CH 2 Theories

Question 1

A parent says, “My 2-year-old child refuses toilet training and shouts ‘No!’ when given
directions. What do you think is wrong?” What is the nurse’s best reply?

a. “Your child needs firmer control. It is important to set limits now.”
b. “This is normal for your child’s age. The child is striving for independence.”
c. “There may be developmental problems. Most children are toilet trained by age
2.”
d. “Some undesirable attitudes are developing. A child psychologist can help you
develop a plan.”

Answer 1

b. “This is normal for your child’s age. The child is striving for independence.”

Question 2

A nurse wants to find information on current evidence-based research, programs, and practices
regarding mental illness and addictions. Which resource should the nurse consult?

a. American Psychiatric Association
b. American Psychological Association (APA)
c. Clinician’s Quick Guide to Interpersonal Psychotherapy
d. Substance Abuse and Mental Health Services Administration (SAMHSA)

Answer 2

d. Substance Abuse and Mental Health Services Administration (SAMHSA)

Question 3

A 26-month-old displays negative behavior, refuses toilet training, and often says, “No!”
Which psychosocial crisis is evident?

a. Trust versus mistrust
b. Initiative versus guilt
c. Industry versus inferiority
d. Autonomy versus shame and doubt

Answer 3

d. Autonomy versus shame and doubt

Question 4

A 4-year-old grabs toys from other children and says, “I want that now!” From a psychoanalytic perspective, this behavior is a product of impulses originating in which system of the personality?

a. Id
b. Ego
c. Superego
d. Preconscious

Answer 4

a. Id

Question 5

The parent of a 4-year-old rewards and praises the child for helping a sibling, being polite, and using good manners. These qualities are likely to be internalized and become part of which system of the personality?

a. Id
b. Ego
c. Superego
d. Preconscious

Answer 5

c. Superego

Question 6

A nurse supports a parent for praising a child who behaves in helpful ways to others. When this child behaves with politeness and helpfulness in adulthood, which feeling will most likely result?

a. Guilt
b. Anxiety
c. Humility
d. Self-esteem

Answer 6

d. Self-esteem

Question 7

An adult says, “I never know the answers,” and “My opinion does not count.” Which
psychosocial crisis was unsuccessfully resolved for this adult?

a. Initiative versus guilt
b. Trust versus mistrust
c. Autonomy versus shame and doubt
d. Generativity versus self-absorption

Answer 7

c. Autonomy versus shame and doubt

Question 8

Which statement by a client would lead the nurse to suspect unsuccessful completion of the
psychosocial developmental task of infancy?

a. “I know how to do things right, so I prefer jobs where I work alone rather than on
a team.”
b. “I do not allow other people to truly get to know me.”
c. “I depend on frequent praise from others to feel good about myself.”
d. “I usually need to do things several times before I get them right.”

Answer 8

b. “I do not allow other people to truly get to know me.”

Question 9

A client is suspicious and is frequently sarcastic toward others. To which psychosexual stage
do these traits relate?

a. Oral
b. Anal
c. Phallic
d. Genital

Answer 9

a. Oral

Question 10

A client expresses a desire to be cared for by others and often behaves in a helpless fashion. Which stage of psychosexual development is most relevant to the client’s needs?

a. Latency
b. Phallic
c. Anal
d. Oral

Answer 10

d. Oral

Question 11

A nurse listens to a group of recent retirees. One says, “I volunteer with Meals on Wheels, coach teen sports, and do church visitation.” Another laughs and says, “I’m too busy taking care of myself to volunteer to help others.” Which psychosocial developmental task do these statements contrast?

a. Trust and mistrust
b. Intimacy and isolation
c. Industry and inferiority
d. Generativity and self-absorption

Answer 11

d. Generativity and self-absorption

Question 12

An adult dies in a tragic accident. Afterward, the siblings plan a funeral service. Which
statement by a sibling best indicates a sense of self-actualization?

a. “Of all of us, I am the most experienced with planning these types of events.”
b. “Funerals are supposed to be conducted quietly, respectfully, and according to a
social protocol.”
c. “This death was unfair, but I hope we can plan a service that everyone feels is a
celebration of life.”
d. “This death was probably the consequence of years of selfish and inconsiderate
behavior by our sibling.”

Answer 12

c. “This death was unfair, but I hope we can plan a service that everyone feels is a
celebration of life.”

Question 13

A student nurse says, “I don’t need to interact with my clients. I learn what I need to know by observation.” An instructor can best interpret the nursing implications of Sullivan’s theory to this student by providing what response?

a. “Interactions are required in order to help you develop therapeutic communication skills.”
b. “Nurses cannot be isolated. We must interact to provide clients with opportunities to practice interpersonal skills.”
c. “Observing client interactions will help you formulate priority nursing diagnoses and appropriate interventions.”
d. “It is important to pay attention to clients’ behavioral changes, because these signify adjustments in personality.”

Answer 13

b. “Nurses cannot be isolated. We must interact to provide clients with opportunities to practice interpersonal skills.”

Question 14

A nurse consistently encourages client to do his or her own activities of daily living. If the client is unable to complete an activity, the nurse helps until the client is once again independent. This nurse’s practice is most influenced by which theorist?

a. Betty Neuman
b. Patricia Benner
c. Dorothea Orem
d. Joyce Travelbee

Answer 14

c. Dorothea Orem

Question 15

A nurse uses Maslow’s hierarchy of needs to plan care for a client diagnosed with mental illness. Which problem will receive priority?

a. Refusal to eat or bathe.
b. Reporting feelings of alienation from family.
c. Reluctance to participate in unit social activities.
d. Being unaware of medication action and side effects.

Answer 15

a. Refusal to eat or bathe.

Question 16

Operant conditioning is part of the treatment plan to encourage speech in a child who is nearly mute. Which technique applies?

a. Encourage the child to observe others talking.
b. Include the child in small group activities.
c. Give the child a small treat for speaking.
d. Teach the child relaxation techniques.

Answer 16

c. Give the child a small treat for speaking.

Question 17

The parent of a child diagnosed with schizophrenia tearfully asks the nurse, “What could I have done differently to prevent this illness?” What is the nurse’s best response?

a. “Although schizophrenia results from impaired family relationships, try not to feel guilty. No one can predict how a child will respond to parental guidance.”
b. “Schizophrenia is a biological illness resulting from changes in how the brain and nervous system function. You are not to blame for your child’s illness.”
c. “There is still hope. Changing your parenting style can help your child learn to cope effectively with the environment.”
d. “Most mental illnesses result from genetic inheritance. Your genes are more at fault than your parenting.”

Answer 17

b. “Schizophrenia is a biological illness resulting from changes in how the brain and nervous system function. You are not to blame for your child’s illness.”

Question 18

A nurse influenced by Peplau’s interpersonal theory works with an anxious, withdrawn client. What principle will the interventions be focused on?

a. Rewarding desired behaviors.
b. Using assertive communication.
c. Changing the client’s self-concept.
d. Administering medications to relieve anxiety.

Answer 18

b. Using assertive communication.

Question 19

A client participated in psychotherapy weekly for 5 months. The therapist used free association, dream analysis, and facilitated transference to help the client understand conflicts and foster change. What is the term that applies to this method?

a. Rational-emotive behavior therapy
b. Psychodynamic psychotherapy
c. Cognitive-behavioral therapy
d. Operant conditioning

Answer 19

b. Psychodynamic psychotherapy

Question 20

Consider this comment from a therapist: “The client is homosexual but has kept this preference secret. Severe anxiety and depression occur when the client anticipates family reactions to this sexual orientation.” Which perspective is evident in the speaker?

a. Theory of interpersonal relationships
b. Classical conditioning theory
c. Psychosexual theory
d. Behaviorism theory

Answer 20

a. Theory of interpersonal relationships

Question 21

A psychotherapist works with an anxious, dependent client. Which strategy is most consistent with psychoanalytic psychotherapy?

a. Identifying the client’s strengths and assets
b. Praising the client for describing feelings of isolation
c. Focusing on feelings developed by the client toward the therapist
d. Providing psychoeducation and emphasizing medication adherence

Answer 21

c. Focusing on feelings developed by the client toward the therapist

Question 22

A person says, “I was the only survivor in a small plane crash. Three business associates died. I got depressed and saw a counselor twice a week for 4 weeks. We talked about my feelings related to being a survivor, and I’m better now.” Which type of therapy was used?

a. Systematic desensitization
b. Psychoanalysis
c. Behavior modification
d. Interpersonal psychotherapy

Answer 22

d. Interpersonal psychotherapy

Question 23

Which technique is most applicable to aversion therapy?

a. Punishment
b. Desensitization
c. Role modeling
d. Positive reinforcement

Answer 23

a. Punishment

Question 24

A client says to the nurse, “My father has been dead for over 10 years but talking to you is almost as comforting as the talks he and I had when I was a child.” Which term applies to the client’s comment?

a. Superego
b. Transference
c. Reality testing
d. Countertransference

Answer 24

b. Transference

Question 25

A college student received an invitation to attend the wedding of a close friend who lives across the country. The student is afraid of flying. Which type of therapy would be most helpful for this client?

a. Psychoanalysis
b. Aversion therapy
c. Systematic desensitization
d. Short-term dynamic therapy

Answer 25

c. Systematic desensitization

Question 26

A client repeatedly stated, “I’m stupid.” Which statement by that client would show progress resulting from cognitive-behavioral therapy?

a. “Sometimes I do stupid things.”
b. “Things always go wrong for me.”
c. “I always fail when I try new things.”
d. “I’m disappointed in my lack of ability.”

Answer 26

a. “Sometimes I do stupid things.”

Question 27

A client says, “All my life I’ve been surrounded by stupidity. Everything I buy breaks because the entire American workforce is incompetent.” This client is experiencing what type of reaction?

a. self-esteem deficit.
b. cognitive distortion.
c. deficit in motivation.
d. deficit in love and belonging.

Answer 27

b. cognitive distortion.

Question 28

A client is fearful of riding on elevators. The therapist first rides an escalator with the client. The therapist and client then stand in an elevator with the door open for 5 minutes and later with the elevator door closed for 5 minutes. Which technique has the therapist used?

a. Classic psychoanalytic therapy
b. Systematic desensitization
c. Rational emotive therapy
d. Biofeedback

Answer 28

b. Systematic desensitization

Question 29

A client says, “I always feel good when I wear a size 2 petite.” Which type of cognitive distortion is evident?

a. Disqualifying the positive
b. Overgeneralization
c. Catastrophizing
d. Personalization

Answer 29

b. Overgeneralization

Question 30

Which comment best indicates a client is self-actualized?

a. “I have succeeded despite a world filled with evil.”
b. “I have a plan for my life. If I follow it, everything will be fine.”
c. “I’m successful because I work hard. No one has ever given me anything.”
d. “My favorite leisure is walking on the beach, hearing soft sounds of rolling waves.”

Answer 30

d. “My favorite leisure is walking on the beach, hearing soft sounds of rolling waves.”

Question 31

A nurse presents a community education program about mental illness. Which comment by a participant best demonstrates a correct understanding of mental illness from a biological perspective?

a. “Some people experience life events so traumatic that they cannot be overcome.”
b. “Disturbed and conflicted family relationships are usually a starting place for
mental illness.”
c. “My friend has had bipolar disorder for years and many problems have resulted.
It’s not her fault.”
d. “Mental illness is the result of developmental complications that cause a person
not to grow to their full potential.”

Answer 31

c. “My friend has had bipolar disorder for years and many problems have resulted.
It’s not her fault.”

Question 32

Which client is the best candidate for brief psychodynamic therapy?

a. An accountant with a loving family and successful career who was involved in a
short extramarital affair
b. An adult with a long history of major depression who was charged with driving
under the influence
c. A woman with a history of borderline personality disorder who recently cut both
wrists
d. An adult male recently diagnosed with anorexia nervosa

Answer 32

a. An accountant with a loving family and successful career who was involved in a short extramarital affair

Question 33

A client states, “I’m starting cognitive-behavioral therapy. What can I expect from the
sessions?” Which responses by the nurse would be appropriate? (Select all that apply.)

a. “The therapist will be active and questioning.”
b. “You will be given some homework assignments.”
c. “The therapist will ask you to describe your dreams.”
d. “The therapist will help you look at your ideas and beliefs about yourself.”
e. “The goal is to increase subjectivity about thoughts that govern your behavior.”

Answer 33

a. “The therapist will be active and questioning.”
b. “You will be given some homework assignments.”
d. “The therapist will help you look at your ideas and beliefs about yourself.”

Question 34

Which comments by an elderly person best indicate successful completion of the individual’s
psychosocial developmental task? (Select all that apply.)

a. “I am proud of my children’s successes in life.”
b. “I should have given to community charities more often.”
c. “My relationship with my father made life more difficult for me.”
d. “My experiences in the war helped me appreciate the meaning of life.”
e. “I often wonder what would have happened if I had chosen a different career.”

Answer 34

a. “I am proud of my children’s successes in life.”
d. “My experiences in the war helped me appreciate the meaning of life.”

Question 35

Which comments by an adult best indicate self-actualization? (Select all that apply.)

a. “I am content with a good book.”
b. “I often wonder if I chose the right career.”
c. “Sometimes I think about how my parents would have handled problems.”
d. “It’s important for our country to provide basic health care services for everyone.”
e. “When I was lost at sea for 2 days, I gained an understanding of what is
important.”

Answer 35

a. “I am content with a good book.”
d. “It’s important for our country to provide basic health care services for everyone.”
e. “When I was lost at sea for 2 days, I gained an understanding of what is
important.”

Question 36

Which activities represent the caring foundation of nursing? (Select all that apply.)

a. Administering medications on time to a group of clients
b. Listening to a new widow grieve her husband’s death
c. Helping a client obtain groceries from a food bank
d. Teaching a client about a new medication
e. Holding the hand of a frightened client

Answer 36

b. Listening to a new widow grieve her husband’s death
c. Helping a client obtain groceries from a food bank
e. Holding the hand of a frightened client

Question 37

Which therapies involve electrical brain stimulation for treatment of mental illness? (Select all
that apply.)
a. Aversion therapy
b. Operant conditioning
c. Systematic desensitization
d. Electroconvulsive therapy (ECT)
e. Transcranial magnetic stimulation (TMS)

Answer 37

d. Electroconvulsive therapy (ECT)
e. Transcranial magnetic stimulation (TMS)