Chapter 2 Practice Questions
Phallic Freud proposed five psychosexual stages of development. The phallic stage is observed in a 5-year-old child. In this stage, the child identifies with the parent of the same sex and develops superego. The oral stage is observed in an infant from birth up to 1 year of age. The anal stage is observed in a child who is between 1 and 3 years of age. The latency stage is observed in a child who is between 6 and 12 years of age.
According to Freud's theory, which stage of psychosexual development is expected in a healthy 5-year-old child? Oral Anal Phallic Latency
Anal stage During the anal stage (1 to 3 years of age), a child begins to develop a sense of control over instinctual drives and is able to delay immediate gratification to gain a future goal. Fixation in the anal stage is manifested as stinginess, rigid thought patterns, and OCD. Fixation in the oral phase is associated with passivity, gullibility, and dependent behavior. Fixation in the phallic stage may result in reckless, self-assured, and narcissistic behavior. Fixation in the latency stage is associated with difficulty identifying with other people and developing social skills.
According to Freudian theory, fixation in which stage of psychosexual development can cause a stingy nature, rigid thought processes, and obsessive-compulsive disorder (OCD)? Oral stage Anal stage Phallic stage Latency stage
Security operations Sullivan coined the term security operations to describe measures the individual uses to reduce anxiety and enhance security. Freud used psychoanalysis to treat patients. A behavioral therapist analyzes behavior patterns. Graphing developmental milestones would be used by a developmental therapist.
As a result of Sullivan's work, the mental health nurse is aware of the patient's use of which tool? Psychoanalysis Security operations Analysis of behavior patterns Graphing developmental milestones
"Give the child a chocolate each time the child scores well on a test." According to Skinner's theory of operant conditioning, voluntary behaviors are learned through consequences of the behavior. In this case, the child does not score well on tests because they lack interest in studying. Per operant conditioning theory, rewarding the child for scoring well on a test would positively reinforce studying, resulting in better scores. Although spending time with the child and taking extra tests at home would be helpful in improving academic performance, this intervention is not based on the theory of operant conditioning. Appointing a home tutor who makes studying enjoyable or creating a conducive environment for study are interventions to improve the academic performance. Neither of these efforts are based on the theory of operant conditioning.
Based on Skinner's theory of operant conditioning, which advice would the nurse give to a parent who states, "My child performs very badly on exams. My child is quite intelligent but does not seem to enjoy studying"? "Give the child a chocolate each time the child scores well on a test." "Hire a home tutor who can create an interest toward study in the child's mind." "Spend some time with the child and help them take extra practice tests at home." "Design the study room in such a way that it creates a favorable environment for study."
Source of a person's instincts to save themself from harm 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 does not explain emotional frustration, physical abuse, or the ability to differentiate between beliefs and reality.
Which explanation correctly identifies a patient's id? Ability to control the emotional frustration felt from a loss Source of a person's instincts to save themself from harm Not in place if physical abuse occurs after the age of 5 months Able to effectively differentiate between believed experiences and reality
Antipsychotic medication use Psychopharmacotherapy is indicative of an organic or biological reason behind mental illness. Family history may contribute to the patient's diagnosis, but mental illness is not strictly correlated with biology. Situational depression, such as that which accompanies the loss of a loved one, is not considered biological in nature. Personality disorders are generally not considered biological.
Which aspect of a patient's history represents the biological model of mental illness? Family history of anxiety Antipsychotic medication use Depression after the death of a loved one Previous diagnosis of a personality disorder
View each patient as unique and show positive regard. Rogers' theory of humanism encourages the nurse to view each patient as unique and to show positive regard. Ellis's theory of existentialism encourages the patient to focus on "here and now" issues. Piaget's theory of cognitive development provides information for cognitive intervention. Kohlberg's theory of moral development evaluates moral decisions regarding patient care.
Which behavior model based on Rogers' theory of humanism would the nurse apply when caring for patients? Provide information for cognitive intervention. Evaluate moral decisions regarding patient care. View each patient as unique and show positive regard. Encourage the patient to focus on "here and now" issues.
Concrete operational At the concrete operational stage of Piaget's model, the child is able to see other point of views, and logical and abstract thought appears. The sensorimotor stage occurs in infancy, and empathy is not assured. One hallmark of the preoperational stage is expecting the world to see things as one does. The formal operational stage mirrors adult abilities.
Which cognitive stage has a child reached when first starting to have empathy for playmates? Sensorimotor Preoperational Formal operational Concrete operational
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. Trust should be developed during infancy. Autonomy should be developed during the toddler/early childhood stage. A sense of industry is developed during the school-aged years.
Which developmental task of an adolescent would be considered by the nurse when planning care for a 14-year-old patient? Establish trust. Gain autonomy. Achieve identity. Develop a sense of industry.
The original study only included boys and men. Kohlberg's original study only included boys and men and did not consider potential differences between males and females regarding ethical reasoning. The study included adult men, not just adolescents. Other than the lack of female participants, there is no evidence that the group was or was not diverse. Likewise, the sample size has not been implicated.
Which fact about the sample of original participants in Kohlberg's moral development theory suggests that the study was flawed? The original study only included adolescents. The original study only included boys and men. The original study did not include a diverse group. The original study did not have sufficient participants.
Reducing anxiety levels Peplau identified the role of the nurse in reducing anxiety and improving the patient's ability to function at a satisfactory level. Managing milieu, attending to the patient's physiological needs, and documenting patient behaviors and responses are responsibilities of all professional nurses and are not unique to the role of a psychiatric nurse.
Which nursing activity demonstrates the role of a professional psychiatric nurse as identified by Hildegard Peplau? Managing milieu Reducing anxiety levels Documenting patient behaviors Caring for the patient's physiological needs
Reduce anxiety Both Sullivan and Freud coined terms to identify actions that individuals do in an attempt to reduce anxiety. The terms 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.
Which outcome reflects Sullivan's term security operations and Freud's term defense mechanisms? Reduce anxiety Increase self-esteem Increase self-awareness Reduce cognitive distortions
Dysfunctional grieving Interpersonal therapy is considered effective in resolving problems of grief, role disputes, role transition, and interpersonal deficit. Interpersonal therapy is not used with impaired social interaction, medication noncompliance, or disturbed sensory perception.
Which patient problem would be suited most to the use of interpersonal therapy? Dysfunctional grieving Impaired social interaction Medication noncompliance Disturbed sensory perception
Enjoy the holiday until the fractured leg gets better. The advice of enjoying the holiday until the fractured leg gets better suggests focusing on "here and now" issues and taking responsibility for the present situation. This is a characteristic of the existentialism theory. Crying more often to vent feelings can make the patient feel more depressed. Worrying about work being missed does not suggest accepting the situation. Blaming the family for the fracture is not advisable because it does not suggest accepting the situation.
Which patient response to bed rest orders for a leg fracture represents the theory of existentialism? Cry more often to vent feelings. Worry about the work being missed. Blame family members for the fracture. Enjoy the holiday until the fractured leg gets better.
Behavior is learned and can be modified. The premise underlying behavioral therapy is that behavior is learned and can be modified. Behaviorists agree that behavior can be changed without insight into the underlying cause. Unconscious drives are not considered in behavioral therapy. Motives and cognition are not considered in behavioral therapy.
Which premise is associated with behavioral therapy? Behavior is learned and can be modified. Behavior is a product of unconscious drives. Motives must change before behavior changes. Behavior is determined by cognitions, and change in cognitions produces new behavior.
Operant conditioning Theorist B. F. Skinner's work on operant conditioning is based on positive and negative reinforcement. Modeling is demonstrating the desired behavior, but this therapy does not involve negative consequences. Desensitization is used to reduce a patient's fears. Aversion therapy uses negative consequences but not positive reinforcement.
Which prominent behavioral therapy is centered on positive and negative reinforcement? Aversion Modeling Operant conditioning Systematic desensitization
B. F. Skinner B. F. Skinner (1904-1990) represented the second wave of behavioral theorists and is recognized as one of the prime influencers behind the behavioral movement. Sigmund Freud is associated with the psychoanalyst theory. Hildegard Peplau developed an interpersonal theoretical framework. Harry Stack Sullivan focused on interpersonal processes that can be observed in a social framework.
Which researcher is considered a primary behavioral theorist? Sigmund Freud Hildegard Peplau B. F. Skinner Harry Stack Sullivan
Social learning theory Albert Bandura's social learning theory focuses on modeling and self-efficacy. Humanism does not include elements of modeling or self-efficacy. Cognitive development focuses on the progression of a child's cognitive development to adulthood. Existentialism does focus on the individual, particularly self-respect, but modeling has no role in this theory.
Which school of thought is represented by a nurse modeling a behavior and encouraging a young patient to find their own sense of self-efficacy? Humanism Existentialism Social learning theory Cognitive development
Interpersonal psychotherapy Interpersonal psychotherapy is effective short-term therapy that helps in reducing psychiatric symptoms by improving interpersonal relationships, which can be the main cause for depression. Erikson's ego theory gives a developmental model that is more useful for assessment to identify age-appropriate normal skills. Psychodynamic therapy is more suitable for relatively healthy people and is usually considered long-term with a number of sessions. Freud's psychoanalytical theory presents a human developmental process throughout childhood and its relation to human personality.
Which short-term therapy would the nurse apply to reduce the psychiatric symptoms of a patient with depression? Erikson's ego theory Psychodynamic therapy Interpersonal psychotherapy Freud's psychoanalytical theory
Social contract and individual rights Stage 5 of Kohlberg's moral development theory states that social order must be good, which is to say if the social order is corrupt, then changes must be made to assure protection of others' rights. Individualism and exchange (stage 2) occurs when an individual discovers others have differing viewpoints. Maintaining the social order (stage 4) values rules above all else. Universal ethical principles (stage 6) states there should be justice for all involved.
Which stage of Kohlberg's theory of moral development is illustrated by a nurse stating, "If the healthcare policies are not good for my patients, then the policies should change"? Universal ethical principles Maintaining the social order Individualism and exchange Social contract and individual rights
Safety needs Safety needs include both psychological and physical safety. Intimate partner violence may threaten the physical being, and the potential loss of employment affects the patient's psychological security. Physiological needs are less affected, but that could change as the patient's situation changes. Belonging and love needs are also affected but less so than safety. Esteem needs may be secondarily affected.
Which stage of Maslow's hierarchy of needs is most threatened when a patient faces a possible layoff from work and witnesses intimate partner violence at home? Safety needs Esteem needs Physiological needs Belonging and love needs
Does not recognize any other influences The biological model, to the exclusion of other theories and perspectives, does not consider influences such as educational, social, spiritual, cultural, environmental, and economic factors, and these also have proven to play a part in mental health and mental illness. The biological model is not the oldest and most reliable model for explaining mental illness, does not explain every symptom of mental illness, and is not the most popular theory among leading psychiatrists.
Which statement is true of the biological model? Does not recognize any other influences Does not explain every symptom of mental illness Is the most popular theory among leading psychiatrists Is the oldest and most reliable model for explaining mental illness
Carl Rogers Carl Rogers developed a person-centered model of psychotherapy. He emphasized that attitudes of unconditional positive regard, empathetic understanding, and genuineness are essential for the nurse-patient relationship and are helpful for improving outcomes in a patient. Albert Ellis developed an approach of rational emotive behavioral therapy. He believed in encouraging patients to accept themselves as they are, and that patients should be taught to take risks and try out new behaviors. Jean Piaget identified the stages of cognitive development, which is helpful in developing behavioral interventions based on cognitive levels. Albert Bandura developed the concepts of modeling and self-efficacy. He believed that desired outcomes in a patient can be achieved by modifying the patient's beliefs or expectation of their capacity.
Which theorist believed that the nurse's attitudes of unconditional positive regard and empathetic understanding are effective in improving outcomes in patients with psychiatric illnesses? Albert Ellis Carl Rogers Jean Piaget Albert Bandura
Carl Rogers Rogers's contributions included the concept of empathetic understanding, which is the ability to comprehend the feelings and experiences of the patient as if these things were happening to you. This is accomplished best by asking the appropriate questions. He also proposed the importance of unconditional acceptance that, in this case, allows the nurse to ask the question regarding the client's behaviors in a therapeutic manner. This focus is not associated with Piaget, Bandura, or Frankl.
Which theorist is the influence behind the mental health nurse asking the patient, "What can I do to help you reduce anxiety?" Carl Rogers Jean Piaget Albert Bandura Viktor Frankl
Social learning Social learning theory promotes concepts of self-efficacy and includes cognitive functioning related to environmental factors. Rogers's theory of humanism encourages the nurse to view each patient as unique and to show positive regard. Ellis presented the theory of existentialism, which encourages the patient to live in the present. Kohlberg's theory of moral development teaches how to evaluate moral decisions.
Which theory would the nurse use to help a teenage patient learn about the harmful effects of tobacco use to promote de-addiction? Humanism Existentialism Social learning Moral development
