Bonus Chapter 1: Concepts of Personality Development

17. "It is never right to take something that doesn't belong to you." According to Sigmund Freud, this statement reflects the predominance of the _______________ structure of the personality.

ANS: superego Page: 2-3 Feedback: According to Sigmund Freud, the statement "It is never right to take something that doesn't belong to you" reflects the predominance of the superego structure of the personality. Freud organized the structure of personality into three major components: the id, the ego, and the superego, which are distinguished by their unique functions and different characteristics. The superego is the perfection principle, in which the values and morals set forth by primary caregivers are internalized.

14. A female complains that her husband only satisfies his sexual needs and never her needs. According to Freud, which personality structure should a nurse identify as predominantly driving the husband's actions? 1. The id 2. The superid 3. The ego 4. The superego

ANS: 1 Page: 2-3 Feedback 1 The nurse should identify that the husband's actions are driven by the predominance of the id. According to Freud, the id is the part of the personality that is identified as the pleasure principle. The id is the locus of instinctual drives. 2 The superid is not one of Freud's components of personality. 3 The ego is the reality principle. 4 The superego is the perfection principle.

6. Which underlying concept should a nurse associate with interpersonal theory when assessing a client? 1. The effects of social processes on personality development 2. The effects of unconscious processes and personality structures 3. The effects on thoughts and perceptual processes 4. The effects of chemical and genetic influences

ANS: 1 Page: 5 Feedback 1 The nurse should associate interpersonal theory with the underlying concept of effects of social process on personality development. Sullivan developed stages of personality development based on his theory of interpersonal relationships and their effect on personality and individual behavior. 2 Sullivan's theory did not include unconscious processes and personality structures. 3 Sullivan's theory did not include thoughts and perceptual processes. 4 Sullivan's theory did not include chemical and genetic influences.

11. A 10-year-old child wins the science fair competition and is chosen as a cheerleader for the basketball team. A nurse should recognize that this child is in the process of successfully accomplishing which stage of Erikson's developmental theory? 1. Industry versus inferiority 2. Identity versus role confusion 3. Intimacy versus isolation 4. Generativity versus stagnation

ANS: 1 Page: 8 Feedback 1 The nurse should recognize that a 10-year-old child who is successful in school both academically and socially has effectively accomplished the industry versus inferiority developmental stage of Erikson's psychosocial theory. The industry versus inferiority stage of development usually occurs between 6 and 12 years of age, at which time individuals achieve a sense of self-confidence by learning, competing, performing successfully, and receiving recognition from others. 2 Identity versus role confusion occurs between the ages of 12 and 20 years. 3 Intimacy versus isolation occurs between the ages of 20 and 30 years. 4 Generativity versus stagnation occurs between the ages of 30 and 65.

3. A 9-month-old child screams every time his mother leaves and will not tolerate anyone else changing his diaper. The nurse should determine that, according to Mahler's developmental theory, this child's development was arrested at which phase? 1. The autistic phase 2. The symbiotic phase 3. The separation-individuation phase 4. The rapprochement phase

ANS: 2 Page: 10 Feedback 1 Phase I is the autistic phase, which the child has completed. 2 The nurse should understand that this client's development was halted in the symbiotic phase of Mahler's developmental theory, which usually occurs between 1 and 5 months of age. 3 The child has not entered into the separation-individuation phase of development, in which a child establishes the understanding of being separate from the mother. 4 The rapprochement phase occurs in phase III, sub-phase 3.

8. A 1-month-old infant is left alone for extended periods, has little physical stimulation, and is malnourished. Based on this infant's situation, in which phase of development, according to Mahler's theory, should a nurse expect to see a potential deficit? 1. The symbiotic phase 2. The autistic phase 3. The consolidation phase 4. The rapprochement phase

ANS: 2 Page: 10 Feedback 1 The symbiotic phase occurs at 1-5 months of age. 2 The nurse should expect that a 1-month-old infant who is left alone, has little physical stimulation, and is malnourished would not meet the autistic phase of development. The autistic phase of development usually occurs from birth to 1 month, at which time the infant's focus is on basic needs and comfort. 3 The consolidation phase occurs at ages 24-36 months. 4 The rapprochement phase occurs at ages 16-24 months.

2. A nurse observes a 3-year-old client willingly sharing candy with a sibling. According to Peplau, which psychological stage of development should the nurse determine that this child has completed? 1. Learning to count on others 2. Learning to delay satisfaction 3. Identifying oneself 4. Developing skills in participation

ANS: 2 Page: 13 Feedback 1 Learning to count on others occurs during the first stage of Peplau's theory. 2 The nurse should determine that this client has completed the learning to delay satisfaction stage of development, according to Peplau's interpersonal theory. This stage typically occurs in toddlerhood when one learns the satisfaction of pleasing others. 3 Identifying oneself occurs during the third stage. 4 Developing skills in participation occurs during the fourth stage.

5. When assessing clients, a psychiatric nurse should understand that psychoanalytic theory is based on which underlying concept? 1. A possible genetic basis for the client's problems 2. The structure and dynamics of the personality 3. Behavioral responses to stressors 4. Maladaptive cognitions

ANS: 2 Page: 2 Feedback 1 Freud did not consider genetics as the basis to psychoanalytic theory. 2 The nurse should understand that psychoanalytic theory is based on the underlying concepts of the structure and dynamics of personality. Psychoanalytic theory was developed by Sigmund Freud and explains the structure of personality in three different components: the id, the ego, and the superego. 3 Freud did not consider stressors as the basis to psychoanalytic theory. 4 Freud did not consider maladaptive cognitions as the basis to psychoanalytic theory.

13. According to Freud, which statement should a nurse associate with predominance of the superego? 1. "No one is looking, so I will take three cigarettes from Mom's pack." 2. "I don't ever cheat on tests; it is wrong." 3. "If I skip school, I will get into trouble and fail my test." 4. "Dad won't miss this little bit of vodka."

ANS: 2 Page: 2-3 Feedback 1 Option 1 indicates the predominance of the id, or the pleasure principle. 2 The nurse should associate the statement "I don't ever cheat on tests; it is wrong" as indicative of the predominance of the superego. Freud described the superego as the part of the personality that internalizes the values and morals set forth by primary caregivers. The superego can be referred to as the "perfection principle." 3 Option 3 indicates the predominance of the ego, or the reality principle. 4 Option 4 indicates the predominance of the id, or the pleasure principle.

16. A nurse is caring for a hospitalized client who is quarrelsome, opinionated, and has little regard for others. According to Sullivan's interpersonal theory, the nurse should associate the client's behaviors with a previous deficit in which stage of development? 1. Infancy 2. Childhood 3. Early adolescence 4. Late adolescence

ANS: 2 Page: 6 Feedback 1 A deficit in the infancy stage of development would not cause the client to have anxiety with delayed gratification. 2 The nurse should associate the client's behavior with a deficit in the childhood stage of Sullivan's interpersonal theory. The childhood stage in Sullivan's interpersonal theory typically occurs from 18 months to 6 years of age, during which the child learns to experience a delay in personal gratification without undue anxiety. 3 A deficit in the early adolescence stage of development would not cause the client to have anxiety with delayed gratification. 4 A deficit in the late adolescence stage of development would not cause the client to have anxiety with delayed gratification.

15. A father of a 5-year-old demeans and curses his child for disobedience. In turn, when upset, the child uses swear words at kindergarten. A school nurse recognizes this behavior as unsuccessful completion of which stage of development, according to Peplau? 1. Learning to count on others 2. Learning to delay satisfaction 3. Identifying oneself 4. Developing skills in participation

ANS: 3 Page: 11-12 Feedback 1 Learning to count on others occurs in stage one when newborns have needs met. 2 Learning to delay satisfaction occurs in stage two. 3 The nurse should identify that the child using swear words in kindergarten has not successfully completed the identifying oneself stage, according to Peplau's interpersonal theory. During this stage of early childhood, a child learns to structure self-concept by observing how others interact with him or her. 4 Developing skills in participation occurs in stage four.

4. According to Peplau, a nurse who provides an abandoned child with parental guidance and praise following small accomplishments is serving which therapeutic role? 1. Technical expert 2. Resource person 3. Surrogate 4. Leader

ANS: 3 Page: 13 Feedback 1 A technical expert performs medical interventions in the best interest of the patient. 2 A resource person provides specific, needed information to help the client with a problem. 3 The nurse who provides an abandoned child with parental guidance and praise is serving the role of the surrogate, according to Peplau's interpersonal theory. A surrogate serves as a substitute for another person—in this case, the child's parent. 4 A leader directs nurse-client interaction to facilitate achievement of goals.

12. A client has flashbacks of sexual abuse by her uncle. She did not have these memories until recently, when she became sexually active with her boyfriend. A nurse should identify this experience as which part of Sullivan's concept of the self-system? 1. The good me 2. The bad me 3. The not me 4. The bad you

ANS: 3 Page: 5 Feedback 1 The good me develops in response to positive feedback. 2 The bad me develops in response to negative feedback. 3 The nurse should identify a client remembering sexual abuse when becoming sexually active with her boyfriend as experiencing the not me part of the personality. According to Sullivan, the not me part of the personality develops in response to situations that produced intense anxiety in childhood. 4 The bad you is not a component of Sullivan's self-system.

9. A 6-year-old boy uses his father's flashlight to explore his 3-year-old sister's genitalia. According to Freud, in which stage of psychosocial development should a nurse identify this behavior as normal? 1. Oral 2. Anal 3. Phallic 4. Latency

ANS: 3 Page: 5 Feedback 1 The oral stage occurs at ages birth to 18 months and includes: chewing, sucking and biting behaviors. 2 The anal phase occurs 18 months to 3 years and involves gaining independence and control. 3 The nurse should identify this behavior as normal, because the 6-year-old client who focuses on genital organs is in the phallic stage of Freud's psychosexual stages of development. Children in the phallic stage of development focus on genital organs and develop a sense of sexual identity. Identification with the same-sex parent also occurs at this stage. 4 The latency phase occurs ages 6-12 years old and involves socialization with peers.

1. A jilted college student is admitted to a hospital following a suicide attempt and states, "No one will ever love a loser like me." According to Erikson's theory of personality development, a nurse should recognize that this patient has a deficit in which developmental stage? 1. Trust versus mistrust 2. Initiative versus guilt 3. Intimacy versus isolation 4. Ego integrity versus despair

ANS: 3 Page: 7 Feedback 1 The trust versus mistrust stage occurs from birth to 18 months. 2 Initiative versus guilt occurs between ages 3 to 6 years 3 The nurse should recognize that the client who states, "No one will ever love a loser like me" has not adequately completed the intimacy versus isolation stage of development. The intimacy versus isolation stage is presumed to occur in young adulthood between the ages of 20 and 30 years. The major developmental task in this stage is to establish intense, lasting relationships or commitment to another person, cause, institution, or creative effort. 4 Ego integrity versus despair occurs between age 65 and death.

10. A married, 26-year-old client works as a schoolteacher. She and her husband have just had their first child. A nurse should recognize that this client is successfully accomplishing which stage of Erikson's developmental theory? 1. Industry versus inferiority 2. Identity versus role confusion 3. Intimacy versus isolation 4. Generativity versus stagnation

ANS: 3 Page: 9 Feedback 1 Industry versus inferiority occurs between ages 6 and 12 years old. 2 Identity versus role confusion occurs between ages 12 and 20 years old. 3 The nurse should recognize that a 26-year-old client who is married and has a child has successfully accomplished the intimacy versus isolation stage of Erikson's developmental theory. The intimacy versus isolation stage of young adulthood involves forming lasting relationships. Achievement of this task results in the capacity for mutual love and respect. 4 Generativity versus stagnation occurs between ages 30 and 65 years old.

7. A physically healthy, 35-year-old, single client lives with his parents, who provide total financial support. According to Erikson's theory, which developmental task should a nurse assist the client to accomplish? 1. Establishing the ability to control emotional reactions 2. Establishing a strong sense of ethics and character structure 3. Establishing and maintaining self-esteem 4. Establishing a career, personal relationships, and societal connections

ANS: 4 Page: 9 Feedback 1 The ability to control emotional reactions occurs in the initiative versus guilt stage. 2 Establishing a strong sense of ethics and character occurs in the identity versus role confusion stage. 3 Establishing and maintaining self-esteem occurs in the industry versus inferiority stage. 4 The nurse should assist the client in establishing a career, personal relationships, and societal connections. According to Erikson, non-achievement of the generativity versus stagnation stage results in self-absorption, including withdrawal from others and having no capacity for giving of the self to others.