Mental Health Evolve Chapter 2

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Maslow's theory of humanistic psychology provided nursing with a framework for which of the following? 1 Providing holistic assessment 2 Determining moral development 3 Identifying the potential for success in therapy 4 Conducting nurse-patient interpersonal interactions

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Sullivan's term "security operations" and Freud's term "defense mechanisms" both reflect actions that serve to accomplish which of the following? 1 The reduction of anxiety 2 The increase of self-esteem 3 The increase of self-awareness 4 The reduction of cognitive distortions

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The following table identifies various theorists while summarizing the impact their theories have on mental health nursing. Which theorist has influenced the mental health nurse to ask the patient, "What do you believe triggers you to abuse alcohol?" 1 Carl Rogers 2 Jean Piaget 3 Albert Bandura 4 Viktor Frankl

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What is the premise underlying behavioral therapy? 1 Behavior is learned and can be modified. 2 Behavior is a product of unconscious drives. 3 Motives must change before behavior changes. 4 Behavior is determined by cognitions; change in cognitions produces new behavior

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Interpersonal psychotherapy identifies several different problem types. Which psychosocial dilemma represents one of these classic areas? Select all that apply. 1 Multiple incidences of spousal infidelity 2 The inability to accept the death of a child 3 Depression that is a result of a forced retirement 4 Loss of employment caused by anger management issues 5 Ritualistic behaviors resulting from obsessive-compulsive tendencies

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Sequence these outcomes from highest to lowest priority for a patient diagnosed with mental illness. 1. Within 24 hours, the patient will refrain from carving on arms and self-mutilation behaviors. 2. The patient will consume at least 50% of 2 meals per day. 3. The patient will identify 3 ways to improve troubled relationship with sibling within a week. 4. The patient will identify 3 appealing community volunteer activities within a week. 5. The patient will identify assets and strengths about self within a week.

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A nurse is learning about the characteristics of a self-actualized person. Which features should the nurse evaluate? Select all that apply. 1 Self-acceptance 2 Self-centeredness 3 Respect for others 4 Active social interest 5 Lack of social interest

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A nurse cares for an elderly retired physician hospitalized with a diagnosis of heart failure. Applying Erikson's ego theory, how should the nurse address this patient? 1 Using the patient's first name 2 Doctor, followed by the patient's surname 3 Mr., Ms., or Mrs., followed by the patient's surname 4 A familiar and endearing term, such as Dear or Sweetheart

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A nurse is asked to assess a patient on admission to a psychiatric floor. What part of the history might be representative of the biological model of mental illness? 1 Family history of anxiety 2 Medication with antipsychotics 3 Depression after the death of a loved one 4 Previous diagnosis of a personality disorder

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One implication of Freud's theory of the unconscious on psychiatric mental health nursing is related to the consideration that conscious and unconscious influences can help nurses better understand which situation? 1 The patient's immature behavior 2 The root causes of patient suffering 3 The patient's interpersonal interactions 4 The patient's psychological ability to reason

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Using Maslow's model of needs, the nurse providing care for an anxious patient identifies the priority intervention to be which of the following? 1 Assessing the patient's success at fulfilling appropriate developmental level tasks 2 Assessing the patient for strengths upon which a nurse-patient relationship can be based 3 Planning one-on-one time with the patient to assist in identifying the fears behind anxiety 4 Evaluating the patient's ability to learn and retain essential information regarding condition

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Which nursing activity demonstrates the role of a professional psychiatric nurse as identified by Hildegard Peplau? 1 Managing the milieu 2 Providing counseling 3 Documenting patient behaviors 4 Caring for the patient's physiological needs

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A 5-year-old child has this nursing diagnosis: Ineffective coping related to distress regarding impending divorce of parents as evident by disrespectful behavior toward adults and frequent temper tantrums. Which is the best initial outcome for this child's plan of care? 1 Within one week, the child will show respect for authority figures. 2 Within one week, the child will engage in cooperative play with other children. 3 Within one week, the child will describe feelings about pending family changes. 4 Within one week, the child will identify which parent he or she wants to live with after the divorce.

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Schemas, automatic thoughts, and cognitive distortions are terms that relate to which type of therapy? 1 Biofeedback 2 Psychoanalysis 3 Cognitive-behavioral therapy 4 Rational-emotive behavioral therapy

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Which of the following is considered a primary behavioral theorist? 1 Freud 2 Peplau 3 Skinner 4 Sullivan

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A nurse has been asked for a personal opinion regarding a current set of healthcare policies. The nurse expresses the opinion that, "If it is not good for my patients, then the policy should change." What stage of Kohlberg's theory of moral development is illustrated? 1 Universal ethical principles 2 Maintaining the social order 3 Individualism and exchange 4 Social contract and individual rights

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A nurse is counseling a patient who is advised bed rest due to leg fracture. Which patient response to the injury is as per the theory of existentialism? 1 Cry more often to vent feelings 2 Worry about the work being missed 3 Blame family members for the fracture 4 Enjoy the holiday until the fractured leg gets better

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Which does Freud believe individuals use to cope with anxiety? 1 Suppression 2 The superego 3 Security operations 4 Defense mechanisms

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A nurse is assessing a patient who has destructive tendencies. Which stage of Freud's psychosexual stages of development should the nurse analyze for this behavior? 1 Oral 2 Anal 3 Phallic 4 Latency

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On assessment, the nurse finds that the patient has obsessive-compulsive disorder. The patient has a stingy nature and has rigid thought processes. According to the Freudian theory, fixation in which stage of psychosexual development can cause such symptoms? 1 Oral stage 2 Anal stage 3 Phallic stage 4 Latency stage

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Which of the following is as important difference between the developmental theories of Freud and Erikson? 1 Freud considers the entire life span from birth to old age 2 Erikson viewed individual growth in terms of social setting 3 Freud focuses to a greater extent on cognitive development. 4 Erikson focuses on the development of individual moral thinking.

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Which statement by an 86-year-old patient reflects successful resolution of the expected psychosocial crisis? 1 "I enjoy being retired and having time to myself. Sometimes I go two or three weeks without seeing anyone." 2 "After my spouse died five years ago, my siblings and I have become closer. That gives me a sense of contentment." 3 "I worked all my life to take care of my family but my kids never come to see me. That's okay because I like being alone." 4 "I had chemotherapy for colon cancer three years ago. Since then, I do not have much energy so I quit going to activities at the senior center."

2

A nurse is assessing a group of individuals for psychodynamic therapy. Which type of candidates should the nurse choose? Select all that apply. 1 Patients with mild depression 2 Relatively healthy individuals 3 Patients motivated for change 4 Patients who are psychologically minded 5 Patients with borderline personality disorder

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A nurse is learning about common cognitive distortions. Which distortions related to drawing conclusions should the nurse evaluate? Select all that apply. 1 Labeling 2 Mind reading 3 Fortune-telling 4 Overgeneralization 5 Emotional reasoning

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A nurse models a behavior and encourages a young patient to find his or her own sense of self-efficacy. Which school of thought does this represent? 1 Humanism 2 Existentialism 3 Social learning theory 4 Cognitive development

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Which patient problem would be suited most to the use of interpersonal therapy? 1 Dysfunctional grieving 2 Impaired social interaction 3 Medication noncompliance 4 Disturbed sensory perception

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A 10-year-old child has this nursing diagnosis: delayed growth and development related to insufficient opportunities to interact with other children as evidenced by inability to engage in group play. What is the best outcome for this child's plan of care within the next two months? 1 Voluntarily join a team sport. 2 Find useful ways to engage in solitary play. 3 Attend three sessions with a certified child psychologist. 4 Have an improved sense of self.

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A cognitive therapist would help a patient restructure the thought "I am stupid!" to making which statement? 1 "What I did was stupid." 2 "I am not as smart as others." 3 "Things usually go wrong for me." 4 "Things like this should not happen to anyone."

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A nurse is assessing behavior patterns in patients based on age-appropriate development. Which developmental model should the nurse apply? 1 Erik Erikson's eight stages of development 2 Harry Stack Sullivan's interpersonal theory 3 Sigmund Freud's psychosexual stages of development 4 Hildegard Peplau's theory of interpersonal relationships

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A nurse is learning about the common cognitive distortions that affect patient behavior. Which distortion is present when a patient is obsessed about a minor negative feedback to the extent that it hampers daily life? 1 Labeling 2 Mental filter 3 Overgeneralization 4 Jumping to conclusions

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A patient is suffering from chronic liver disease. The physician has prescribed disulfiram, which causes severe nausea and vomiting when taken with alcohol. Which behavioral theory describes a process the patient might experience? 1 Aversion therapy 2 Operant conditioning 3 Rational-emotive therapy 4 Systematic desensitization

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A patient who smokes several packs of cigarettes daily and drinks large quantities of coffee and soda reacts to every nursing intervention with sarcasm. When asking advice, which is the nurse manager's most helpful response? 1 "Remember that sarcasm represents the oral-stage fixation of development." 2 "You are attempting to work with a patient who likes to keep others off-balance." 3 "You are dealing with a very difficult and resistant patient; just keep with your plan." 4 "If you haven't been able to establish patient trust by now, ask for a change of assignment."

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According to Erikson's Theory of Ego Development, which psychosocial stage of development is a healthy preschool child likely to demonstrate? 1 Initiative vs. guilt 2 Trust vs. mistrust 3 Intimacy vs. isolation 4 Industry vs. inferiority

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According to Maslow's hierarchy of needs theory, which of the following symptoms needs to be addressed as the first priority in caring for a manic patient? 1 Lack of sleep 2 Grandiose thoughts 3 Hyperactive behavior 4 Rapid, pressured speech

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The nurse has to administer an injectable drug to a child. The child is very frightened at the sight of the injection and cries out loudly. To eliminate the fear, the nurse asks the child to watch another child who is getting injected. The other child, who is used to taking injections, shows no reaction while receiving the injection. What type of behavior therapy does this represent? 1 Modeling 2 Aversion therapy 3 Operant conditioning 4 Systematic desensitization

1

The nurse is speaking to the mother of a student. The mother complains, "My child has performed very badly on exams. My child is quite intelligent, but somehow doesn't seem to enjoy studying." Based on B. F. Skinner's theory of operant conditioning, what advice should the nurse give the mother to help her resolve this problem? 1 "Give the child a chocolate each time the child scores well on a test." 2 "Hire a home tutor who can create an interest in the child's mind toward study." 3 "Spend some time with the child and help him or her take extra practice tests at home." 4 "Design the study room in such a way that it creates a favorable environment for study."

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The nurse is talking with a patient to find if there is any unresolved psychosocial crisis present. Based on Erikson's stages of psychosocial development, which statement indicates that the patient has had an unsuccessful resolution of the psychosocial crisis of autonomy vs. shame and doubt? 1 "Why should I take these medicines if this treatment is not going to help me?" 2 "I am sure that I would be able to manage on my own and take care of myself." 3 "I am not as expressive as others. I don't think I would be able to speak up to you." 4 "I do not trust this health care provider. I am not going to take the medicines prescribed."

1

When assessing a patient, the nurse learns the patient is facing a possible layoff from work and is witnessing domestic violence at home. Which stage of Maslow's hierarchy of needs is most threatened? 1 Safety needs 2 Esteem needs 3 Physiological needs 4 Belonging and love needs

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Which nursing theorist identified the impact of internal and external stressors on the equilibrium of the system as the focus of the theory? 1 Betty Neuman 2 Patricia Benner 3 Dorothea Orem 4 Sister Callista Roy

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Which of the following statements is true of the biological model? 1 It does not recognize any other influences. 2 It does not explain every symptom of mental illness. 3 It is the most popular theory among leading psychiatrists. 4 It is the oldest and most reliable model for explaining mental illness.

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While speaking about a student's behavioral problems, the teacher tells the nurse that the student is a bully and is very difficult to control. The teacher is unable to focus on other students because of this student. The nurse advises the teacher to ignore when the child acts out. Based on which concept does the nurse give this advice? 1 Extinction 2 Punishment 3 Positive reinforcement 4 Negative reinforcement

1

Behavior modification methods likely would be most successful when applied to which individual? Select all that apply. 1 The 3-year-old who bites others when angry 2 The 13-year-old who regularly disregards family rules 3 The 38-year-old who is grieving the loss of a spouse and child 4 The 50-year-old who was diagnosed with schizophrenia 30 years ago 5 The 25-year-old who is depressed over being rejected for graduate school

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A nurse is learning about the various theories related to psychiatric nursing. Which functions does the nurse consider as important for learning these therapies? Select all that apply. 1 Improving the patient's symptoms 2 Improving the patient's coping skills 3 Increasing the patient's dependence 4 Helping the patient ignore the problem 5 Helping the patient realize the situation

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Freud identified three levels of human consciousness. Which of the following are characteristics associated with the unconscious level? Select all that apply. 1 May represent unacceptable urges 2 Referred to as the "tip of the iceberg" 3 Generally unretrievable without trained assistance 4 Information is stored just below the surface of awareness 5 Often accounts for memories too painful with which to deal

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Which statements concerning Erikson's developmental model are true? Select all that apply. 1 This model focuses on the recognition of interpersonal skills. 2 The role of defense mechanisms is evaluated using this model. 3 Analysis of this model allows for identification of arrested development. 4 This model is an essential component of the patient's evaluation process. 5 identification of the developmental stage supports effective care planning.

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A patient has begun seeing a psychologist who recommends cognitive-behavioral therapy (CBT). Which are features of this form of therapy? Select all that apply. 1 Successful therapy involves "homework assignments." 2 Rational cognitive distortions are at the root of the psychiatric issue. 3 Thoughts come to the patient slowly, and this adds to depression and anxiety. 4 People have schemas that are unique assumptions about themselves and others. 5 Feelings and behaviors are a result of how people think about and perceive the world.

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A patient has arrived in the emergency department for a psychiatric evaluation. The psychiatrist on call is known to practice using the existentialist theories established by Albert Ellis. What statement best reflects the practitioner's beliefs? 1 "I believe in future-oriented logotherapy." 2 "I believe moral development occurs in stages." 3 "I believe patients should accept themselves as they are and take risks." 4 "I believe in treating patients with unconditional acceptance and positive regard."

3

To assess whether a school age child is satisfactorily resolving the industry vs. inferiority psychosocial crisis, the nurse should ask the parent which question? 1 "Is your child able to bathe and get dressed daily without your help?" 2 "What is your child's reaction when you are separated for an extended period of time?" 3 "How would you describe your child's academic, physical, and social accomplishments?" 4 "What do you think are the strongest and weakest features of the relationship between you and your child?"

3

The nurse is speaking to a patient who recently got divorced and is very depressed. The patient blames himself or herself for the failure of the marriage and feels incapable of getting involved in a future relationship. According to Freud's psychoanalytic theory, what can the nurse interpret from this behavior? 1 The patient's id, ego, and superego are well-balanced. 2 The patient's id is more powerful than superego and ego. 3 The patient's ego is more dominant than id and superego. 4 The patient's superego is more powerful than ego and id.

4

The nurse providing anticipatory guidance to the mother of a toddler should advise that childhood temper tantrums are handled best by which action? 1 Giving the child what he or she is asking for 2 Spanking the child at the onset of the tantrum behaviors 3 Scolding the child when he or she displays tantrum behaviors 4 Ignoring the tantrum and giving attention when the child acts appropriately

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Using Maslow's pyramid, which comment by a patient would have the highest priority for the nurse's response? 1 "I feel so alone. I wish I had someone special in my life." 2 "I did not do a good job on the project my supervisor assigned." 3 "I live too far from art and history museums to visit them as often as I would like." 4 "Four robberies and three assaults occurred in my neighborhood in the past month."

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Which situation expresses how Sullivan viewed anxiety? 1 A sign of guilt in adults 2 Emotional experience felt after the age of 5 years 3 Adults trying to go beyond experiences of guilt and pain 4 Any painful feeling or emotion arising from social insecurity

4

Which technique is used in interpersonal therapy? 1 Challenging defense mechanisms 2 Evaluating thoughts and behaviors 3 Seeking social support and self-assurance 4 Facilitating new patterns of communication and expectations for relationships

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Which therapy is most likely to be effective in treating patients with eating disorders? 1 Behavior therapy 2 Interpersonal therapy 3 Psychodynamic therapy 4 Cognitive-behavioral therapy

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