Mental Health Chapter 3

Which is an advantage of group therapy over individual therapy for a client with a borderline personality disorder?

Group therapy provides the client with relationship opportunities upon which to test behavior modifications

A 55-year-old client is being treated for narcissistic personality disorder. The therapist shows caring and appropriate regard for the client. The therapist's behavior is an example of which concept of behavior theory?

Modeling

The case manager is assessing a 2-year-old child who was adopted by their foster parents 5 months ago. The child has been mistrustful of their foster parents. What is the most likely current psychosocial stage of development that the case manager identifies for the child?

autonomy versus shame and doubt

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

basic needs

Which therapeutic factor refers to the group members' relationships to the therapist and other group members?

group cohesion

Individual psychotherapy consists of three phases. Which statement by the group therapist would reflect that the group is in the working phase of therapy?

"James, when Shane speaks, it seems you become angry and tend to withdraw."

To provide culturally sensitive care, the nurse should consider which when developing psychiatric interventions?

A client's background, beliefs, and concerns

Which individual is most likely to benefit from brief cognitive therapy?

A college freshman who is experiencing intense anxiety in the days before the client's final exams

Which should be considered the fundamental principle of family therapy?

A family is a system of interrelated dependent relationships.

The nurse is working with a client seeking treatment for bulimia and determines that cognitive restructuring will help build the client's self-esteem. Which best describes the goals of cognitive restructuring?

Change distorted thinking and the subsequent behaviors

A nurse regularly volunteers to work double shifts in order to impress the nursing supervisor. This is an example of which defense mechanism?

Compensation

A nurse is reading a journal article about Freud's personality structure. The nurse demonstrates understanding of this information when they identify the ability to form mutually satisfying relationships as a function of which aspect?

Ego

While a nurse is performing an admission assessment for a client in an inpatient mental health setting, the client states, "All of my problems are caused by my parents." The client statement reflects which factor that influences mental health?

Emotional development

The nurse observes an elderly client teaching an adolescent how to crochet a pot holder. The nurse evaluates this behavior as evidence of resolution of Erickson's developmental stage of what?

Generativity vs. stagnation

Which group role is best reflected by the client who consistently validates members' contributions, tries to be the "mediator" between members, and interprets the group's procedures?

Group building and maintenance

Which theorist viewed interpersonal relations as a basis of human development and behavior?

Harry Stack Sullivan

From the standpoint of cognitive therapy, the term cognition refers to what?

How clients think about themselves and their world

A nurse is planning an educational program for families with a mentally ill relative. Which goal is consistent with the current objectives of family education?

Improved family quality of life

Which statement offers the most likely explanation for the decline in the use of Freudian psychoanalysis?

Insurers will not cover the costs.

Interpersonal theorists, such as Harry Stack Sullivan, emphasize which tenet?

Interpersonal socialization of humans throughout their developmental stages

Which nursing theory focuses on the nurse-client relationship and development of problem-solving skills?

Interpersonal theory

In the Freudian model, which is true regarding the id?

It is formed by unconscious desires and primitive instincts.

As has been a habit for as long as the client can recall, the client has a pattern of unconsciously answering questions with half-truths that portray the client in a positive light. When the client engages in this way with his psychotherapist, the client is exhibiting what?

Parataxis

What is the most basic need, according to Maslow's hierarchy of needs?

Physiological

Calling the client by name and spending time with the client are examples of what?

Positive regard

A client has recently joined a group and presented a scenario in which the client ran out of funds to pay the rent this month. The therapist states, "Has anyone else in the group had this experience? Can you share any ideas about how you resolved this situation when it happened to you?" The therapist's intervention utilizes which theory to intervene?

Problem-solving group

Which action reflects group development in the initial stage?

Seeking similarities

The nurse is caring for a client postoperatively who has recently experienced a family member's death. The nurse is demonstrating empathetic linkage with the client with which action?

Telling the client that it is normal to feel sad when someone has died.

A psychiatric mental health nurse is applying Erikson's theory of psychosocial development in the care of a young adult client. What outcome should the nurse identify to best address the developmental conflict that this client is experiencing at this age?

The client demonstrates new interpersonal skills to promote the development of intimate relationships

While assessing a client, the nurse notes the client is functioning at the fourth level according to Maslow's hierarchy of needs. Which observation of the client led the nurse to conclude this?

The client longs to have validation for success and accomplishments.

The client has a longstanding history of depression. A psychoanalytic theorist might say what about the client?

The client may be unconsciously repressing feelings of anger that arise due to early childhood abuse experiences, and these feelings emerge as depression.

A basic function of psychiatric nurses is to implement a group that focuses on helping individuals coping with their illness. This refers to ...

a supportive therapy group.

The nurse is reviewing the note for a 35-year-old female client participating in a group therapy session with others experiencing unexpected life changes. Which role would the nurse identify that the client assumed in the group therapy session?

aggressor

Aaron T. Beck is associated with ...

cognitive therapy.

An adult client diagnosed with depression and social isolation is admitted to the psychiatric-mental health unit. The client states, "I am lonely and don't have any friends because no one cares about me." Which type of therapy would the nurse suggest for the client?

cognitive-behavioral therapy

A nurse is reading a journal article that reviews the various theories of human behavior and mental illness. One of the theories described states that all human beings have the potential for goodness and that therapy helps clients explore their own ability to develop self-worth. The nurse is reading about which theory?

humanistic theory

The nurse and client decided that a booster session should be scheduled during the evaluation and termination phase of cognitive behavioral therapy (CBT). Which is the best time to schedule this appointment?

in 6 months

The nurse is beginning a group counseling session with an open group system. The nurse should explain to the group members that one advantage of an open group system is that ...

new members can join the group at any time.

A group is trying to handle issues related to dominance, control, and power within the group. In what stage of group development is this group?

Working

What is a group that has structure and authority known as?

A formal group

The nurse educator on the psychiatric-mental health unit teaches the staff nurses about utilizing theoretical frameworks while caring for clients and their families. Which statement made by a staff nurse would indicate that teaching was effective?

"Theoretical frameworks are helpful as a guide for our care, but it's important to be flexible with the concepts if necessary for the client."

All psychotherapeutic approaches share the common goal to help the client take on which therapeutic tasks? (Select all that apply.)

- Become a mature, independent individual - Manage or be relieved of the symptomology of the client's personality disorder - Gain an understanding of the internal conflicts associated with the disorder - Identify and understand the importance of the client's true feelings

The nurse is caring for a client with depression using milieu therapy. Which intervention(s) will the nurse include in this therapy? Select all that apply.

- Promote growth by role modeling. - Practice interpersonal relationship skills. - Maintain a therapeutic environment. - Encourage communication between clients.

Which cognitive theorist conceptualized distorted cognitions as a basis for depression?

Aaron Beck

The "ABCD" approach, used in rational-emotive therapy, includes the following four components:

Activating stimulus; identify how to fill the 'blank' about an automatic thought; disproportionate response; disputation of maladaptive beliefs.

Which is the key common element in the various psychotherapeutic approaches?

An effective client-therapist relationship

Cognitive techniques focus on the client's patterns of which type of thinking?

Automatic

The nurse has been asked to sit in and observe a support group for individuals who were once addicted to drugs. The nurse notices that one group member disagrees with statements made by all other group members. What role is this individual playing in the group?

Blocker

A nurse working in a psychiatric facility identifies the goal of cognitive therapy (CT) to be what?

Restructure how a person perceives events.

Client 1 has been talking to Client 2 about Client 2's frequent denial in the group for two weeks. On the third week, Client 2 comes late to the group. When they begin to discuss Client 2's lateness, Client 2 gets up and leaves. The content of this exchange is the discussion. The process that is occurring may be that ...

Client 2 is angry with Client 1 for the confrontation.

The working stage of group therapy is marked by which characteristic?

Conflict and cooperation among group members.

The nurse therapist is setting goals for a family in therapy. One goal is for the family to adopt a healthy family structure. Which would be an appropriate outcome criterion for this goal?

Conflicts are resolved in a rational manner

The nurse has a client who reminds the nurse of the nurse's sister, with whom the nurse has a close and positive relationship. This phenomenon is best characterized by which term?

Countertransference

In a group therapy session, group members confront a 35-year-old client about the client's abuse of prescription pain medications. The client states, "The doctor prescribed me these pills, that doesn't make me a drug addict." The nurse identifies this as an example of which defense mechanism?

Denial

A psychiatric-mental health nurse is leading a group. The nurse identifies that the several group members are assuming individual roles within the group. The nurse understands that individual roles in group Practice Settings for Mental Health Caredynamics have which effect on group functioning?

Disrupt group functioning

A client in a psychiatric clinic has a history of two distinct personality states. The client is also unable to remember important personal information. What is the client likely to be suffering from?

Dissociative identity disorder

The psychiatrist states that repressed memories in the client's unconscious are causing depression. This reasoning implies that the psychiatrist uses which theory?

Psychoanalytic theory

The concept that irrational beliefs lead to negative emotions underlies which psychotherapeutic approach?

Rational emotive behavior therapy

The nurse is providing hygiene care for a 70-year-old client in a nursing home who states that the client does not like the physician. Later, when the physician enters the room, the nurse notes that the client is very friendly with the physician, complimenting the physician's care. Which defense mechanism is this client displaying?

Reaction-formation

The nurse is conducting an admission interview with an adult mental health client. The client begins to talk in a childish voice about riding a bike and playing outside. What defense mechanism is this client demonstra

Regression

A group of psychiatric-mental health nurses are reviewing information about different theorists who have played a role in shaping pyschiatric-mental health nursing practice. The group demonstrates understanding of the information when they identify which theorist as proposing that adult sexuality is an end product of a complex process of development that begins in early childhood and involves a variety of body functions or areas that correspond to stages of relationships, especially with parents?

Sigmund Freud

A client is engaging in conscious resistance to the psychiatric unit's rules when the client does what?

Stating that, "I don't make my bed at home and I'm not making it here."

A student nurse does not want to think about the upcoming final exam. The student nurse will start studying for the exam tomorrow. The student nurse is exhibiting which type of defense mechanism?

Suppression

A mental health nurse is discussing the potential adverse effects of electroconvulsive therapy (ECT). According to Peplau's interpersonal theory, the nurse is functioning in which nursing role?

Teacher

The mental health nurse is helping a client learn more about the client's psychotropic medication. The nurse, in this instance, is functioning with which type of approach to nursing practice?

Teacher

The nursing theorist Peplau identified which as the essence of psychiatric-mental health nursing?

The nurse-client relationship

Why are the developmental theories important to nursing practice?

They outline the process of human growth and development.

A client is undergoing individual psychotherapy. The client is yelling at the therapist because of a fight with the client's spouse about their children several years ago. In this instance, the client is exhibiting which response?

Transference

The nurse is demonstrating countertransference with a client with which behavior?

relating to the client because the client resembles a favorite cousin

An adult client is receiving psychoanalysis with a therapist and realizes that they feel angry toward their parents for past emotional neglect. The client begins to feel angry toward the therapist. Which term describes this phenomenon?

transference

When a therapist is interviewing a client diagnosed with depression, the client's feelings toward the client's parents as a child are being directed at the therapist. This is an example of:

transference.