to develop self-worth reflects humanistic theories. Focusing on thought processes and how they relate to behavior reflects cognitive theories.

Question 14

A nurse applying King's model to a nurse-client interaction identifies the outcome using what term?

Accepted Answer

According to King's theory, the outcome of the interaction within a nurse-client relationship is a transaction, defined as the transfer of value between two or more people. Adaptation is associated with Roy's model. Transpersonal caring is associated with Watson. Self-system is associated with Peplau.

Question 15

A nurse is assessing a young adult and determines that the individual has achieved successful resolution of the previous stage of growth and development as evidenced by demonstrating which traits?

Accepted Answer

In the stage before young adulthood-adolescence, the young adult would have successfully developed identity, achieving the outcome of devotion and fidelity. A young adult is experiencing a current developmental conflict of intimacy versus isolation, with the ultimate long-term outcome of achieving affiliation and love. Drive and hope are the long-term outcomes of infancy. Direction and purpose are the long-term outcomes of the preschool stage. Production and care are the long-term outcomes of adulthood, which the young adult has yet to reach.

Question 16

A group of nursing students is reviewing information about psychodynamic theories. The students demonstrate a need for additional study when they identify who as a humanistic theorist?

Accepted Answer

Carl Jung is considered a Neo-Freudian theorist. Rogers, Maslow, and Perls are considered humanistic theorists.

Question 17

A nurse is assessing a client diagnosed with anxiety and observes the client yelling and screaming. The nurse, integrating Peplau's theory, describes this behavior using what term?

Accepted Answer

According to Peplau, behavioral cues related to the levels of anxiety are "relief behaviors." Panic is the most severe form of anxiety manifested by an inability to function. Empathetic linkage is the ability to feel in oneself the feelings experienced by another person. Social distance is a concept associated with formal and informal support systems. It is the degree to which the values of the formal support organization and primary group members differ.

Question 18

A nurse is watching a video that depicts a client and therapist interacting. The client is asked to say whatever comes to the client's mind. The nurse identifies this technique using what term?

Accepted Answer

The video is depicting free association, as described by Freud, in which a person verbalizes spontaneous, uncensored words of whatever comes to mind. Dream work refers to the interpretation of dreams as part of psychoanalysis. Gestalt therapy involves individual and group exercises to bring unmet needs into awareness. Classical conditioning refers to behavior that occurs in response to a stimulus.

Question 19

A nurse is developing a plan of care integrating Maslow's hierarchy of needs. Which area would the nurse identify as the priority?

Accepted Answer

According to Maslow's hierarchy, physiologic and survival needs, such as adequate food, are the priorities. These are followed by safety and security needs (predictable social environment), love and belonging needs (acceptance from family), and esteem needs (positive self-image).

Question 20

A group of nurses is reviewing the various theories that form the basis for psychiatric-mental health nursing. The nurses demonstrate understanding of these theories when they identify which theorists as addressing female development? Select all that apply.

Accepted Answer

Both Gilligan and Miller addressed female development, identifying that females develop differently from males. Maslow focused on a hierarchy of needs, Bandura focused on learning through the internalization of behaviors of others, and Thorndike focused on reinforcement of positive behavior as important for learning.

Quiz 7: Psychosocial Theoretic Basis of Psychiatric Nursing