Psychosocial Integrity - Mental Health Nursing
An 8-year-old child has experienced the death of a sister. The child begins to ask many questions about what happens to the body after death. The parents wonder if this is abnormal behavior picked up from playing video games. Which is the best response by the nurse?
"School-aged children are inquisitive and ask a lot of questions about death."
Which statement by a new mother observing her preterm infant in the neonatal intensive care nursery indicates that she has not yet begun the bonding process?
"It's such a tiny baby."
A 5-year-old girl is undergoing a course of chemotherapy. One day the nurse sees the child crying. The child tells the nurse, "All my hair is gone, and everyone stares at me." Which is the best response by the nurse?
"Let's ask your mother to bring in a hat for you to wear until your hair grows back."
A girl arrives at the school health office in tears, telling the nurse that several of her classmates have been teasing her. Which is the most therapeutic response by the nurse?
"Tell me more about it."
A parent tells the nurse that he or she is apprehensive that an antidepressant has been prescribed for an adolescent. Which is the best response by the nurse?
"Tell me more about what's concerning you."
Which is the nurse's most therapeutic response for the child who is about to have an intravenous (IV) line inserted and cries out that he is afraid of IV's?
"Tell me what frightens you."
Which response would the nurse make to a client who says, "I'm a terrible, evil person. The voices are telling me that God needs to punish me"?
"Tell me what you're thinking about yourself."
Which aspect of psychosocial development is commonly observed in adolescents?
A search for personal identity Development of an ethical system
Which characteristics develop in an adolescent according to Piaget's theory of cognitive development?
Ability to reason with respect to possibilities Feelings and behaviors characterized by self-consciousness
Which role is most important for the nurse to assume when providing therapeutic crisis intervention?
Active participant
According to Erikson's stages of life, which is the stage of development when a child begins walking, feeding, and using the toilet?
Autonomy versus sense of shame and doubt
Which action would the nurse take for a client with borderline personality disorder?
Be firm, consistent, and understanding while focusing on specific target behaviors
Which of these thoughts in an adolescent corresponds to a sense of "invulnerability"?
"Even if I drive my car at 120 miles per hour, nothing will happen to me."
Which response would the nurse make to a client with an obsessive-compulsive disorder who on the day of a job interview begins to display compulsive behavior?
"Going for your interview must be upsetting you. Describe what you're feeling now."
Which response would the nurse make to a client with obsessive-compulsive disorder who says, "I know that my hands aren't dirty, but I just can't stop washing them"?
"I understand that - maybe we can work together to limit the number of times you wash them."
Which response would the nurse make to a client who has been attending a day treatment facility for 1 month with depressive disorder and is to be discharged in a week?
"I understand that your discharge is set for next week. I'm wondering how you feel about that?"
Which response would the nurse make while speaking to a client with schizophrenia who keeps interjecting sentences that have nothing to do with the main thoughts being expressed?
"I'd like to understand what you're saying, but I'm having difficulty following you."
"But you don't understand" is a common statement associated with adolescents. Which is the nurse's best response to this statement?
"It would be helpful to understand; let's talk."
A child is admitted to the pediatric unit for an appendectomy. Which question would the nurse ask to determine what the child thinks is the reason for hospitalization?
"What are you doing at the hospital?"
The nurse is providing care to the family of a preschool-age child who is diagnosed with sickle cell disease. Which statement made by the sibling would initiate a teaching session with the parents regarding discipline?
"When I lied to my parents, I was punished for a week and my brother never gets punished."
A child is admitted to the pediatric intensive care unit after an accident. The mother, at the child's bedside, is visibly upset. Which is the most therapeutic statement the nurse can make?
"You must have lots of emotions right now."
The day after receiving instructions regarding dressing changes and care of a recently inserted nephrostomy tube, the client states, "I hope I can handle all this at home; it's a lot to remember." Which response would the nurse use?
"You seem to be nervous about going home."
According to current studies, what percentage of adolescents have used alcohol by the end of their high school years?
85%
At which age would the nurse anticipate the appearance of an imaginary friend for a preschool-age client?
3 years old
Which school-age client would the nurse anticipate will experience sibling rivalry as a source of stress?
A 6-year-old female
Which type of crisis has occurred when a sudden terrorist act causes the deaths of thousands of adults and children and negatively affects their families, friends, communities, and the nation?
Adventitious
Which statement is true about the instrumental relativist orientation stage?
An individual recognizes that there is more than 1 correct point of view
Which of these statements are true about an adolescent according to Lawrence Kohlberg's theory of moral development?
An individuals thoughts are influenced by moral decisions and behaviors An individual expands his or her focus from a relationship with others to societal concerns
Which type of play would the nurse encourage when providing age-appropriate care to a preschool-age child who is hospitalized?
Associative
Which is a similarity between Havighurst's stage-crisis and Erikson's psychosocial development theories?
Both theories are based on developmental tasks
Which assessment data would cause the nurse to suspect that a toddler is experiencing physical abuse?
Bruises in various stages of healing
The nurse finds that an adolescent has episodes of binge eating followed by self-induced vomiting and strenuous exercise. Which condition is the adolescent likely to have?
Bulimia
How do adolescents establish group identity during psychosocial development?
By building close peer relationships to achieve acceptance in the society
How do adolescents establish health identity during psychosocial development?
By evaluating their own health with a feeling of well-being By having the ability to function normally in the absence of any disease of infirmity
Which would the nurse consider when caring for a family with three school-age children as the unit of service?
Certain members of the family may be capable of giving more support than the nurse
Which definition describes the defense mechanism of sublimation?
Channeling unacceptable impulses into socially appropriate behavior
Which information is most important for the nurse to obtain during the assessment of a child with a tentative diagnosis of leukemia?
Child's experience with illness and hospitalization
According to Freud, which must occur before an individual is able to have a mature adult sexual relationship?
Conflict resolution
A child who has newly arrived from Latin America attends a nursery school where everyone speaks English. The mother is concerned the child is no longer outgoing and has become passive in the class. Which is the probable reason for the child's behavior?
Culture shock
A client who recently was told by her primary health care provider that she has extensive terminal metastatic carcinoma of the breast tells the nurse that she believes an error has been made. She states that she does not have breast cancer, and she is not going to die. Which stage of death and dying is the client experiencing?
Denial
According to Piaget, which statement describes the concrete operation stage?
During this stage, children are able to perform mental operations
According to Piaget, during which developmental stage is the pediatric client egocentric?
Early childhood
Which would be common characteristics of a relationship between a middle adolescent and parents?
Great push for emancipation Low point in the parent-child relationship Major conflicts over independence and control
The parents of a child with a terminal illness appear overwhelmed and anxious. Which is the best response by the nurse?
Encouraging the parents to express their feelingsWhich
Which psychosocial change does a toddler exhibit?
Engages in temper tantrums
Which action related to gender is often expected in regards to socialization for school-age girls within the community setting?
Expressing feelings openly
Which would the nurse consider before confronting the problem of obesity with individual children?
Familial and cultural influences are deciding factors in eating habits
Which approach would the nurse take for a client who was involved in a near-fatal automobile collision and arrives at the crisis center with reports of anxiety and flashbacks?
Focusing on the present
A professor asks a student nurse to explain the stage when an adolescent has prevalence of egocentric thought. Which period of the Piaget's theory will the nurse explain?
Formal operations
In which period of Piaget's theory does the adolescent feel a sense of invulnerability?
Formal operations
Which period of Piaget's theory covers the prevalence of egocentrism in adolescents?
Formal operations
Which period of Piaget's theory marks the end of cognitive development?
Formal operations
Identify the stage at which an adolescent develops abstract thinking?
Formal operations period
At what stage of Kohlberg's theory does an individual want to fulfill the expectations of one's immediate group?
Good boy-nice girl orientation
Which would the nurse anticipate when assessing a preschool-age child, according to Erikson's developmental stages?
Having highly imaginative thoughts
Which characteristics are commonly associated with adolescent depression?
Having suicidal ideation Exhibiting tearfulness Avoiding previously enjoyed activities and relationships
Which action would the nurse take for an older client with Alzheimer disease who has laid out several outfits on the bed to wear to a recreational session but is still wearing nightclothes?
Help the client select appropriate attire and offer to help the client get dressed
To further assess a client's suicidal potential, the nurse would be especially alert to the client's expression of which emotions?
Helplessness and hopelessness
The nurse is performing an assessment and notes that the client has exophthalmos and complains of double vision. These assessment findings are consistent with which condition?
Hyperthyroidism
According to Erikson's theory, which of these actions can predispose an adolescent to being in a state of confusion?
If an adolescent fails to establish a sense of identity
Which communication pattern is defined as confabulation?
Imagination is used to fill in memory gaps
At which stage of development would the nurse anticipate that pediatric clients will begin to show differences in play activities that are related to gender?
Late school-age
A 15-year-old plans to go to a nightclub without informing his or her parents but is afraid of being caught. Which behavior would this indicate?
Invulnerability
Which of these features is exhibited by an adolescent?
Invulnerability Personal fable
How does group identity facilitate psychosocial development in adolescents?
It helps them feel a sense of admiration and approval It provides them the opportunity to learn acceptable behavior
Which action would the nurse take to minimize agitation in a disturbed client?
Limit unnecessary interactions with the client
Which action would the nurse take for a client with major depression who is tearful and refuses to eat dinner after a visit with a friend?
Offer an opportunity to discuss the visit
A child has a fractured arm and multiple old injuries. Child maltreatment is suspected. Which parental characteristic supports this suspicion?
Offering inconsistent stories about the injuries
Which stage of the development would the nurse document for an infant when using Freud's theory of psychosocial development?
Oral
Which factors may cause an adolescent to develop a smoking addiction?
Peer pressure Imitating adult behavior of smoking Imitating lifestyles portrayed in movies and advertisements
Arrange the initial step and subsequent sequence of stages of behavior change according to the stages of change model.
Precontemplation Contemplation Preparation Action Maintenance Relapse
According to Piaget's theory, which period describes a child's stage of egocentrism?
Preoperational
In which age group would the nurse anticipate observing associative play?
Preschoolers
According to Erikson, which would the nurse anticipate when assessing an adolescent?
Questioning sexual identity
Which action would the nurse take for a client with schizophrenia who needs self-esteem increased?
Reward healthy behaviors
Which characteristic related to achieving autonomy would the nurse anticipate when providing care to a toddler?
Ritualism
Which guideline would the nurse consider when planning care for a hospitalized older client with Alzheimer disease?
Routines provide stability for clients with neurocognitive disorders
Which type of relationship is most important to the school-age child?
Same-sex peer relationships
Which characteristic of adolescence is exemplified by risk-taking behavior without consequences?
Sense of invulnerability
Which characteristic of a therapeutic milieu would the nurse consider important for a confused older adult with socially aggressive behavior?
Set limits
Which identity may fail to develop if an adolescent lacks physical evidence of maturity?
Sexual
The nurse in the emergency department notes large welts and scars on the back of a toddler who has been admitted for an asthma attack. Which additional information must be included in the nurse's assessment?
Signs of child abuse
Which sensory function is difficult to assess in preschoolers?
Smell
Which stage of Kohlberg's theory of moral development is associated with a person following a law even if it is discriminatory to a racial group?
Social contract orientation
Which action would the nurse encourage for an adolescent diagnosed with a chronic illness to achieve independence from his or her family?
Socializing with peers
Which type of impairment does the nurse expect the client who has expressive aphasia to exhibit?
Speaking or writing
Which stage of Kohlberg's theory does an individual show societal concerns?
Stage 4
Which activity would the nurse ask an older adult client to do when testing short-term memory?
State three random words mentioned earlier in the examination
Which parental description would the nurse recognize as characteristic of sleep terrors in a preschool-age child?
Sweating profusely
Which behavior would an adolescent exhibit?
Synchronization of moral skills
Which of these characteristics are found in an adolescent according to Erikson's theory of psychosocial development?
The adolescent is concerned about his or her appearance and body image The adolescent acquires a sense of identity by participating in decision-making
Which is true about the preoperational period of Piaget's theory?
The child believes that everyone experiences the world exactly as he or she does
Which statement describes stage 4 of Kohlberg's theory?
The child shows respect for authority and maintains the social order Adolescents choose to avoid a party where they know beer will be served
According to Erikson's theory, which behavior would a toddler exhibit?
The child starts performing self-care activities
Which would be treatment goals in anorexia nervosa?
The repairing of family interactions The reinstitution of normal nutrition to counteract a state of malnutrition The correction and deficits and distortions in psychological functioning via psychotherapy
Which is true about the effect of grief and loss in toddlers?
They express a sense of change in sleeping
A 3-year-old child has been observed in the clinic waiting room taking toys from others, tearing pages out of books, and striking the mother. The nurse takes time when interviewing the mother to ask about television habits because of which reason?
Viewing violent programs is positively correlated with the development of aggression
Which physical or behavioral signs of substance abuse would a nurse observe for in the adolescent population?
Worrying about being addicted Experiencing an overdose or withdrawal symptoms Manifesting bizarre behavior or confusion
