Chapter 3: PrepU
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." "Your parents and I are hoping that we can teach you some conflict management strategies that you can use to intervene when your parents disagree at home." "Part of your responsibility as a member of a family is to devote time and energy to helping others, including your parents' marriage." "Even though none of this has a direct impact on you, we all believe that you deserve to be informed about what is happening in your parents' marriage."
"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." If there is a breakdown in the system, all members are affected. Thus, a change or disruption in one family member affects the family system and all its members. This does not mean, however, that children are responsible for fixing or mediating their parents' relationship.
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? "The context of practice has changed considerably over the years for psychiatric nurses." "Solution-focused approaches have been effective with hospitalized people experiencing delusions." "Lengths of stay for clients in inpatient settings are becoming shorter each year." "Lengths of stay for clients in inpatient settings are becoming longer each year."
"Lengths of stay for clients in inpatient settings are becoming longer each year." Explanation: The lengths of stay for clients in inpatient settings are becoming shorter each year, not longer. All the other statements are true.
The psychiatric nurse considers online psychotherapy most appropriate for the which client? 14-year-old male diagnosed with oppositional defiance disorder who has been expelled from school 26-year-old new mother diagnosed with postpartum depression 59-year-old male with chronic alcohol abuse and mobility problems 68-year-old cognitively impaired female who recently experienced a stroke
59-year-old male with chronic alcohol abuse and mobility problems Online psychotherapy, or e-therapy, is a viable alternative source for help when traditional psychotherapy is not accessible. Modifications have also occurred in the use of psychotherapy to treat the older adult, chronically suicidal clients with borderline personality disorders, and clients with destructive behaviors such as alcohol or drug abuse. Online therapy can also serve as a means to remove barriers to accessing therapy, such as difficulty with mobility and driving. Thus, online psychotherapy is most appropriate for a 59-year-old male with chronic alcohol abuse who has mobility problems. Therapy for a 14-year-old male diagnosed with oppositional defiance disorder should be seen within the context where the client is experiencing the most difficulty, such as in the school setting. A new mother diagnosed with postpartum depression should be seen in person to be able to see the bonding process occur between her and the newborn. The 68-year-old with cognitive impairment due to stroke should be seen in the office or at home to assess further for cognitive or physical deficits. This client may not be able to access or effectively utilize the Internet.
Which should be considered the fundamental principle of family therapy? A family is composed of individuals who care about each other. A family is a system of interrelated dependent relationships. Children are pivotal to family function. Parental involvement is the key to family health.
A family is a system of interrelated dependent relationships. The fundamental principle of family therapy is that a family is a system of interrelated dependent relationships. The other statements are not reflective of the fundamental principle of family therapy.
What is a group that has structure and authority known as? An informal group A formal group A primary group A secondary group
A formal group A formal group has limited interaction, structure, and authority, which usually emanates from above. A faculty meeting is an example. Informal groups provide much of a person's education and contribute greatly to individual values. Members of primary groups have face-to-face contact, boundaries, norms, and explicit and implicit interdependent roles. An example is a family. Secondary groups usually are larger and more impersonal than primary groups. Members do not have emotional ties.
The nurse is planning care for a family with a child having peer difficulties due to the child's conduct. The nurse demonstrates understanding of the principles of family system theories by which action? Addressing the child and family as a single inseparable unit. Developing a therapeutic relationship with the child. Working with the parents to meet the child's needs. Developing interventions for the parents and siblings to adjust to the child's needs.
Addressing the child and family as a single inseparable unit. Just as any group can be viewed as a system, a family can be understood as a system with interdependent members. Family system theories view the family as an open system whose members interact with their environment as well as among themselves. One family member's change in thoughts or behavior can cause a ripple effect and change everyone else's. The family is the unit of care; however, the members involved define themselves as a "family." A therapeutic relationship and working with the parents and/or siblings may be involved, but these are unrelated to the principles of family system theories.
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 Formal groups Primary groups Secondary groups
All groups Explanation: A group is three or more people with related goals. The following characteristics vary among different types of groups: size, homogeneity or heterogeneity of members, stability, degree of cohesiveness among members, climate, conformity to group norms, degree of agreement with the leader's and the group's norms, ability to deal with members' infractions, and goal-directedness and task orientation of the group's work.
Which is the key common element in the various psychotherapeutic approaches? An effective client-therapist relationship The clients' history of therapeutic success in the past The therapist's ability to manage the clients' symptoms The underlying origin of the clients' issues
An effective client-therapist relationship 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 client's parents have begun a program of therapy that includes giving the client a token each time the client follows directions. Which theoretical framework provides the background for such a program? Behavioral theory Systems theory Token economy theory Psychodynamic theory
Behavioral theory Explanation: Reinforcing behaviors with rewards reflects a basic principle of behavioral therapy.
A nurse therapist feels sad after sessions with a client. The client's passiveness reminds the nurse of a family member who led a very unhappy life. What is the term for this emotional dynamic? Free association Reaction formation Transference Countertransference
Countertransference Countertransference occurs when nurses have extreme emotional responses (positive or negative) to clients.
In a group therapy session, group members confront a 35-year-old client about the client's abuse of prescription pain medications. The client states, "The doctor prescribed me these pills, that doesn't make me a drug addict." The nurse identifies this as an example of which defense mechanism? Sublimation Projection Regression Denial
Denial Denial is refusing to recognize a reality that might be troublesome or traumatic. -Regression refers to going back to an earlier and happier time of development. -Projection is when a person refuses to recognize behavior in oneself and instead "projects" it or sees it in someone else. -Sublimation means taking repressed feelings and transforming them into positive and constructive pursuits.
When working with children, the major consideration for framing assessment and all nursing interventions is what? Chronological age Developmental level Personal likes and dislikes Relationships with peers
Developmental level Explanation Whenever assessing children or adolescents, development level will frame the assessment and implementation of the management plan.
A client in a psychiatric clinic has a history of two distinct personality states. The client is also unable to remember important personal information. What is the client likely to be suffering from? Acute stress disorder Derealization disorder Dissociative amnesia Dissociative identity disorder
Dissociative identity disorder Explanation: Dissociative identity disorder is one of the dissociative disorders characterized by disruption of the integrated functions of consciousness, memory, identity, or environmental perception. In dissociative identity disorder, the client may assume two or more distinct identities that recurrently take control of the client's behavior. The client may also be unable to remember important personal information that is of a stressful nature. Dissociative amnesia is characterized by a fugue experience in which the client moves to a new geographical location, with no memory of past events. Derealization disorder is characterized by a feeling of being detached from one's mental processes or body. Acute stress response occurs in response to a stressful event and is characterized by reexperiencing, hyperarousal, and avoidance.
Which action by the group leader demonstrates effective leadership? Firmly disciplining negative behavior Using autocratic leadership strategies Encouraging participation by all members Conducting meetings based on personality attributes
Encouraging participation by all members The key to being a good leader is to integrate group leadership, knowledge, and skills with nursing interventions that fit a selected group. Firmly disciplining negative behavior, using autocratic leadership strategies, and conducting meetings based on personality attributes are not keys to being a good leader.
The nurse is aware of the changing demographics and growth of ethnic subcultures of the community and is trying to ensure that the needs for psychotherapy are effectively met. How should the nurse best work toward this goal? Ensure that therapists and clients always share the same ethnic background. Foster cultural competency among those caregivers who perform psychotherapy and counseling. Perform teaching for clients about the different cultures represented in the United States. Enlist the assistance of counselors in clients' home countries using e-therapy.
Foster cultural competency among those caregivers who perform psychotherapy and counseling. Explanation: While e-therapy and client education may have some utility, the primary factor needed in order to provide trans-cultural care is cultural competence on the part of practitioners. It is not always feasible to match care providers and clients based on ethnicity.
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? Trust vs. mistrust Initiative vs. guilt Industry vs. inferiority Generativity vs. stagnation
Generativity vs. stagnation 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).
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? Individual Task Group cohesion Group building and maintenance
Group building and maintenance Explanation: Group building and maintenance roles are oriented toward overall group functioning. They alter or maintain the way of working to strengthen, regulate, and perpetuate the group. Individually oriented behavior, which often stems from anxiety, distracts from and temporarily stymies the group and its progress. Task roles promote growth and productivity. Group cohesion relates to bonding and solidarity, the feeling of "we" instead of "I."
Which nursing theorist was opposed to the idea that the client passively receives treatment? Sister Callista Roy Madeleine Leininger Hildegard Peplau Dorothea Orem
Hildegard Peplau Explanation: Hildegard Peplau was opposed to the idea that the client passively receives treatment and the nurse passively acts out doctor's orders. Peplau believed that the nurse serves as a stranger, resource person, teacher, leader, surrogate, and counselor.
From the standpoint of cognitive therapy, the term cognition refers to what? Faulty thought patterns that result in abnormal behavior How clients think about themselves and their world Dysfunctional ways of responding to situations An idea
How clients think about themselves and their world Cognitive therapy focuses on how clients think about themselves and their world. Addressing cognitions, cognitive therapy posits that how a person perceives an event, rather than the event itself, determines its relevance and the emotional response to it. Cognitive therapy helps clients recognize the process and results of their thinking.
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? Focusing on each individual member's health problems Identifying strengths and problem areas within the family structure Educating the sick client with methods to maintain independence Fostering emotional support for each family member
Identifying strengths and problem areas within the family structure 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 nurse is planning an educational program for families with a mentally ill relative. Which goal is consistent with the current objectives of family education? Fewer hospital admissions Improved family quality of life Improved medication compliance Increased independence with activities of daily living
Improved family quality of life Explanation: The successful outcome measures for family education are reduced family burden and improvement in the family's quality of life. Client improvement often accompanies this outcome but is not a primary goal.
Interpersonal theorists, such as Harry Stack Sullivan, emphasize which tenet? The existence of the id, ego, and superego The importance of conditioning responses in working with people Interpersonal socialization of humans throughout their developmental stages Alleviating symptoms by utilizing biological tools, such as medicines
Interpersonal socialization of humans throughout their developmental stages 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.
Which nursing theory focuses on the nurse-client relationship and development of problem-solving skills? Theory of human becoming Interpersonal theory Behavioral nursing theory Adaptation theory
Interpersonal theory Explanation: Hildegard Peplau's interpersonal theory focuses primarily on the nurse-client relationship, in which problem-solving skills are developed. The theory incorporates communication and relationship concepts from Harry Stack Sullivan's interpersonal theory. Orem's self-care deficit theory is a behavioral nursing theory. Roy's adaptation theory states that humans are biopsychosocial adaptive systems who use coping mechanisms to adapt to both internal and external stimuli. Parse's theory of human becoming posits that quality of life from each person's own perspective is the goal of nursing practice.
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 Deciding how often the group will meet Selecting individuals for membership in the group Determining that the group's format will be closed
Keeping the group on task by restating goals 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 group maintenance 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.
To facilitate the understanding of a crisis, which intervention should the nurse employ? Allow the crisis to escalate to reach a quicker resolution Provide direction of next steps for the client to take Focus on long-term resolutions to prevent reoccurrence of the crisis Listen and assist the client to articulate his or her feelings
Listen and assist the client to articulate his or her feelings Explanation: An important part of crisis intervention is helping individuals to develop an accurate understanding of the situation and its potential consequences. This usually involves listening to individuals' accounts of their experience and assisting them to identify and articulate their feelings about what is happening.
What is the most basic need, according to Maslow's hierarchy of needs? Safety and security Love and belonging Physiological Self-actualization
Physiological Explanation: The most basic needs—the physiological needs of food, water, sleep, shelter, asexual expression and freedom from pain—must be met first.
Calling the client by name and spending time with the client are examples of what? Values Empathy Positive regard Acceptance
Positive regard Explanation: Positive regard is an unconditional, nonjudgmental attitude. Acceptance occurs when the nurse does not become upset or respond negatively to a client's outbursts, anger, or acting out. Empathy is the ability of the nurse to perceive the meaning and feelings of the client and to communicate that understanding to the client. Values are abstract standards that give a person a sense of right and wrong and establish a code of conduct for living.
The nurse is providing hygiene care for a 70-year-old client in a nursing home who states that the client does not like the physician. Later, when the physician enters the room, the nurse notes that the client is very friendly with the physician, complimenting the physician's care. Which defense mechanism is this client displaying? Rationalization Reaction-formation Projection Displacement
Reaction-formation Explanation: Reaction-formation is displaying a behavior, attitude, or feeling opposite to that which one would normally exhibit in the same situation. Displacement is unconsciously transferring feelings onto another person or object. Rationalization is trying logically to justify irrational, socially, or personally unacceptable behaviors or feelings. Projection is attributing to another person one's unacceptable thoughts and feelings.
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? Challenging the client when the nurse feels that the client is mimicking the nurse's ideas or demeanor Teaching the client basic techniques for enhancing coping skills and managing stress Dialoguing with the client about the client's tendency to direct feelings about the client's father on to the nurse Reflecting on the nurse's own thinking to identify times where the nurse may project individual feelings on to the client
Reflecting on the nurse's own thinking to identify times where the nurse may project individual feelings on to the client Explanation: Countertransference exists when the nurse projects individual feelings on to the client. The opposite phenomenon constitutes transference. Mimicking by a client is not an aspect of countertransference. Fostering coping skills in the client does not affect the nurse's risk of experiencing countertransference.
The nurse is conducting an admission interview with an adult mental health client. The client begins to talk in a childish voice about riding a bike and playing outside. What defense mechanism is this client demonstrating? Regression Suppression Repression Projection
Regression Regression refers to going back to an earlier and happier time of development. Suppression involves wishing to put something unpleasant out of awareness and voluntarily doing so. Repression involves involuntarily placing material of life experience out of the conscious. Projection is when a person refuses to recognize behavior in oneself and instead "projects" it or sees it in someone else.
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 Erik Erikson B. F. Skinner Harry Stack Sullivan
Sigmund Freud Explanation: Freud believed 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 (oral, anal, and genital zones) that correspond to stages of relationships, especially with parents. This belief was not associated with Skinner, Erikson, or Sullivan.
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 may prefer to be in the mother's lap. The child spends more time with friends than family. The child performs actions to earn praise from parents. The child expresses individual views and ideas to the child's parents.
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 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 A client's ability to express oneself is limited by the stage of development The client needs to relate to the nurse as a surrogate parent The nurse is subject to developing countertransference issues with the client
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.
Why are the developmental theories important to nursing practice? They outline the process of human growth and development. They describe how parts work together as a system. They explain the importance of legal and ethical care. They define human adaptation to others and to the environment.
They outline the process of human growth and development. Explanation: Developmental theories outline the process of growth and development of humans as orderly and predictable, beginning with conception and ending with death. Nurses apply this knowledge to develop interventions for people across the lifespan. Systems theory, adaptation theories, and legal/ethical care are also important to nursing, but these do not explain the importance of human growth and development in nursing care.
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? Resistance Countertransference Transference Parataxis
Transference 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? Replacing consciously unacceptable emotions, drives, attitudes, or needs by those that are more acceptable Negating a previous unconsciously tolerable action or experience to reduce or alleviate feelings of guilt Transferring feelings—such as frustration, hostility, or anxiety—from an idea, person, or object to one that is less threatening Making up for a real or imagined inability or deficiency by engaging in a specific behavior to maintain self-respect or self-esteem
Transferring feelings—such as frustration, hostility, or anxiety—from an idea, person, or object to one that is less threatening Displacement refers to the transfer of feelings from one object to another. It involves neither replacement or making up for feelings nor negating them.
The following statements are heard in a group: "You can't say that because you don't really know me." "I wonder if the therapist is going to leave?" and "I'm not sure whether or not I can really talk freely." These best reflect which group theme? Guilt and punishment Fear for safety Trust and belonging Loss and abandonment
Trust and belonging The theme expressed in these statements represents the latent lack of trust in the leader or other group members. These statements are not related to guilt and punishment, fear for safety, or loss and abandonment.
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? formal support system modeling family dynamics transference
family dynamics Explanation: Family dynamics are most important in determining client needs. This involves patterns of both social and interpersonal interactions and the behavior of one person can influence the others in this open system of a family. Therefore the nurse would want to determine the family dynamics in order to be sure the client's needs would be met in this environment. Family members would be part of the informal, not formal, support system. While transference involves displacement of thought, feelings and behaviors related to significant others, the client would displace these with a therapeutic relationship instead of with significant others such as family members. Modeling involves internalizing behaviors of others but may not be a positive aspect to meet a client's needs based on family members.
Which concept states that if a certain behavior is rewarded with praise, the behavior will probably be repeated? modeling operant conditioning behaviorism self-efficacy
operant conditioning Explanation: In operant conditioning, the focus is on the consequences of a behavioral response, not a specific stimulus. If a behavior is reinforced or regarded with success, praise, money, and so on, the behavior will probably be repeated. -Modeling is one person trying to be similar to another -Self-efficacy is a person's sense of the individual's ability to deal effectively with the environment. -Behaviorism is a learning theory that focuses only on objectively observable behaviors and discounts any independent activities of the mind.
The primary purpose for generalist nurses to develop skills with psychosocial interventions is: there are a growing number of nursing practice opportunities in mental health settings. psychosocial interventions are included on the nursing licensure examinations. nurses will be consulted to assist in the care of psychiatric clients in acute care settings. psychosocial interventions are needed in all nursing practice settings.
psychosocial interventions are needed in all nursing practice settings. Explanation: Nurses often use psychosocial interventions to help meet clients' needs and achieve outcomes in all practice settings, not just mental health. Psychosocial interventions are included on the licensing exam, but that is not the primary reason for developing proficiency. Any health care personnel will care for psychiatric patients in acute care settings. Current trends reflect a decline in mental health services and employment opportunities.
The nurse is demonstrating countertransference with a client with which behavior? maintaining a professional demeanor with the client discussing the client's behavior with a family member explaining to the client that it is normal for the client to feel attachment relating to the client because the client resembles a favorite cousin
relating to the client because the client resembles a favorite cousin Countertransference is a concept identified by Sigmund Freud and involves the mental health care worker's feelings toward a client. It is problematic when the nurse assigns these based on an interpersonal experience, such as with the client resembling a cousin. The nurse may be hampered in treatment of the client based on these feelings. The nurse discussing the client's behavior or maintaining a professional demeanor do not represent use of interpersonal experiences by the nurse. The client may feel attachment as part of transference based on his/her own interpersonal experience.
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. countertransference. psychoanalysis. object relations.
transference. Transference is the displacement of thoughts, feelings, and behaviors originally associated with significant others from childhood onto a person in a current therapeutic relationship. Countertransference is defined as the direction of all of the therapist's feelings and attitudes toward the client. Psychoanalysis is the therapeutic process of accessing the unconscious conflicts that originate in childhood and then resolving the issues with a mature adult mind. Object relations is the psychological attachment to another person or object.
Aaron T. Beck is associated with ... developmental stages. cognitive therapy. social learning theory. family development theory.
cognitive therapy. Explanation: Aaron T. Beck is associated with cognitive therapy that he and his colleagues used to treat clients with depression.
While working with an older male client, a nurse begins to think of the client as a grandfather and responds to the client as a grandchild. The nurse is developing what type of emotional reaction? empathy transference modeling countertransference
countertransference Explanation: The nurse, upon feeling that the client reminds the nurse of a grandfather, is developing countertransference; that is, the nurse is developing an attachment to the client, treating the client as a grandfather. Empathy refers to the ability to feel what the client is feeling. Transference is the displacement of the thoughts, feelings, and behaviors originally associated with a significant other from childhood onto a person in a current therapeutic relationship. Modeling is pervasive imitation, or one person trying to be similar to another.
The nurse is working with a client who is grieving over the death of a parent. Which concept is the nurse demonstrating when stating to the client, "I know how sad I was when I lost my parent"? empathy transference object relations operant behavior
empathy Explanation: The nurse is demonstrating empathy with discussion of the same experience so that the nurse can relate to the client's grief. Transference is the displacement of thoughts, feelings, and behaviors originally associated with significant others from childhood onto a person in a current therapeutic relationship and would represent the client's and not the nurse's statement. Object relations involves the psychological attachment to another person and while the nurse may demonstrate this with a parent, this doesn't relate to the client's need. Operant behavior involves conditioning such as with Pavlov's theory.
While participating in a group therapy session, one group member consistently asks for clarification of the topic the group is discussing. The nurse leading the group interprets this behavior as reflecting which group role? information seeker coordinator standard setter recorder
information seeker Explanation: For any group to be successful, it must have members who assume task roles. The task role of information seeker is one in which the group member asks for clarification. The coordinator shows or clarifies the relationships among various ideas and suggestions. The recorder writes suggestions, keeps minutes, and serves as the group memory. The standard setter expresses the standards for the group to achieve.
The nurse is beginning a group counseling session with an open group system. The nurse should explain to the group members that one advantage of an open group system is that ... it can offer the best treatment outcomes. the topics for the group can be controlled. relationships are more easily established in the group. new members can join the group at any time.
new members can join the group at any time. Explanation: One advantage of an open group system is that new members can join the group at any time and stay in the group as long as needed.
Cognitive interventions are based on the concept of cognition. Who developed cognitive behavioral therapy? Aaron Beck Albert Ellis Steven DeShazer Insoo Kim Berg
Aaron Beck Explanation: Beginning in the 1960s, more cognitive-based theories and therapeutic approaches were developed, the most prominent being cognitive behavioral therapy by Aaron Beck.
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? Psychoanalytic therapy Group therapy Cognitive therapy Humanistic therapy
Cognitive therapy Cognitive therapy is a psychotherapeutic method used to alter distorted beliefs and problem behaviors by identifying and replacing negative and inaccurate thoughts.
The working stage of group therapy is marked by which characteristic? Conflict and cooperation among group members. Members' propensity to leave the group. Therapists' tendency to "back off" to allow the group to work. Group members' concern about confidentiality issues.
Conflict and cooperation among group members. Explanation: The group accomplishes its real work during the working phase. Conflict and cooperation indicate that trust has been established and group members are taking risks and working together to create behavior changes. In this stage, conflict and cooperation surface during the group's work.
A client has recently joined a group and presented a scenario in which the client ran out of funds to pay the rent this month. The therapist states, "Has anyone else in the group had this experience? Can you share any ideas about how you resolved this situation when it happened to you?" The therapist's intervention utilizes which theory to intervene? Personality reconstruction group Problem-solving group Psychoanalysis group Reeducational group
Problem-solving group The intervention attempts to engage the entire group in a problem-solving approach to the client's current problem.
Freud thought that the main defense mechanism in paranoia (delusional disorder) was what? Denial Projection Rationalization Suppression
Projection Explanation: Freud believed that delusions were part of a healing process. In 1896, he described projection as the main defense mechanism in paranoia (now referred to as delusional disorder). Denial is the unconscious refusal to face intolerable thoughts, feelings, wishes, needs, or reality factors. Rationalization is the unconscious justification of one's ideas, actions, or feelings to maintain self-respect, prevent feelings of guilt, or obtain social approval. Suppression is the voluntary pushing of unacceptable thoughts or feelings from conscious awareness.
A student nurse does not want to think about the upcoming final exam. The student nurse will start studying for the exam tomorrow. The student nurse is exhibiting which type of defense mechanism? Denial Conversion Suppression Regression
Suppression Explanation: Suppression is the voluntary rejection of unacceptable thoughts or feelings from conscious awareness. Denial is unconscious refusal to face thoughts, feelings, wishes, needs, or reality factors that are intolerable. Regression is the retreat to past developmental states to meet basic needs. Conversion is the unconscious expression of a mental conflict as a physical symptom to relieve tension or anxiety.
A client refuses to talk to anyone about the recent death of the client's mother. Which defense mechanism is this client using? Sublimation Intellectualization Displacement Suppression
Suppression Suppression is consciously inhibiting an impulse or emotion that is unacceptable to the person. Sublimation is diverting unacceptable urges into personally and socially acceptable channels. Intellectualization is unconsciously transferring emotions into the realm of intellect—using reasoning as a means of avoiding confrontation with an objectionable impulse. Displacement is unconsciously transferring feelings onto another person or object.
Which defense mechanism is being used when a student decides not to think about a parent's illness but to rather concentrate on studying for an upcoming test? Suppression Substitution Projection Introjection
Suppression Suppression is the conscious exclusion of unacceptable thoughts and feelings from conscious awareness. Substitution is replacing the desired gratification with one that is more readily available. Projection is the unconscious blaming of unacceptable inclinations or thoughts on an external object. Introjection is accepting another person's attitudes, beliefs, and values as one's own.
A mental health nurse is discussing the potential adverse effects of electroconvulsive therapy (ECT). According to Peplau's interpersonal theory, the nurse is functioning in which nursing role? Resource person Stranger Leader Teacher
Teacher Peplau believed that the nurse serves as a therapist, counselor, socializing agent, manager, technical nurse, mother surrogate, and teacher. In this situation, the nurse is functioning in the teacher mode by helping the client to learn formally or informally.
The nursing theorist Peplau identified which as the essence of psychiatric-mental health nursing? Nursing care independent of physicians The nurse's use of self The nurse-client relationship A neurobiologic approach
The nurse-client relationship Peplau was known for first highlighting the importance of the relationship between the nurse and the client as the basis for the therapeutic relationship. She believed that this relationship was the essence of psychiatric-mental health nursing.
Family members of a client in the nursing home continually complain about the food service and care the client is receiving. The nurse is guided by which principle in considering this conflict? There is an imbalance between the formal and informal social support of the client. There is a lack of self-efficacy on the part of the family with care of the client. The family does not accept the role of the caregiver in the nursing home. The family has feelings of transference with the nurse in the nursing home environment.
There is an imbalance between the formal and informal social support of the client. The client is in a formal support system with the nursing home and the family is considered an informal support system. There can be conflicts if the family does not maintain social distance with a balance between communication and being separated enough from the situation to effectively work with the nursing home staff. There is no evidence of a lack of self-efficacy, or the family's inability to work with the environment, and the family can be brought in to help with caregiving roles if desired. Transference does not apply in this situation as it relates to feelings of attachment by the family with the caregiver and would most appropriately apply to the patient.
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? Mature Initial Termination Working
Working 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.
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 universality catharsis group cohesiveness
altruism Altruism is learning to give to others. Universality refers to finding out that others have similar problems. Catharsis is the open expression of affect to purge or "cleanse" oneself. Group cohesiveness is the group members' relationship to the therapist and other group members.
