Mental Health Chapter 2_Theories and Therapies

A cognitive therapist would help a client restructure the thought "I am stupid!" to which statement? a. "What I did was stupid." b. "I am not as smart as others." c. Things usually go wrong for me." d. "Things like this should not happen to anyone."

a. "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.REF: 25-26

What is the premise underlying behavioral therapy? a. behavior is learned and can be modified b. behavior is a product of unconscious drives c. motives must change before behavior changes d. behavior is determined by cognitions; change in cognitions produces new behavior.

a. 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.REF: 22-23

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? a. Making the client feel physically and emotionally safe b. Teaching the client effective coping skills c. Identifying the client's positive traits d. Focusing on preparing the client for a speedy discharge

a. 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.REF: 27

Which nursing intervention demonstrates the theory behind operant conditioning? a. Rewarding the client with a token for avoiding an argument with another client b. Showing the client how to be assertive without being aggressive c. Demonstrating deep breathing techniques to a group of clients d. Explaining to the client the consequences of not following unit rules

a. 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, patients 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.DIF: Cognitive Level: Apply (Application)REF: page 14TOP: Nursing Process: InterventionMSC: NCLEX: Psychosocial Integrity

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? a. "I really think I can succeed in school now." b. "I'm experiencing much less anxiety about school now." c. "Going back to school is hard and I'll need support." d. "I know that I'm not the only person who has a difficult time in school."

b. "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.DIF: Cognitive Level: Apply (Application)REF: page 24TOP: Nursing Process: AssessmentMSC: NCLEX: Psychosocial Integrity

Freud believed that individuals cope with anxiety by implementing which mechanism? a. superego b. defense mechanisms c. security operations d. cognitive distortions

b. 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.REF: 25-26

How does Harry Stack Sullivan's Interpersonal Theory view anxiety? a. an emotional exerience felt after the age of 5 years b. a sign of guilt in adults c. a painful emotion arising from social insecurity d. the result of trying to go beyond experiences of guilt and pain

c. 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.REF: 21-22

According to Freud, a client experiencing dysfunction of the conscious as part of the mind will have problems with which aspect of memory? a. Recent memory b. Long-term memory c. All memories d. Painful memories

c. All 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.REF: 19

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? a. Spending one-on-one time with staff to establish trust b. Providing them with the opportunity to select which unit activities they will participate in to gain autonomy c. Encouraging them to talk about their school plans to help achieve identity d. Assign them to help clean up the dayroom to develop a sense of industry

c. 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.REF: 23; Table 2-2

A nurse is providing care to a 28-year-old patient diagnosed with bipolar disorder who was admitted in a manic state. According to Maslow's Hierarchy of Needs theory, the nurse should identify which patient symptom as having priority? a. Rapid, pressured speech b. Grandiose thoughts c. Lack of sleep d. Hyperactive behavior

c. 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.DIF: Cognitive Level: AnalyzingREF: page 23TOP: Nursing Process: Outcome IdentificationMSC: NCLEX: Physiological Integrity

Which theorist is associated with behavioral therapy? a. freud b. skinner c. Sullivan d. Peplau

c. 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.REF: 29

Which client problem would be most suited to the use of interpersonal therapy? a. disturbed sensory perception b. impaired sensory perception c. medication noncompliance d. dysfunctional grieving

d. Dysfunctional grieving Interpersonal therapy is considered to be effective in resolving problems of grief, role disputes, role transition, and interpersonal deficit.REF: 21-22

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? a. Giving the child what he/she is asking for b. Scolding the child when he/she displays tantrum behaviors c. Spanking the child at the onset of the tantrum behaviors d. Ignoring the tantrum and giving attention when the child acts appropriately

d. 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.REF: 29, Box 2-1

Using Maslow's model of needs, the nurse providing care for an anxious client identifies which intervention as being a priority? a. Assessing the client's ability to fulfill appropriate developmental level tasks b. Assessing the client for strengths upon which a nurse-client relationship can be based c. Planning one-on-one time to assist in identifying the fears trigger the client's anxiety d. Evaluating the client's ability to learn and retain essential information regarding their current condition

b. Assessing the client for strengths upon which a nurse-client relationship can be based The value of Maslow's model in nursing practice is twofold. First, the emphasis on human potential and the client's strengths is key to successful nurse-client relationships. The second value lies in establishing what is most important in sequencing of nursing actions in the nurse-client relationship.REF: 27-28

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? a. It has control over the emotional frustration felt as an adult. b. It is the source of one's survival instincts. c. It is severely damaged by abuse experienced before the age of 5 years. d. It provides an individual with the ability to differentiate believed and real experiences.

b. 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.REF: 19-20

Role-playing is associated with which type of psychotherapy? a. psychoanalysis b. modeling c. operant conditioning d. systemic desensitization

b. 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.REF: 24

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? a. Emotional consequence b. Schema c. Schema d. Aversion

b. 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.DIF: Cognitive Level: Analyze (Analysis)REF: page 20TOP: Nursing Process: AssessmentMSC: NCLEX: Psychosocial Integrity

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? a. The biological model is the oldest and most reliable model for explaining mental illness. b. The biological model has been proven to be successful in finding the cause of most symptoms of mental illness. c. The biological model is the most popular theory among leading psychiatrists and therefore the one that should be fully embraced. d. In believing only in the biological model, other influences on mental health including cultural, environmental, social, and spiritual influences are not taken into account.

d. 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.DIF: Cognitive Level: Analyze (Analysis)REF: page 26TOP: Nursing Process: AssessmentMSC: NCLEX: Psychosocial Integrity