Question 1

A patient diagnosed with lung cancer continues to smoke and says, "I think my cancer is more the result of a bad gene than of smoking." The patient shows the use of which defense mechanism?

Accepted Answer

The patient is denying their responsibility for their illness and is blaming it on genetics rather than smoking.

Question 2

When interacting with patients, it is important for the nurse to recognize that defense mechanisms are used for what outcome?

Accepted Answer

Defense mechanisms are psychological strategies that are unconsciously used to protect a person from feelings of anxiety, guilt, or shame. These mechanisms serve to protect the ego from excessive anxiety by distorting reality, resisting change, and denying the source of anxiety. The goal of defense mechanisms is ultimately to protect the person's mental health and prevent them from becoming overwhelmed by anxiety or other negative emotions.

Question 3

A patient tells the nurse, "The reason I use drugs is because everybody nags me to do things that don't interest me." The patient shows use of which defense mechanism?

Accepted Answer

The patient is using rationalization as a defense mechanism by justifying their drug use with the reason that they are trying to avoid activities that they find uninteresting.

Question 4

The nurse who uses the interpersonal model as a basis for practice will focus assessment on identifying which patient issue?

Accepted Answer

The interpersonal model focuses on the patient's relationships with others and how these relationships can impact their health and well-being. Therefore, the nurse using this model will assess and address any relationship problems the patient may be experiencing.

Question 5

A patient experiencing severe panic attacks uses denial, repression, and displacement.Which nursing statement reflects an appropriate intervention regarding this patient's needs?

Accepted Answer

Focusing on exposing the patient to more effective coping strategies is an appropriate intervention for someone using maladaptive defense mechanisms like denial, repression, and displacement. It aims to replace these mechanisms with healthier ways of dealing with stress and anxiety.

Question 6

When a nurse uses the interpersonal model as a basis for practice, which goal is most appropriate for the patient care plan?

Accepted Answer

The interpersonal model emphasizes the importance of relationships and focuses on developing mature and satisfying relationships that are relatively free of anxiety. Therefore, the most appropriate goal for the patient care plan would be for the patient to develop such relationships. Option B focuses on beliefs, Option C focuses on meeting basic needs, and Option D focuses on managing stress, which are not the primary goals of the interpersonal model.

Question 7

A young adult who has few interpersonal relationships, says, "Most people can't be trusted." This person makes decisions only after consulting with his parents.Using Erikson developmental theory, the nurse can draw which conclusion?

Accepted Answer

The patient's belief that most people cannot be trusted suggests a sense of mistrust, which is the first stage in Erikson's developmental theory. Additionally, the patient's reliance on their parents for decision making suggests a lack of autonomy and a sense of inferiority, which is the fourth stage in Erikson's theory. Therefore, the conclusion is that the patient has evidence of inferiority and lacks a sense of direction.

Question 8

A patient uses defense mechanisms excessively.The nurse should expect to find evidence that the patient is demonstrating what resulting effect?

Accepted Answer

Excessive use of defense mechanisms can hinder a patient's ability to effectively solve problems as they may avoid facing the underlying issues directly.

Question 9

A patient asks, "Why is it important to uncover memories and conflicts hidden in the unconscious?" According to Freud, what effect does this intervention support?

Accepted Answer

According to Freud, uncovering memories and conflicts hidden in the unconscious allows for insight into behavior and enables meaningful change to occur. This process, known as psychoanalysis, provides a way to explore and resolve the unconscious conflicts that are causing psychological distress or limiting an individual's potential. Ultimately, the goal of psychoanalysis is to bring these unconscious conflicts into conscious awareness so that they can be examined and resolved, leading to personal growth and enhanced well-being.

Question 10

What should be the initial assessment in the rational-emotive therapy process implemented to help the chronically depressed patient?

Accepted Answer

The initial assessment in rational-emotive therapy for a chronically depressed patient should involve identifying any irrational beliefs that contribute to their negative emotions. This is because rational-emotive therapy focuses on helping patients change their irrational beliefs and thought patterns in order to improve their mental health. Assessing developmental tasks, environmental stressors, and childhood influences may provide useful background information, but identifying and addressing irrational beliefs is the primary focus of rational-emotive therapy.

Question 11

A young adult reports overwhelming guilt about minor social errors, feels self-pity, and says, "I stay on the sidelines of life so I can avoid the embarrassment of being noticed." The nurse can assess deficits in mastery of critical tasks associated with which developmental stage?

Accepted Answer

This scenario suggests deficits in mastery of critical tasks associated with the industry versus inferiority stage (ages 6-12). The young adult expressing overwhelming guilt about minor social errors indicates low self-esteem and a lack of confidence in their abilities to successfully complete tasks. The statement about staying on the sidelines to avoid embarrassment suggests a lack of initiative and a fear of failure, which are factors associated with the industry versus inferiority stage.

Question 12

A patient is mute, curled in a fetal position, and incontinent of urine.The patient eats small amounts only if spoon-fed.The nurse assesses this behavior as most indicative of what defense mechanism?

Accepted Answer

The behavior of being mute, curled in a fetal position, and incontinent of urine is indicative of regression, which is a defense mechanism where an individual retreats to a previous stage of development. The fact that the patient is only eating small amounts when spoon-fed also indicates regression as this is a behavior typically seen in infants.

Question 13

A young adult has a realistic sense of self, a commitment to reasonable career goals, a satisfying intimate-partner relationship, and a circle of loyal friends.This person says, "I volunteer for important projects in my community." The nurse can draw which conclusion?

Accepted Answer

The statement suggests that the person has a realistic sense of self and a commitment to reasonable career goals, which are critical tasks associated with the stage of identity versus role diffusion. The statement also suggests a satisfying intimate-partner relationship and a circle of loyal friends, which indicate mastery of critical tasks associated with intimacy. The voluntary participation in community projects shows a sense of industry, but does not necessarily indicate a lack of mastery of critical tasks associated with the stage of industry versus inferiority. There is no indication of vacillation between dependence and independence or fear of criticism and affection affecting mastery of critical tasks.

Question 14

An older retired executive reports, "I am unable to say 'no' when asked to help with community causes.These projects overtax my strength, but if I don't do them, who will?" The nurse can assess that this person is having difficulty with critical tasks related to which developmental stage?

Accepted Answer

The older retired executive's statement suggests that they are struggling with the task of finding meaning and purpose in their life as they enter the final stages of their developmental lifespan, which corresponds to Erikson's stage of integrity versus despair. This stage involves a review of one's life and accomplishments, with feelings of satisfaction and peace or disappointment and despair. The executive's statement suggests feelings of obligation and duty, rather than a sense of fulfillment or satisfaction.

Question 15

The parent of a 26-month-old child says, "My child refuses toilet training and shouts 'No!' when given direction.What do you think is wrong?" Select the nurse's best reply.

Accepted Answer

It is normal for a child of this age to experience defiance and a desire for independence. Punishing the child or seeking out a psychologist may not be necessary at this time. Encouragement and consistent positive reinforcement may aid in toilet training.

Question 16

During an interdisciplinary team meeting, a nurse shares that, "The patient's psychological distress seems to result from automatic thoughts that cause self-defeating behaviors." The nurse is conceptualizing the patient's problem from the viewpoint of which model?

Accepted Answer

The nurse's reference to automatic thoughts that cause self-defeating behaviors indicates a conceptualization of the patient's problem in terms of the cognitive-behavioral model, which focuses on the interaction between thoughts, behaviors, and emotions.

Question 17

A patient says, "It's my fault because I always make bad decisions.I should never have taken that job." Using a rational-emotive approach, how would the nurse respond?

Accepted Answer

The patient's statement shows negative self-talk, which is a common feature in irrational thinking. The nurse should use the rational-emotive approach to challenge this negative self-talk and help the patient come up with more positive self-talk. The nurse could ask the patient to consider the words they are using to talk about themselves and try to change them to more positive ones. This will help the patient build a more positive view of themselves and improve their self-esteem. Option A is not the best response as it doesn't address the underlying negative self-talk. Option B is also not the best response as it focuses on managing stress rather than challenging negative self-talk. Option C is not appropriate as it asks the patient to focus on their childhood, which isn't directly related to the patient's current condition.

Question 18

A nurse plans an intervention to support a patient's ego.What makes supporting ego a therapeutic intervention?

Accepted Answer

Supporting ego is a therapeutic intervention because it provides rational, logical reality testing. By helping a patient recognize and understand the reality of their situation, they can develop healthier perspectives and coping strategies.

Question 19

When the nurse conducts a developmental assessment with a new patient, the assessment can be expected to yield information regarding what patient characteristic?

Accepted Answer

A developmental assessment is designed to assess a patient's level of development and mastery of critical tasks specific to their age group. Therefore, it is expected to yield information regarding the degree of mastery of critical tasks.

Question 20

Which statement by an adult would lead a nurse to suspect deficits in mastery of the developmental task of infancy?

Accepted Answer

The developmental task of infancy, according to Erikson's stages of psychosocial development, is to develop trust versus mistrust. A statement like "I am afraid to let anyone really get to know me" suggests a failure in establishing trust, which is the primary task during infancy.

Quiz 7: Models for Working With Psychiatric Patients