Varcarolis’s Canadian Psychiatric Mental Health Nursing 1st Canadian Edition Halter Pollard Ray Haase Test Bank

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Varcarolis’s Canadian Psychiatric Mental Health Nursing 1st Canadian Edition Halter Pollard Ray Haase Test Bank Download

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ISBN-10: 1926648331

ISBN-13: 9781926648330 978-1926648330

Chapter 03: Relevant Theories and Therapies for Nursing Practice
Test Bank

MULTIPLE CHOICE

1. A parent says, “My 2-year-old child refuses toilet training and shouts “No!” when given directions. What do you think is wrong?” Select 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.”
ANS: B
This behaviour is typical of a child around the age of 2 years, whose developmental task is to develop autonomy. The distracters indicate the child’s behaviour is abnormal.

DIF: Cognitive Level: Apply (Application) REF: Page 30 (Table 3-2)
TOP: Nursing Process: Implementation MSC: Client Needs: Health Promotion and Maintenance

2. A 26-month-old displays negative behaviour, refuses toilet training, and often says, “No!” Which stage of psychosexual development is evident?
a. Oral
b. Anal
c. Phallic
d. Genital
ANS: B
The anal stage occurs from age 1 to 3 years and has as its focus toilet training and learning to delay immediate gratification. The oral stage occurs between birth and 1 year. The phallic stage occurs between 3 and 5 years, and the genital stage occurs between age 13 and 20 years.

DIF: Cognitive Level: Understand (Comprehension) REF: Page 29 (Table 3-1)
TOP: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance

3. A 26-month-old displays negative behaviour, 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
ANS: D
The crisis of autonomy versus shame and doubt relates to the developmental task of gaining control of self and environment, as exemplified by toilet training. This psychosocial crisis occurs during the period of early childhood. Trust versus mistrust is the crisis of the infant. Initiative versus guilt is the crisis of the preschool and early school-aged child. Industry versus inferiority is the crisis of the 6- to 12-year-old child.

DIF: Cognitive Level: Understand (Comprehension) REF: Page 30 (Table 3-2)
TOP: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance

4. A 4-year-old grabs toys from siblings and says, “I want that now!” The siblings cry, and the child’s parent becomes upset with the behaviour. According to Freudian theory, this behaviour is a product of impulses originating in which system of the personality?
a. Id
b. Ego
c. Superego
d. Preconscious
ANS: A
The id operates on the pleasure principle, seeking immediate gratification of impulses. The ego acts as a mediator of behaviour and weighs the consequences of the action, perhaps determining that taking the toy is not worth the mother’s wrath. The superego would oppose the impulsive behaviour as “not nice.” The preconscious is a level of awareness. This item relates to an audience response question.

DIF: Cognitive Level: Understand (Comprehension) REF: Page 27
TOP: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance

5. The parent of a 4-year-old rewards and praises the child for helping a younger sibling, being polite, and using good manners. The nurse supports this use of praise related to these behaviours. These qualities are likely to be internalized and become part of which system of the personality?
a. Id
b. Ego
c. Superego
d. Preconscious
ANS: C
The superego contains the “should nots,” or moral standards internalized from interactions with significant others. Praise fosters internalization of desirable behaviours. The id is the center of basic instinctual drives, and the ego is the mediator. The ego is the problem-solving and reality-testing portion of the personality that negotiates solutions with the outside world. The preconscious is a level of awareness from which material can be retrieved easily with conscious effort. This item relates to an audience response question.

DIF: Cognitive Level: Understand (Comprehension) REF: Page 27
TOP: Nursing Process: Implementation MSC: Client Needs: Health Promotion and Maintenance

6. A nurse supports a parent for praising a child behaving in a helpful way. 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
ANS: D
The individual will be living up to the ego ideal, which will result in positive feelings about self rather than feelings of inferiority. The other options are incorrect because each represents a negative feeling.

DIF: Cognitive Level: Understand (Comprehension) REF: Pages 27, 39
TOP: Nursing Process: Implementation MSC: Client Needs: Health Promotion and Maintenance

7. An adult says, “I never know the answers,” and “My opinion doesn’t 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
ANS: C
These statements show severe self-doubt, indicating that the crisis of gaining control over the environment was not met successfully. Unsuccessful resolution of the crisis of initiative versus guilt results in feelings of guilt. Unsuccessful resolution of the crisis of trust versus mistrust results in poor interpersonal relationships and suspicion of others. Unsuccessful resolution of the crisis of generativity versus self-absorption results in self-absorption that limits the ability to grow as a person.

DIF: Cognitive Level: Understand (Comprehension) REF: Page 30 (Table 3-2)
TOP: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance

8. Which patient statement would lead the nurse to suspect unsuccessful completion of the developmental task of infancy?
a. “I have very warm and close friendships.”
b. “I’m afraid to allow anyone to really get to know me.”
c. “I’m always absolutely right, so don’t bother saying more.”
d. “I’m ashamed that I didn’t do things correctly in the first place.”
ANS: B
According to Erikson, the developmental task of infancy is the development of trust. The correct response is the only statement clearly showing lack of ability to trust others. Warm, close relationships suggest the developmental task of infancy was successfully completed; rigidity and self-absorption are reflected in the belief one is always right; and shame for past actions suggests failure to resolve the crisis of initiative versus guilt.

DIF: Cognitive Level: Apply (Application) REF: Page 30 (Table 3-2)
TOP: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance

9. A patient is suspicious and frequently manipulates others. To which psychosexual stage do these traits relate?
a. Oral
b. Anal
c. Phallic
d. Genital
ANS: A
The behaviours in the question develop as the result of attitudes formed during the oral stage, when an infant first learns to relate to the environment. Anal-stage traits include stinginess, stubbornness, orderliness, or their opposites. Phallic-stage traits include flirtatiousness, pride, vanity, difficulty with authority figures, and difficulties with sexual identity. Genital-stage traits include the ability to form satisfying sexual and emotional relationships with members of the opposite sex, emancipation from parents, a strong sense of personal identity, or the opposites of these traits.

DIF: Cognitive Level: Understand (Comprehension) REF: Page 29 (Table 3-1)
TOP: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance

10. Which stage of psychosexual development is most relevant to the patient that expresses a desire to be cared for by others and often behaves in a helpless fashion?
a. Latency
b. Phallic
c. Anal
d. Oral
ANS: D
Fixation at the oral stage sometimes produces dependent infantile behaviours in adults. Latency fixations often result in difficulty identifying with others and developing social skills, resulting in a sense of inadequacy and inferiority. Phallic fixations result in having difficulty with authority figures and poor sexual identity. Anal fixation sometimes results in retentiveness, rigidity, messiness, destructiveness, and cruelty. This item relates to an audience response question.

DIF: Cognitive Level: Understand (Comprehension) REF: Page 29 (Table 3-1)
TOP: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance

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 developmental task do these statements contrast?
a. Trust and mistrust
b. Intimacy and isolation
c. Industry and inferiority
d. Generativity and self-absorption
ANS: D
Both retirees are in middle adulthood, when the developmental crisis to be resolved is generativity versus self-absorption. One exemplifies generativity; the other embodies self-absorption. This developmental crisis would show a contrast between relating to others in a trusting fashion and being suspicious and lacking trust. Failure to negotiate this developmental crisis would result in a sense of inferiority or difficulty learning and working as opposed to the ability to work competently. Behaviours that would be contrasted are emotional isolation and the ability to love and commit oneself.

DIF: Cognitive Level: Understand (Comprehension) REF: Page 30 (Table 3-2)
TOP: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance

12. Although ego defence mechanisms and security operations are mainly unconscious and designed to relieve anxiety, the major difference is which of the following?
a. Defence mechanisms are intrapsychic and not observable.
b. Defence mechanisms cause arrested personal development.
c. Security operations are masterminded by the id and superego.
d. Security operations address interpersonal relationship activities.
ANS: D
Sullivan’s theory explains that security operations are interpersonal relationship activities designed to relieve anxiety. Because they are interpersonal, they are observable. Defence mechanisms are unconscious and automatic. Repression is entirely intrapsychic, but other mechanisms result in observable behaviours. Frequent, continued use of many defence mechanisms often results in reality distortion and interference with healthy adjustment and emotional development. Occasional use of defence mechanisms is normal and does not markedly interfere with development. Security operations are ego-centred. This item relates to an audience response question.

DIF: Cognitive Level: Understand (Comprehension) REF: Page 31
TOP: Nursing Process: Analysis MSC: Client Needs: Health Promotion and Maintenance

13. A student nurse says, “I don’t need to interact with my patients. 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 responding with which of the following?
a. “Interactions are required in order to help you develop therapeutic communication skills.”
b. “Nurses cannot be isolated. We must interact to provide patients with opportunities to practice interpersonal skills.”
c. “Observing patient interactions will help you formulate priority nursing diagnoses and appropriate interventions.”
d. “It is important to pay attention to patients’ behavioural changes because these signify adjustments in personality.”
ANS: B
The nurse’s role includes educating patients and assisting them in developing effective interpersonal relationships. Mutuality, respect for the patient, unconditional acceptance, and empathy are cornerstones of Sullivan’s theory. The nurse who does not interact with the patient cannot demonstrate these cornerstones. Observations provide only objective data. Priority nursing diagnoses usually cannot be accurately established without subjective data from the patient. The other distracters relate to Maslow and behavioural theory. This item relates to an audience response question.

DIF: Cognitive Level: Apply (Application) REF: Page 31
TOP: Nursing Process: Implementation MSC: Client Needs: Health Promotion and Maintenance

14. A nurse consistently encourages a patient to do his or her own activities of daily living (ADLs). If the patient is unable to complete an activity, the nurse helps until the patient 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

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