Psych - Videbeck Ch 3

A client with a history of trauma has told the nurse that he is pursuing psychoanalysis with an independent therapist. What statement by the client would be most consistent with a Freudian approach to psychoanalysis?

"We're spending quite a bit of time exploring the themes in my dreams."

A client has entered treatment for substance abuse and psychotherapy. The client asks about what to expect from individual psychotherapy sessions if the client "works really hard at it." The nurse can answer the question most effectively with which response?

"You'll never return to substance use again."

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

Two staff nurses in a psychiatric emergency department are being considered for a promotion that will be announced via memo on a unit bulletin board. They work in a collaborative team environment, have been colleagues for 15 years, and socialize outside work. Nurse A hears from a third colleague that Nurse B was promoted. Nurse A goes into the staff coffee room and slams several cupboard doors. A custodian enters and remarks, "You seem pretty upset." Nurse A replies, "I am not at all upset." In this instance, Nurse A is probably using:

denial.

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

Positive regard

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.

The nurse determines that Pavlov's theory of classical conditioning is demonstrated with which client behavior?

The client states "My stomach is growling" with the sound of the food cart in the hallway.

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.

A client has completed treatment for an addiction to prescription pain medications. As part of the client's therapy, the family participates in a family therapy program. Which reason would best explain the need for a family system approach to therapy?

The dynamics of the entire family have and will continue to shift to accommodate a change.

A couple is going to marital counseling. During a session, the husband states that, after working long hours at the office, he just wants to come home and relax. He reports that his wife often "bombards" him with problems as soon as he settles down, which results in a prolonged argument. The wife admits that she does this, but states that she feels neglected and that her husband does not take the family problems seriously. She doesn't want her marriage to turn out like her parents' marriage. How would a behaviorist explain the wife's actions?

The long argument in which she and her husband participate positively reinforces her behavior.

Aaron T. Beck is associated with ...

cognitive therapy.

A group of nursing students is reviewing information about Freud's personality structure. The students demonstrate understanding of this information when they identify the ability to form mutually satisfying relationships as a function of:

ego.

The nurse is considering a client's hierarchy of needs according to Maslow's theory. Place the needs of a client in order from basic to higher level.

the client's need for food, sleep, and exercise the client's need to feel safe in the environment the client's need for family involvement the client's need for a positive self-image

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.

In viewing the stages of the family life cycle, those families in later life undergo which emotional transition?

Accepting the shifting of generational roles

Degree of agreement between the leader's norms and the group's norms, ability to deal with members' infractions, and conformity to group norms are characteristics of what kind of groups?

All groups

An instructor is teaching a class about the use of cognitive therapies in psychiatric nursing. Which statement made by a student identifies a need for further instruction?

"Lengths of stay for clients in inpatient settings are becoming longer each year."

Against her wishes, a 14-year-old daughter has accompanied her parents to a family therapy session. Ongoing marital problems had prompted the parents to seek weekly counseling, though this is the first time that their daughter has attended. Which of the nurse-therapist's statements provides the best rationale for the daughter's attendance at this therapy session?

"Even though your parents started coming for help because of their relationship with each other, a problem in one part of the family affects everyone in the family."

A nurse is meeting with a therapy group for the first time. The nurse notes that members are silent and fidgety. Which statement by the nurse would be best in this situation?

"I notice there is a lot of silence and some discomfort. This is pretty common in new groups and is perfectly OK. Who would like to share how they feel right now?"

Which client would the nurse assess as having the priority need for attendance at a life and social skills group?

A 38-year-old homeless man with a history of chronic paranoid schizophrenia

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

Cognitive interventions are based on the concept of cognition. Who developed cognitive behavioral therapy?

Aaron Beck

Who developed cognitive therapy for persons with depression?

Aaron Beck

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

Automatic

Which developmental conflict correlates with the toddler, according to Erikson's eight stages of man?

Autonomy vs. shame and doubt

A nurse is leading a group. During the session, the nurse observes the members testing each other to see if they can trust each other. The nurse leader also notes that the members are testing the nurse, too. The nurse interprets this behavior as characteristic of which phase?

Beginning

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

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.

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

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

A psychiatric nurse who was sexually assaulted by a tall, blonde man finds herself becoming severely anxious whenever a man with those characteristics is admitted to the unit. Which symptom is the nurse is exhibiting?

Countertransference

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

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

Interpersonal socialization of humans throughout their developmental stages

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 emergence of nursing theories has had a positive, direct impact on client care through which channels?

Evidence-based nursing practice

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

Interpersonal theory

A client states to the nurse "I am anxious because I feel that I don't belong." The nurse recognizes that, based on the client's history of growing up in foster care, the client would benefit most from which theory use?

Frederick Perl's Gestalt therapy

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

Several members of a self-help group are making T-shirts for the group to wear in a parade. This is an example of which element of group therapy?

Group cohesiveness

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 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

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

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 phase of individual psychotherapy involves establishing mutual boundaries of the relationship between the client and the mental health nurse?

Introductory

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

A new program has been launched with the goal of fostering the development of life skills for community-dwelling clients with mental illness, aiming to teach them how to shop, cook, and manage money more effectively. This program demonstrates what approach to practice?

Needs-oriented approach

A nurse has been working with a client who has a personality disorder and the nurse has recognized the potential for countertransference. How can the nurse best prevent this phenomenon?

Reflecting on the nurse's own thinking to identify times where the nurse may project individual feelings on to the client

Which action reflects group development in the initial stage?

Seeking similarities

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 has lost a job of 20 years. This is an example of which type of crisis?

Situational

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.

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."

The initiator-contributor, information seeker, information giver, and coordinator are examples of what?

Task roles

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.

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.

According to Maslow, mentally healthy people who achieve self-actualization are able to do what?

Use varied approaches to solve problems

According to Yalom (2005), there are 11 therapeutic factors through which changes occur in group psychotherapy. Which factor correlates with learning to give to others?

altruism

What best describes the use of psychotherapy as a mental health intervention?

bringing about a change in feelings, attitudes, thinking, and behavior

Ivan P. Pavlov is associated with the term ...

classical conditioning.

A nurse is performing discharge planning for a client who will be returning home to live with family members. Which concept will be most important for the nurse in considering client needs?

family dynamics

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.

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

group cohesion

When describing the influence of Harry Stack Sullivan on psychiatric-mental health nursing, which would an instructor address as a major concept?

interpersonal relations

Which concept states that if a certain behavior is rewarded with praise, the behavior will probably be repeated?

operant conditioning

A client states to the nurse, "I am not sure how others see me but I want them to think I am happy." The nurse determines the client is describing which behavior?

persona

Two staff nurses in a psychiatric emergency department are being considered for a promotion that will be announced via memo on a unit bulletin board. They work in a collaborative team environment, have been colleagues for 15 years, and socialize outside work. Nurse A hears from a third colleague that Nurse B was promoted. Nurse A responds, "I knew I'd never get the job. The nurse manager hates me." Nurse A is most likely demonstrating:

projection.