Prep U: Ch 3: Psychosocial Theories and Therapy
A nurse working on a psychiatric unit is helping clients to understand how individual perceptions determine a person's response or behavior in stressful situations. Which therapeutic approach is the nurse employing?
Cognitive therapy explanation: Cognitive therapy is a psychotherapeutic method used to alter distorted beliefs and problem behaviors by identifying and replacing negative and inaccurate thoughts.
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 explanation: The five roles of the "energized" or healthy family include responding to family members' needs, coping actively with life's problems and stresses, accomplishing family tasks with equal distribution of power, encouraging interaction among family members and the community, and promoting positive personal health practices.
Which is one common mistake that people working in the helping professions do when applying theory to the therapeutic process?
Develop an overzealous commitment to one form of therapy, ignoring the benefits that other types of therapies may have for a given individual. explanation: All theories can contribute beneficial knowledge in various situations. An eclectic approach to care is the most comprehensive and effective.
Which is the key common element in the various psychotherapeutic approaches?
An effective client-therapist relationship explanation: The key common element in the various psychotherapeutic approaches is an effective client-therapist relationship. The nurse-client relationship is critical to the success of the use of any therapeutic modality because the client is unlikely to engage authentically if trust in the relationship is lacking.
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 explanation: The blocker resists progress by arguing or disagreeing beyond reason. The dominator asserts authority and superiority by manipulating the group or certain members. The follower goes along with the ideas of others, assuming an audience role. The gatekeeper facilitates and encourages the contributions of others, thereby keeping communication open.
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. explanation: Supportive therapy groups are usually less intense than psychotherapy groups and focus on helping individuals cope with their illnesses and problems as well as build interpersonal connections. Implementing supportive therapy groups is one of the basic functions of the psychiatric nurse.
Which indicates that the nurse, acting as a leader for a group of recovering clients with alcohol abuse, is addressing the responsibility of maintaining the group's process?
Keeping the group on task by restating goals explanation: In a therapy group, the nurse-therapist has both task and maintenance role functions. Group task functions are concerned with the practical issues of leading a group, whereas groupmaintenance functions focus on less-tangible group processes. Keeping the group focused on its goals is "maintenance" in its nature. Deciding how often the group will meet, selecting individuals for membership in the group, and determining the group's format are considered tasks rather than maintenance items.
The nurse is caring for a 4-year-old child during a well-child visit. According to the Sullivan's stages of development, which behavior would the nurse expect to find in this child?
The child performs actions to earn praise from parents. explanation: According to Sullivan's life stages, this child is in the childhood stage. During this stage, children look at their parents as sources of praise and appreciation. If the child is in the infant stage (0-language), the child's primary need is to have bodily contact and tenderness and would most likely prefer to sit in the mother's lap. The preadolescent child (8-12 years) tends to move away from family as the primary satisfaction in the relationship and start making friends. In the juvenile stage (5-8 years), the child learns to negotiate individual needs. Expressing views and ideas to the parents begin at this age.
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. explanation: Psychoanalytic theory explores a person's past to explain current behaviors. In addition, the explanations of levels of conscious and defense mechanisms are derived from psychoanalytic theory.
The significance of the use of praise in the therapeutic relationship between the psychiatric nurse and the school-aged client is particularly important for which reason?
The client takes pleasure in individual accomplishments and develops confidence explanation: The relationship that develops between the therapist and client is very important. In accordance with Erikson's stages of psychosocial development, a school-aged child is in a stage of industry vs. inferiority with a need to fulfill the virtue of competence. The nurse can establish and maintain the therapeutic relationship by recognizing and validating successes through praise.
A client is using cognitive therapy as an adjunct treatment for bipolar disorder. Which would be an overall goal for this client related to the use of cognitive therapy for this condition?
The client will engage in self-care independent of professional assistance. explanation: Cognitive therapy assumes that individuals have an innate ability to solve their own problems; thus, the overarching treatment goal is for the patient to engage in self-care independent of professional assistance.
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 explanation: During the working stage of group development, the group solves selected problems of working together; handles conflicts between members or between members and the leader; and works on issues of dominance, control, and power within the group.
The nurse leader of a group observes a group member attempting to stimulate the group to action or decision. The nurse interprets this member as fulfilling which role?
energizer explanation: The energizer attempts to stimulate the group to action or decision. The recorder writes suggestions, keeps minutes, and serves as group memory. The orienter defines the position of the group with respect to its goals. The coordinator shows or clarifies the relationships among various ideas and suggestions.
A nurse is watching a video that depicts a client and therapist interacting. The client is asked to say whatever comes to the client's mind. The nurse identifies this as:
free association. explanation: The video is depicting free association, as described by Freud, in which a person verbalizes spontaneous, uncensored words of whatever comes to mind. Dream work refers to the interpretation of dreams as part of psychoanalysis. Gestalt therapy involves individual and group exercises to bring unmet needs into awareness. Classical conditioning refers to behavior that occurs in response to a stimulus.
Which statement would indicate that the group is in the working phase of development?
"I don't understand why Mary doesn't see my point of view, and frankly it really irritates me when she does that!" explanation: In the working phase, members confront each other with constructive feedback and honesty to gain insight into dysfunction. The initial stage of group development occurs when members are becoming acquainted and searching for similarity between themselves and others. The mature stage of the group demonstrates positive characteristics such as empathy, effective communication, and a definite, inclusive group culture. The termination stage encompasses when the group evaluates and explores members' feelings about it and the impending separation.
When the psychiatric nurse is aware of the cultural beliefs of a client diagnosed with bipolar disorder, the therapeutic process is most enhanced by what?
Facilitating the nurse's understanding of how these beliefs affect the client's perception of the disorder explanation: When the psychiatric nurse is aware of the cultural beliefs of a client diagnosed with bipolar disorder, the therapeutic process is most enhanced by facilitating the nurse's understanding of how these beliefs affect the client's perception of the disorder. The therapeutic process is not most enhanced by strengthening the therapeutic nature of the nurse-client relationship through mutual respect, facilitating the nurse's ability to effectively empathize with the client, or showing the client that the nurse is truly interested in the client as a person.
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 explanation: The ability to teach and help others reveals progression through the developmental stage of generativity (in which individuals are industrious and offer themselves to society) vs. stagnation (characterized by introversion and lack of outward connection with others).
When focusing on the primary goal of crisis therapy, a psychiatric nurse counsels a single mother who is recovering from a suicide attempt to help her achieve which goal?
Help regain confidence in her pervious ability to cope with the stress of being a single parent explanation: The psychiatric nurse uses counseling interventions to assist clients in improving or regaining their previous coping abilities since the primary goal of crisis therapy is to regain precrisis levels of function. When focusing on the primary goal of crisis therapy, a psychiatric nurse counsels a single mother who is recovering from a suicide attempt to help her regain confidence in her pervious ability to cope with the stress of being a single parent.
A psychologist chose the profession because the psychologist was inspired by an aunt who was a successful psychologist. Which of Freud's ego defense mechanisms is this indicative of?
Identification explanation: Identification is an ego defense mechanism where a person models the actions and opinions of influential others while searching for identity or aspiring to reach a personal, social, or occupational goal. In this case the psychologist has taken up the profession as the psychologist admires an aunt who is successful in the same profession. Denial is the failure of an individual to accept his or her situation. Compensation is an ego defense mechanism where an individual tries to work hard and achieve well in one area in order to compensate for the perceived deficiencies in another area. Displacement is an ego defense mechanism where a client expresses intense feelings toward persons who are less threatening than the one who aroused those feelings.
A nurse is preparing to assess a family. The nurse best adopts the view of the family unit as a system by using which approach?
Identifying strengths and problem areas within the family structure explanation: When viewing the family unit as a system, the nurse does not focus on one individual member. Instead the nurse works at all times simultaneously with a mental picture of the family system and the individuals in that system. The nurse focuses on determining strengths and problem areas within the family structure and function.
A psychiatric-mental health nurse is integrating key concepts associated with psychodynamic theories into the care of clients with mental health problems. Which concept would the nurse integrate as a core concept to guide the planning of nursing interventions?
Interpersonal relationships explanation: Several psychodynamic concepts are important in the practice of psychiatric-mental health nursing, such as interpersonal relationships, defense mechanisms, transference, countertransference, and internal objects. In particular, a therapeutic interpersonal relationship is a core of psychiatric-mental health nursing intervention.
Interpersonal theorists, such as Harry Stack Sullivan, emphasize which tenet?
Interpersonal socialization of humans throughout their developmental stages explanation: Development is somewhat predictable as progression through stages and achieved by means of interactions with others. Freud emphasized the id, ego, and superego. Conditioning stems from the behavioral theory. Alleviating symptoms by utilizing biological tools, such as medications, is related to the biophysiological theory.
A nurse has completed an assessment of a family and has identified the family's strengths. Which would the nurse be least likely to identify as a strength?
Rigid roles of family members explanation: Family strengths, although variable, often inlcude effective communication, mutual support of members, flexible roles, general stability, healthy coping strategies and good support systems.
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 explanation: Transference is the client's unconscious assignment of feelings and attitudes originally associated with important figures in the client's early life to the therapist. Countertransference is the emotional reaction to the client based on the therapist's unconscious needs and conflicts. Resistance is defined as the conscious or unconscious psychological defense against bringing repressed thoughts into conscious awareness. Parataxis is the presence of distorted perception or judgment exhibited by the client during therapy.
A client asks the nurse to help the client understand what a psychologist meant when the psychologist said that the client displaced anger. Which is the best definition for displacement the nurse can provide?
Transferring feelings—such as frustration, hostility, or anxiety—from an idea, person, or object to one that is less threatening explanation: Displacement refers to the transfer of feelings from one object to another. It involves neither replacement or making up for feelings nor negating them.
