CH. 2 Quiz
Consider both Sullivan's term security operations and Freud's term defense mechanisms. Which statement suggests that the client's specialized treatment goal has been successfully met? "I really think I can succeed in school now." "I'm experiencing much less anxiety about school now." "Going back to school is hard and I'll need support." "I know that I'm not the only person who has a difficult time in school."
"I'm experiencing much less anxiety about school now." Both Sullivan and Freud coined terms to mean actions that individuals do that are an attempt to reduce anxiety. The terms to do not refer to activities that increase self-esteem. Security operations and defense mechanisms are not conscious and therefore do not increase self-awareness. These terms do not refer to reducing cognitive distortions.
Which client problem would be most suited to the use of interpersonal therapy? Disturbed sensory perception Impaired sensory perception Medication noncompliance Dysfunctional grieving
Dysfunctional grieving Interpersonal therapy is considered to be effective in resolving problems of grief, role disputes, role transition, and interpersonal deficit.
The nurse is planning care for a 14-year-old. The nurse demonstrates an understanding of the developmental task appropriate for this client by providing which experience? Spending one-on-one time with staff to establish trust Providing them with the opportunity to select which unit activities they will participate in to gain autonomy -Encouraging them to talk about their school plans to help achieve identity Assign them to help clean up the dayroom to develop a sense of industry According to Erikson, the task of adolescence is to achieve identity rather than to be left in role confusion. A sense of identity is essential to making the transition into adulthood. While appropriate activities none of the options are specifically identified with the developmental task for a 14-year-old.
Encouraging them to talk about their school plans to help achieve identity According to Erikson, the task of adolescence is to achieve identity rather than to be left in role confusion. A sense of identity is essential to making the transition into adulthood. While appropriate activities none of the options are specifically identified with the developmental task for a 14-year-old.
A prescription for which medication would require the nurse to monitor the client for potential development of the side effect of hypothyroidism? Fluoxetine Bupropion Lithium Imipramine
Lithium Long-term use of lithium may cause hypothyroidism. The other options refer to drugs whose long-term use does not cause hypothyroidism.
The nurse is working with a client experiencing depression stemming from low self-esteem. The client is distrustful of unit staff and "just wants to go home." Initially what is the nurse's priority? -Making the client feel physically and emotionally safe -Teaching the client effective coping skills -Identifying the client's positive traits -Focusing on preparing the client for a speedy discharge
Making the client feel physically and emotionally safe Maslow describes safety as a basic need, meaning that it is so basic to existence that it must be resolved to reduce the tension associated with it. These needs have the greatest strength and must be satisfied before a person turns his attention to higher level needs.
Role-playing is associated with which type of psychotherapy? Psychoanalysis Modeling Operant conditioning Systematic desensitization
Modeling In modeling, the therapist provides a role model for specific identified behaviors, and the client learns through imitation. The therapist may do the modeling, provide another person to model the behaviors, or present a video for the purpose. Some behavior therapists use role-playing in the consulting room for modeling therapy. Demonstration of specific behaviors are not supported by any of the remaining options.
A 49-year-old client diagnosed with schizophrenia at 22 years old is prescribed risperidone. Which nursing assessment is the priority for this client? -Monitoring blood levels to avoid toxicity -Monitoring for abnormal involuntary movements -Observing for secondary mania -Observing for memory changes
Monitoring for abnormal involuntary movements Risperidone has the highest rate of extrapyramidal side effects (EPSs) of the second-generation antipsychotic medications, thus making it imperative to monitor for EPSs. Risperidone is not monitored with blood levels and does not cause mania or memory changes.
Which nursing intervention demonstrates the theory behind operant conditioning? -Rewarding the client with a token for avoiding an argument with another client -Showing the client how to be assertive without being aggressive -Demonstrating deep breathing techniques to a group of clients -Explaining to the client the consequences of not following unit rules
Rewarding the client with a token for avoiding an argument with another client Operant conditioning is the basis for behavior modification and uses positive reinforcement to increase desired behaviors. For example, when desired goals are achieved or behaviors are performed, clients might be rewarded with tokens. These tokens can be exchanged for food, small luxuries, or privileges. This reward system is known as a token economy. None of the remaining options demonstrate reward for positive behaviors, climate, and structure, for healing.
A 38-year-old client diagnosed with major depression states, "my provider said something about the medicine I've been prescribed will affect my neurotransmitters. What exactly are neurotransmitters?" What is the nurse's best response to the client's question? "Neurotransmitters are chemical messengers in the brain that help regulate specific functions such as depression." "Neurotransmitters are too complicated to explain easily. Just know that the medication will help your mood and make you less depressed." "Neurotransmitters are chemicals in the brain that are the reason you are depressed." "I will ask your provider to give you a more in-depth explanation about why this medication will help your depression."
"Neurotransmitters are chemical messengers in the brain that help regulate specific functions such as depression." Neurotransmitters are chemicals released from neurons that function as a neuromessenger and influence brain functions. Telling the client that the answer is too complicated belittles the client by implying she cannot understand, while stating that neurotransmitters are the reason, she is depressed is too simplistic. Asking the provider to give the education abdicates your responsibility to provide client education.
A cognitive therapist would help a client restructure the thought "I am stupid!" to which statement? "What I did was stupid." "I am not as smart as others." "Things usually go wrong for me." "Things like this should not happen to anyone."
"What I did was stupid." Cognitive therapists help clients identify, reality test, and correct distorted conceptualizations and dysfunctional beliefs, such as realizing that doing a stupid thing does not mean the person is stupid.
A nurse expresses an exclusive belief in the biological model for mental illness when stating "it's the only one I really believe." What conclusion should be drawn from this statement? -The biological model is the oldest and most reliable model for explaining mental illness. -The biological model has been proven to be successful in finding the cause of most symptoms of mental illness. -The biological model is the most popular theory among leading psychiatrists and therefore the one that should be fully embraced. -In believing only in the biological model, other influences on mental health including cultural, environmental, social, and spiritual influences are not taken into account.
-In believing only in the biological model, other influences on mental health including cultural, environmental, social, and spiritual influences are not taken into account. In believing only in the biological model to the exclusion of other theories and perspectives, influences such as educational, social, spiritual, cultural, environmental, and economic are not considered, and these have also been proven to play a part in mental health and mental illness. The other options are untrue.
How does Harry Stack Sullivan's Interpersonal Theory view anxiety? An emotional experience felt after the age of 5 years. A sign of guilt in adults. A painful emotion arising from social insecurity. The result of trying to go beyond experiences of guilt and pain.
A painful emotion arising from social insecurity. According to Sullivan, the purpose of all behavior is to get needs met through interpersonal interactions and decrease or avoid anxiety. He viewed anxiety as a key concept and defined it as any painful feeling or emotion arising from social insecurity or blocks to getting biological needs satisfied.
What is the premise underlying behavioral therapy? -Behavior is learned and can be modified. -Behavior is a product of unconscious drives. -Motives must change before behavior changes. -Behavior is determined by cognitions; change in cognitions produces new behavior.
Behavior is learned and can be modified. The premise underlying behavior therapy is that behavior is learned and can be modified. Behaviorists agree that behavior can be changed without insight into the underlying cause. None of the remaining options are true statements when considering behavioral therapy.
Freud believed that individuals cope with anxiety by implementing which mechanism? The superego Defense mechanisms Security operations Cognitive distortions
Defense mechanisms The ego develops defenses or defense mechanisms to ward off anxiety by preventing conscious awareness of threatening feelings. None of the other options were proposed by Freud as a mechanism for dealing with anxiety.
Based on the current understanding of brain physiology, which neurotransmitter would be the expected target of medication prescribed to manage depression? (Select all that apply.) Dopamine γ-aminobutyric acid (GABA) Serotonin Norepinephrine Acetylcholine
Dopamine Serotonin Norepinephrine Antidepressant medication targets serotonin and norepinephrine. While dopamine is implicated in schizophrenia (increase) and Parkinson's disease (decrease), it is also believed to be a factor in depression. GABA is implicated in anxiety disorders. Acetylcholine is implicated in Alzheimer's disease as well as Huntington's disease and Parkinson's disease.
According to Freud, a client experiencing dysfunction of the conscious as part of the mind will have problems with which aspect of memory? Recent memory Long-term memory All memories Painful memories
Freud described the conscious part of the mind as containing all of the material that the person is aware of at any one time and so as dysfunction of the conscious mind involves all memories.
The nurse providing anticipatory operant conditioning guidance to the mother of a toddler should advise that childhood temper tantrums are best handled by which intervention? -Giving the child what he/she is asking for -Scolding the child when he/she displays tantrum behaviors -Spanking the child at the onset of the tantrum behaviors -Ignoring the tantrum and giving attention when the child acts appropriately
Ignoring the tantrum and giving attention when the child acts appropriately Ignoring the tantrum provides no reinforcement of the undesirable behavior. Instead, approval and reinforcement are given when the child is behaving in the desired way. This is an example of absence of reinforcement, or extinction.
The nurse is caring for an adult client who experienced severe physical abuse from the age of 2 through 12. What information should the nurse provide the client concerning the function of the "id" and the ability to function as an adult? -It has control over the emotional frustration felt as an adult. -It is the source of one's survival instincts. -It is severely damaged by abuse experienced before the age of 5 years. -It provides an individual with the ability to differentiate believed and real experiences.
It is the source of one's survival instincts. Freud delineated three major and distinct but interactive systems of the human personality. At birth we are all id. The id is the source of all drives, instincts, reflexes, needs, genetic inheritance, and capacity to respond as well as all the wishes that motivate us. The id provides an individual with the instincts to survive the emotional trauma associated with physical abuse. None of the other statements accurately describes the id's role in adult functioning.
A nurse is providing care to a 28-year-old client diagnosed with bipolar disorder who was admitted in a manic state. According to Maslow's Hierarchy of Needs theory, the nurse should identify which client symptom as having priority? -Rapid, pressured speech -Grandiose thoughts -Lack of sleep -Hyperactive behavior
Lack of sleep Based on Maslow's theory, physiological needs such as food, water, air, sleep, etc., are the priority and must be taken care of first. The other options are symptoms of mania but not as critical as lack of sleep.
A client states, "I will always be alone because nobody could ever love me." The nurse recognizes that the client is expressing what cognitive-behavioral concept? Emotional consequence Schema Actualization Aversion
Schema Schemas are unique assumptions about ourselves, according to Beck's theory. This statement is an example of a negative schema. Emotional consequence is the end result of negative thinking process, as described by Ellis. Actualization is a level of Maslow's Hierarchy of Needs. Aversion is a therapy characterized by punishment.
Which theorist is associated with behavioral therapy? Freud Skinner Sullivan Peplau
Skinner B.F. Skinner (1904-1990) represented the second wave of behavioral theorists and is recognized as one of the prime movers behind the behavioral movement.
Which assessment should the nurse perform to evaluate the pharmacokinetic effect of a monoamine oxidase inhibitors (MAOIs) antidepressant medication? The status of the client's appetite The results of the liver function test The level of depression exhibited by the client The client's current sleeping patterns
The results of the liver function test Pharmacokinetics refers to the movement of a drug through the body. Four basic processes of pharmacokinetics which determine the concentration of a drug at its sites of action are easily remembered with the acronym ADME: absorption, distribution, metabolism, and excretion. MAOIs can affect liver function and require monitoring. The other options are related to the medication's pharmacodynamic effects.
